在农村自尊量表评价以及自尊与自杀死亡的病例对照研究

目的 检验Rosenberg自尊量表的信度、效度，探讨自尊与农村自杀死亡之间的关系。方法 采用配对病例对照研究。在山东省疾病监测点上选取2008年9月1日～2009年8月31日3个县(市)25个乡镇的自杀死亡病例作为自杀死亡组，正常对照组按照性别、年龄(相差3岁以内)、当地居住者1∶1配比选取，共获得200对自杀死亡病例和正常对照的资料。结果 自杀死亡组中自尊量表的Cronbach′s α系数为0.880，正常对照组Cronbach′s α系数为0.875，两组中每一条目去除后的α系数波动幅度较小。两组自尊量表评分与特质焦虑量表总分相关系数分别为-0.509、-0.564(P<0.01)；主成分分析显示，两组数据各提取2个公因子，分别解释总变异的61.700%和63.802%。两组在自尊评分上存在统计学差异(t=17.525，P<0.01)，自尊与自杀的OR值为0.880(95%CI=0.818~0.947)。结论 自尊量表具有较高的信度、效度，适应于农村自杀死亡研究；自尊是农村自杀死亡的保护因素。

Psychometric characteristics of the self-esteem scale and association between self-esteem and suicide in the rural population

Objective To test reliability and validity of Chinese version of Rosenberg (1965) Self Esteem Scale (SES) in rural suicides and their controls, and to explore the relationship between self esteem and rural suicide. Methods A paired case control study was conducted. 25 towns in 3 counties of Shandong Province were randomly selected. The case group involved suicide cases that happened from 1 September 2008 to 31 August 2009 in the 25 towns. The controls were selected from normal subjects matched with the same age (no more than 3 years differences), same gender, and same or neighbor village as the suicide cases. Data from 200 suicides and 200 paired controls were collected. ResultsThe Cronbach′s α of suicides was 0.880, and the Cronbach′s α of the controls was 0.875. Fluctuation of Cronbach′s α coefficients of SES was slight after each item was deleted. Correlation coefficients between total scores of the SES and Trait Anxiety Inventory (TAI) were -0.509 and -0.564 in suicides and controls, respectively (P<0.01). The factor analysis showed that two common factors extracted from the SES in the two groups could explain 61.700% and 63.802% of the total variance. There was a significant difference in SES scores between suicides and controls(t=17.525, P<0.01). The odds ratio (OR) of self esteem associated with suicide was 0.880 (95%CI=0.818 0.947). Conclusion SES has high reliability and validity, and it is worth applying in rural suicide study in China. Self-esteem is negatively associated with suicide in the rural population.