The mechanism of family adaptability and cohesion in suicidal ideation among Chinese cancer patients

Purpose The purpose of this cross-sectional survey was to investigate how family adaptability and cohesion, coping styles and depression affect suicide ideation in patients with malignant tumors. This study also aimed to examine the potential mechanisms of family adaptability and cohesion in suicidal ideation.Methods From January 2019 to May 2019, 357 patients with malignant tumors who were admitted to a Chinese general hospital were surveyed. Patient Health Questionnaire-9 and the Chinese version of the Family Adaptability and Cohesion Evaluation Scale II, Medical Coping Modes Questionnaire were used. Student's t-test, chi-square test, Mann-Whitney U test, Spearman's rho correlation, and logistic regression analysis were used. Path analysis was used to examine the relationships among family adaptability and cohesion, coping styles, depression and suicidal ideation.Results A total of 55 (15.4%) cancer patients reported suicidal ideation in the prior 2 weeks. Logistic regression analysis showed that cancer stage, depression, family cohesion, and avoidance were independently associated with suicidal ideation. Path analysis demonstrated that family adaptability and cohesion indirectly affected suicidal ideation, as mediated by coping styles and depression. Family cohesion also directly affected suicidal ideation among cancer patients.Conclusions This study suggested that family adaptability, family cohesion and confrontation coping strategies are protective factors against suicidal ideation in cancer patients. Improving the family support system and coping styles may be used to prevent suicide ideation in cancer patients in the future.Implications for Psychosocial Providers or Policy Enhancing the family adaptability and cohesion of patients will help medical staff improve family support function effectively and eliminate suicidal ideation.