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APHA Scientific Session and Event Listing

Chunyu Li, MS, Community and Preventive Medicine, University of Rochester, 601 ELMWOOD AVE. BOX 644, rochester, NY 14642, 585-275-3432, chunyu_li@urmc.rochester.edu, Yeates Conwell, MD, Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, rochester, NY 14642, and Bruce Friedman, PhD, MPH, Department of Community and Preventive Medicine, University of Rochester, 601 Elmwood Avenue Box 644, Rochester, NY 14642.

Background: Suicide is a serious public health problem among persons age 65+, especially among the disabled. Reducing suicidal ideation (SI) is an efficient path to preventing suicide. Objective: To evaluate whether a health promotion nurse (HPN) intervention is more effective than usual care in reducing SI over 12 and 22 months. Design: A prospective randomized controlled trial conducted at two sites (New York and West Virginia/Ohio) in 1998-2002. Participants: 467 cognitively intact, community-dwelling, disabled Medicare beneficiaries age 65+ with recent significant healthcare services use that were followed for up to two years after study entry. Methods: A widely utilized measure of SI during the past year was employed. Pearson Chi square statistics and multinomial logit regression were utilized. Results: The 467 patients had a mean age of 79.1 years, 25.3% were male, and 2.1% were nonwhite. At baseline the proportion of patients reporting SI did not differ significantly between the HPN group (n=238) (27.0%) and the Control group (n=229) (30.1%) (p=.46). At 12 months the proportion of patients with SI was significantly lower (p=.042) in the HPN group (18.8%) than in the Control group (28.0%). No significant difference was detected at the 22-month follow-up (20.7% versus 26.4%; p=.23). Of the 133 patients with SI at baseline, only 40.5% remained so at 12 months in the HPN group as compared with 64.2% in the Control group. A multinomial logit model found this difference to be significant (p=.023). Conclusion: The HPN intervention may more effective than usual care in reducing SI.

Learning Objectives:

• The participants in the session will acquire information about whether health promotion nursing is more effective than usual care in reducing suicidal ideation among community-dwelling functionally impaired elderly.
• The participants in the session will be able to identify and describe the five indicators of suicidal ideation.

Keywords: Elderly, Mental Health Care

Presenting author's disclosure statement:

Not Answered