title: Determinants of suicidal ideation in gynecological cancer patients.
abstract: OBJECTIVE
  Gynecological cancer survivors are at increased risk of psychological problems including suicide risk. Suicidal ideation, which was thought to be precursor to suicide attempts, has not been well studied. This study aimed to investigate the prevalence, and determinants of suicidal ideation for women with gynecological cancer, and then to assess the effect of coping style and social support on suicidal ideation.
  
  
  METHODS
  Patients with cervical, ovarian and endometrial cancers seen at Hunan Provincial Tumor Hospital from September 2012 to June 2013 were consecutively recruited and were asked to complete the Zung Self-Rating Depression Scale, Suicidal Ideation of Self-rating Scale, Medical Coping Modes Questionnaire and Social Support Rating Scale. Path analysis was used to examine the relationship among coping style, social support, depression symptoms and suicidal ideation.
  
  
  RESULTS
  A total of 579 (579/623, 93.0%) gynecological cancer patients were enrolled in this study and completed all investigations between September 2012 and June 2013. Among them, 105 (18.1%) patients reported suicidal ideation, with the highest rate in patients with ovarian cancer (30.16%). Suicidal ideation was associated with depression symptoms, care providers, chemotherapy history and acceptance-resignation. Path analysis showed that the acceptance-resignation affected suicidal ideation directly as well as mediated by social support and depression symptoms, while confrontation and avoidance affected suicidal ideation entirely through social support and depression symptoms.
  
  
  CONCLUSIONS
  Suicidal ideation is high among patients with gynecological cancer, especially among ovarian cancer patients. Coping strategies such as confrontation and avoidance, and social support may be helpful for preventing suicidal ideation among them.
authors.affiliation: The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: G X
authors.initials: GX
authors.lastname: Tang
authors.affiliation: The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: P P
authors.initials: PP
authors.lastname: Yan
authors.affiliation: The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: C L
authors.initials: CL
authors.lastname: Yan
authors.affiliation: The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: B
authors.initials: B
authors.lastname: Fu
authors.affiliation: The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: S J
authors.initials: SJ
authors.lastname: Zhu
authors.affiliation: Hunan Provincial Tumor Hospital, Changsha, Hunan, China.
authors.forename: L Q
authors.initials: LQ
authors.lastname: Zhou
authors.affiliation: School of Public Health, Central South University, Changsha, Hunan, China.
authors.forename: X
authors.initials: X
authors.lastname: Huang
authors.affiliation: Jining No.1 People's Hospital, Jining, Shandong, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.affiliation: The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.|School of Nursing, Central South University, Changsha, Hunan, China.
authors.forename: J
authors.initials: J
authors.lastname: Lei
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D059020:Suicidal Ideation; D055815:Young Adult