ABSTRACT
Aim: To evaluate the effectiveness of group occupational therapy for children with
suicidal ideation.
Tasks.
a) To establish a factor, which determines cognitive function and independence in
children with suicidal ideation.
b) To evaluate the change of cognitive function while group occupational therapy is
in use.
c) To evaluate the effectiveness of group occupational therapy for independence of
children with suicidal ideation.
Methodology: A author-made questionnaire. The Montreal Cognitive Function Test
(MoCA). The Canadian Occupational Performance Measure. For statistical analysis MS
Excel was used.
Participants: 12 children with suicidal ideation tendencies were chosen for the
research. The chosen target group was divided into two – research and control – groups.
Conclusion:
a) Lack of concentration, attention, motivation and quick fatigue are detrimental
factors in the development of cognitive functions and independence in children with
suicidal ideation.
b) Cognitive function capability improvement had statistically significant
meaning (p<0,05). Greater significance was noted in the study group, where group
occupational therapy was implemented (p<0,05).
c) Independence skills had statistically significant improvement in both groups
(p<0,05). The control group had a statistically significant improvement in general
importance of functional movement, public life and active leisure (p<0,05) while
the study group had statistically significant improvement in general satisfaction of
independent activities, especially in personal and home maintenance, socialization
(p<0,05).
Introduction
Suicide is a deliberate interruption of your life. Unfortunately, despite a decade of trade information and prevention programs, this complex phenomenon has become the most acute problem in the modern world and the main cause of death for people of all ages is in Lithuania and the world. According to the World Health Organization (WHO), about 800,000 people die from suicide each year. Unfortunately, Lithuania has the highest number of deaths per 100,000 people in the world (31.9). Russia (31), Ukraine (22.4) and Latvia (21.2) also lead in suicide ratings. It is observed that suicides are more familiar in the former Soviet Union, middle-aged older people. According to the Lithuanian State Mental Health Center, most deaths were recorded in the 45-54 and 55-64 age groups. This suicide epidemic affects more than just suicide victims: often the suicide of a loved one has to make a psychologically negative choice for relatives, family members, friends and co-workers. Suicidal thoughts - fantasies about suicide, its idealization are especially important for the risk of suicide. It is one of the symptoms of suicidal behavior and is often directly associated with various psychological illnesses, disorders (e.g., depression, schizophrenia, alcoholism, and other addictions) [1-4]. About 10 to 20% of teens say they have persistent suicidal thoughts, which is an important indicator of predicting possible suicide attempts coming from their causes. Both suicide and suicidal thoughts are extremely important topics and problems that require public attention, and most of the information at the moment is about suicide, while suicidal thoughts are discussed in a very general way. During occupational therapy sessions, working with people at risk of suicide focuses not only on suicide attempts, but also on the thoughts that motivate or idealize it. In the absence of typical or common suicidal ideation, occupational therapists should evaluate and assign purposeful and motivating activities on a case-by-case basis. Targeted activities can be encouraged through the use of group therapy [5].
Materials and Methods
Methodology
a) A author-made questionnaire.
b) The Montreal Cognitive Function Test (MoCA).
c) The Canadian Occupational Performance Measure.
d) For statistical analysis MS Excel was used.
A. The Montreal Cognitive Function Test (MoCA) is a standardized,
rapid test of cognitive function that tests memory, logical
thinking, perception of time and space, abstraction, and general
perception of the individual. This study is chosen for its ability
to fully and quickly assess key cognitive functions. There is also
a lack of studies where this test would be used in individuals
under 14 years of age, then the effectiveness of this study in the
same study in younger individuals. The study is divided into
parts, so it is necessary to assess different cognitive abilities:
attention and concentration, executive function, memory,
language, visual - spatial abilities, conceptual thinking,
calculation and orientation. This test is usually performed
within 10 minutes. The highest evaluation is 30 points, the
evaluation within the norm is desired from 26 points [6].
B. Canadian performance test is a universal form of testing
that helps not only to acquire a person’s independent ability,
but also to set goals together with the researcher according
to the most important aspects: social, personal life, work
environment. The test categories are defined by functions
defined by the most important aspects of life: self-care (hygiene,
clothing, functional mobility, social functions: shopping,
financial management, use of public transport), productivity
(work, home care, science, games), leisure activities. During
the survey, the respondent needs to list the most important
problem activities in order to be able to perform this category
and prioritize them on a scale of 1 to 10 [7].
Participants
12 children with suicidal ideation tendencies were chosen
for the research. The chosen target group was divided into two –
research and control – groups.
The study involved 12 children aged 11 to 17 years. The
following were selected according to the criteria:
a) From 11 to 17 years
b) Suicidal ideation or behavior
c) Subjects should be free of episodes of acute psychosis
d) Consent of parents, parents / guardians to participate in the
study
Subjects were purposefully selected and divided into two
groups: control and research. The control group, in addition to
occupational therapy sessions, received regular treatment until the
study group was assigned occupational therapy, during which tasks
were assigned to develop independence and cognitive functions.
Characteristics of the Subjects
During the research, 12 children were studied, who were divided into two equal groups - control and research subjects. The control group received standard treatment consisting of a group of psychotherapy, psychiatric counseling, art therapy, and social skills. Occupational therapy classes and additional tasks for the researcher, focused on the development of cognitive functions and independence [8]. The mean age of the control group was 14.75, and the mean age of the study group was -15. In terms of symptomatology, subjects in both groups had suicidal thoughts or had committed suicidal ideation (Table 1).
Results
After evaluating the cognitive functions by the MoCA test, it was observed that the cognitive functions of the control group increased on average by 4 points, from 20.5 to 24.5, while the study groups evaluated the package with 5 points, from 21.5 to 26.5. The effect of the “ceiling” of the test was also observed in the study group when one of the subjects scored the maximum allowable score (Figure 1). Different scores of scores were observed in both groups when examining scores for independence problems. Before the study, the mean score of the control group was 3.81, and that of the control group was 0.85 points lower - 2.96. This shows that before the study, the control group expressed less relevant independence problems than the study group. After the study, the mean score of the control group dropped from 0.75 points to 3.06, while that of the study group was only 0.02 points to 2.94. These results suggest that after the study, the representatives of the control group marked significantly more relevant independence problems, while the relevance of the research group’s problems remained similar (Figure 2).
Conclusion
a) Lack of concentration, attention, motivation and quick fatigue
are detrimental factors in the development of cognitive
functions and independence in children with suicidal ideation.
b) Cognitive function capability improvement had statistically
significant meaning (p<0,05). Greater significance was noted
in the study group, where group occupational therapy was
implemented (p<0,05).
c) Independence skills had statistically significant improvement
in both groups (p<0,05). The control group had a statistically
significant improvement in general importance of functional
movement, public life and active leisure (p<0,05) while the
study group had statistically significant improvement in
general satisfaction of independent activities, especially in
personal and home maintenance, socialization (p<0,05).
References
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- Bilsen Johan (2018) Suicide and Youth: Risk Factors. Frontiers in psychiatry 9: 540.
- Dema T, Tripathy JP, Thinley S, Manju Rani, Tshering Dhendup, et al. (2019) Suicidal ideation and attempt among school going adolescents in Bhutan – a secondary analysis of a global school-based student health survey in Bhutan 2016. BMC Public Health 19: 1605.
- Sharon D (2017) Novalis, PhD, OTR/L Assistant Professor of Occupational Therapy Chatham University Pittsburgh, PA. Suicide Awareness and Occupational Therapy for Suicide Survivors; AOTA.