الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
According to Wheatley (1997), when stress is long lasting, depression may develop insidiously under the cloak of chronic stress symptoms, whereas depression, in turn, inhibits the ability to cope with stress. Nearly all individuals with major depressive disorder (MDD) report significant life stress before the episode (Kessler, 2002). Also, stress appears to play a prominent role in triggering the first to second episodes of major depressive disorders (Pender, 2002). The same author added that, stress and anxiety in a person with major depression leads to poorer response to treatment, poorer social and work function, greater likelihood of chronicity and an increased risk of suicidal behavior.
Moreover, depression is often accompanied by thoughts of suicide; indeed such suicidal ideation is seen as an important element in the diagnosis of depression. The deeper the depression, the more likely it is that a person will experience suicidal ideation (Stewart, 2006). In addition, American Association of Suicidology ( 2000) added that, two thirds of people who commit suicide are depressed at that time, one in 16 patients diagnosed with depression will commit suicide.
Therefore, the psychiatric nurse has an important role in assessing the needs of suicidal patients, what are the stressors surrounding them, and their tendency for suicide. Furthermore, providing them with knowledge, support and developing a counselling program for them, their families and friends that provide them with knowledge about how the patients cope with their illness and how their families and friends can provide them with support that they need to help them to overcome their illness and prevent recurrence and suicidal tendency or attempts are all nurse’s responsibilities.
The present study aimed to:
Assess, plan, and implement a psychoeducational program and to evaluate its impact on the psychological distress of suicidal patients.
subjects:
A convenience sample consisted of 50 adult male and female suicidal patients admitted to the inpatient at EL Minia Poisoning Control Center were included in the study. The patients’ age ranges from 20-50 years old and they attempted suicide once or more by drugs and/or insectside.
Data were collected through the following tools:
1- Socio-demographic and medical assessment Data sheet
A semi structured questionnaire which includes socio-demographic data such as patient age, gender, level of education, occupation, marital status, residence, phone number if available, date of admission, number of suicidal attempts, and methods of suicide.
2-Stress scale
The English version of this scale was developed by Avera McKennan’s (2008) Behavioral Health Services. This scale consists of 24 items ranges from (0 never to 5 almost always). Reliability was done by Crombach alpha test on ten patients of translated and back translated versions is 0.97. The total score was 120 degree distributed as (34 or under considered low, 35-65 considered average, 66-85 considered bad, and 86 or above considered dangerous).
3- Hamilton Depression Scale
The scale was developed by Max Hamilton (1960) for measuring depressive symptoms and their intensity. It contains 17 items. The scoring systems were as follows: items from 1-8 have five points likert scale ranging from 0-4, and items 9-17 have three points likert scale ranging from 0-2. The total score of the scale was classified as normal (0-7), mild depression (8-13), moderate depression (14-18), severe depression (19-22), and most severe depression (23 and more). The scale was translated to Arabic language at 1996 by Lotfy Fatieem; a professor of mental health at Faculty of Education, Cairo University. The Arabic version was used and its reliability was done by Crombach alpha test on ten patients which is 0.95.
4-Pierce Suicide Intent Scale
The English version of this scale was developed by Pierce (1977); this scale is a modified version of the Beck Suicide Intent Scale (1974). It contains 12 items, divided into three subscales: the first six items describe “circumstances score”, from “items 7 through 10 describe self-report score, and the last two items describe “medical risk score”. Subjects were asked to use 3-point likert scales ranging from 0-2 except for the item of premeditation that ranges from 0-3. The total score is 25; the grades are distributed as low intent (0-3), medium intent (4-10), and high intent (more than 10) reliability was done by Crombach alpha test on ten patients of translated and back translated versions is 0.96.
The main results yielded by this study:
- More than two thirds of the subjects were females (6o%), 48% illiterates, 68% unemployed, 82% were living in rural areas, and most of them (70%), were in the age group of 20-30 years old.
- At pre test, 54% of the studied subjects have bad level of stress, 70% had severe level of depression and 96% of them had a high intent for suicide. However, immediately post test, it was notice that, 74.9% of the studied sample had moderate level of depression and 75.4% had average level of stress. At the follow up, it was found that 80% of the subjects had average level of stress and 60% had moderate level of depression.
- Statistically significant differences were found between pre, post, and follow up test regarding stress, and depression (f=89.05, 94.64 respectively at p=.000).this indicates that the patients levels of stress and depression are improved throughout the program.
- There were statistically significant differences found between males and females regarding stress at pre, post, and follow up test (t=3.39, 3.38 & 3.22 respectively at p=.001, .001 & .003). Also, statistically significant differences were found between males and females regarding depression at pre, and post test (t=2.09& 2.72 at p=.041 & .009 respectively). In addition, the total mean scores for stress and depression were higher among female than male patients at pre, post, and follow up (75.45, 56.44, 50.19 & 30.90, 17.60, 15.83 respectively).
- Suicide intent has a positive correlation and highly statistical significance with psychological distress. This means that whenever there were severe stressful situations with severe depression symptoms the patient’s tendency and intention for suicide was increased.