SUICIDE in RURAL & REMOTE AREAS of AUSTRALIA - Living is for ...

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Suicide in rural and remote areas of Australia 59 Table 17. Physical health and personality based on scales used in the study Suicide Sudden death Rural Urban Suicide Sudden death m SD m SD t p-value m SD m SD t p-value Instrumental activities of daily living (scores 8-31) 9.9 2.9 9.8 5.8 0.12 0.903 9.5 3.4 9.3 4.0 0.47 0.642 Physical Self Maintainance Scale (scores 6-30) 6.2 0.6 6.5 1.8 -0.81 0.426 6.3 1.1 7.2 3.1 -3.14 0.002 Cumulative illness rating scale (scores 13-65) 20.0 5.2 19.0 3.4 0.91 0.364 18.8 4.1 20.1 5.5 -2.01 0.041 Aggression Scale (scores 0-16) Total 13.2 5.9 10.8 4.4 1.85 0.069 11.6 5.3 9.0 2.3 4.71
60 Suicide in rural and remote areas of Australia Methodological considerations and limitations The methodological limitations of PA studies include their retrospective nature which is related to recall bias (Pouliot & De Leo, 2006 ; Kõlves et al, 2006). Further, recall bias and meaning reconstruction dictated the choice of deceased control subjects, over living subjects, as it has been observed that the bereavement process impacts the quality of information (Phillips et al, 2002; Pouliot & De Leo, 2006). There may also be limitations with factors such as levels of physical illness or stress with the use of sudden-deaths as controls. Additionally, it should be noted that the present study only analysed suicides and sudden-deaths which occurred in Queensland and where the deceased was aged 35+ years. Individual case studies taken from the psychological autopsy study in Queensland Four case studies from the Psychological Autopsy Study are presented below. These case studies illustrate the ways in which the different risk factors, examined within the quantitative data analyses, tangibly impacted on the suicidal processes of people living in rural and remote Queensland. Case studies were chosen based on the quality of information received from the NOK and HCP interviews to ensure that a full picture was provided. Furthermore, the case studies were also chosen to illustrate a range of risk factors experienced by people with different ethnic backgrounds, occupations and life experiences. Furthermore, another limitation of the statistical analyses was the low sample size, especially in the rural group. This reduced the statistical power, and multinomial modelling was not applicable. As indicated in Chapter One, various studies have made different distinctions between urban/rural areas and metropolitan/regional/remote areas (Dudley et al, 1998; Page et al, 2007; Taylor et al, 2005a; Miller & Burns, 2008). In the present study, ARIA+ categories were used to locate the deceased. However, due to limited numbers, the deceased were divided into two groups: urban (metropolitan and inner regional) and rural (outer regional, remote and very remote). GriffithBook FINAL 20/09.indd 60 15/11/12 4:28 PM
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Australia’s rural localities face
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Introduction The burden of suicide
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