만성신체질환은 자살의 주요한 위험요인으로 신뢰도와 타당도가 검증된 도구를 통해 만성신체질환자의 자살 위험을 선별 및 평가하는 것이 필요하다. 본 연구는 만성신체질환자의 자살 위험 선별 및 평가 도구의 심리측정 속성에 대한 체계적 고찰을 실시하였다. 국내외 4개 데이터베이스에서 ‘자살’, ‘선별 및 평가도구’, ‘심리측정 속성’ 및 ‘만성신체질환’을 키워드로 문헌을 검색하여 선정된 20편의 연구에서 11개의 도구를 확인하였다. Schedule of Attitudes Toward Hastened Death(SAHD)는 만성신체질환자를 대상으로 개발되어 가장 많이 검증된 도구이며, 단축형 SAHD와 함께 양호한 심리측정 속성을 보였다. 자살 위험 관련 요인 측정도구인 15문항 버전의 대인관계 욕구 질문지(15-item version of the Interpersonal Needs Questionnaire)와 자살하지 않는 이유 척도(Reasons for Living Inventory)는 양호한 심리측정 속성을 보였으나, 만성신체질환자 대상으로 한 심리측정 속성 검증이 제한적이었다. 본 고찰 결과는 만성신체질환자의 특성을 고려한 자살 위험 선별 및 평가도구 개발 필요성 및 만성신체질환자를 대상으로 한 기존 도구의 심리측정 속성 검증 및 임상적 유용성의 추가 검증이 필요함을 시사한다.
Given that chronic physical illness (CPI) is a major risk factor of suicide, the screening/assessment of suicide risk in patients with CPI with reliable and valid tools is crucial. This study performed a systematic review of screening/assessment tools and evaluated their psychometric properties. A literature search was conducted using four databases, and the main search terms were “suicide,” “assess,” “psychometric,” and “chronic disease.” Twenty studies met the selection criteria, and 11 measures were identified. The Schedule of Attitudes Toward Hastened Death (SAHD) is the most frequently used measure, and it was developed to assess the suicide risk in CPI patients and was validated in several languages. The SAHD and its abbreviated versions showed good psychometric properties. The 15-item version of the Interpersonal Needs Questionnaire and Reasons for Living Inventory showed good psychometric properties. Results suggest the need for suicide risk measures that consider the characteristics of suicide risk specific to CPI as well as further verification of the psychometric properties and clinical applicability of the existing measures for patients with CPI.
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