Suicide Risk and Influencing Factors Among Cancer Patients: A Mixed-Methods Study

Abstract

Purpose: Suicide probability is higher in cancer patients than in the general population, yet evidence remains limited, especially in T & uuml;rkiye. This study examined suicide risk and influencing factors using a mixed-methods approach for a comprehensive understanding. Methods: This sequential explanatory mixed-methods design was conducted between October 2024-August 2025. 383 patients receiving chemotherapy for breast, lung, or colon cancer at a city hospital in I(center dot)stanbul participated. Quantitative data were collected using a Personal Information Form and the Suicide Probability Scale, and analyzed using multistage linear regression. For the qualitative phase, patients with the highest and lowest scores were purposively sampled, and data were analyzed using Colaizzi's method. Results: The mean Suicide Probability Scale score was 63.13. Regression analysis identified lower social support, longer cancer duration, lack of health insurance, and psychiatric comorbidities as predictors of higher risk. Qualitative analysis yielded five themes. The dominant themes-'Traces of the Disease' and 'Risk and Protective Factors'-showed how cancer's physical, psychological, and social consequences, together with individual risk and protective mechanisms, shaped patients' suicidal thoughts, behavior, overall distress, and resilience levels. Conclusions: Suicide risk in cancer patients is multidimensional and individualized, shaped by social, clinical, and psychological factors. Holistic support addressing both risk and protective factors is critical. Oncology nurses are pivotal in early risk detection and psychosocial support. Empathetic, patient-centered care, reinforcing protective factors, and integrating structured psychological interventions enhance resilience, reduce suicide risk, and improve quality of life. System-level measures, including accessible psychological services and social support, are also essential.