Exploring patient-centered perspectives on suicidal ideation: A mixed methods investigation in gastrointestinal cancer care

Published Jul 30, 2025 on Dryad. https://doi.org/10.5061/dryad.djh9w0wcf

Data files

Jul 30, 2025 version files 53.68 KB

Cancer_Depression_-_ID12293838402_July_28__2025_07.31.xlsx
45.23 KB
README.md
8.45 KB

Abstract

Many patients diagnosed with gastrointestinal (GI) cancer experience emotional struggles, including feelings of depression and suicidal thoughts, yet these psychological needs often remain overlooked. This study was designed to better understand the mental health challenges faced by GI cancer patients—especially after treatment ends—by listening directly to their experiences through surveys and interviews. The data for this study were collected through a validated web-based survey. Any individual in the US with GI cancer (undergoing or completed treatment) was eligible to participate in this study. In phase 1, a web-based survey was distributed to cancer patients through social media and open cancer forums via an audience paneling service, Centiment. The survey contained validated questions adapted from the Columbia Suicide Severity Rating Scale (C-SSRS) and the Patient Health Questionnaire (PHQ-4). A control question was included to maintain response integrity: “To confirm attentive reading and thoughtful responses, please select Green as your answer.” Responses failing this criterion were excluded from the analysis.

The descriptive statistics of all the variables were calculated in R (JASP Version 0.19.3). To ensure validity and reliability of the survey measures, the questions adapted from PHQ-4 and C-SSRS were converted into latent constructs, namely mental health (Factor 1) and suicidal ideation (Factor 2), respectively. The constructs were validated using multigroup confirmatory factor analysis across both groups (participants from rural Appalachia and others). Model fit was assessed by the comparative fit index (CFI), Tucker Lewis index (TLI), and Bentler Bonnet Normed fit index (NFI). Additional measures such as the parsimony normed fit index (PNFI), Bollen’s relative fit index (RFI), Bollen’s incremental fit index (IFI), and relative non-centrality index (RNI) were also observed. Reliability and validity were assessed using Cronbach’s alpha, which was required to be greater than 0.70; (b) outer loadings greater than 0.50 Fornell-Larcker criterion, and the Heterotrait–Monotrait (HTMT) ratio required to be less than 0.85. Upon validating the latent constructs, the scores of each construct were extracted, and the dataset was scaled. Given the non-normal distribution of the data (based on the Shapiro–Wilk test), we used Bayesian Pearson’s Rho correlation analysis as it is more robust to non-normality than the classical Pearson correlation. Two hundred and two individuals participated, with 76 from the rural Appalachian region and 78 undergoing treatments. Quantitative analysis showed a higher prevalence of passive suicidal ideation than active planning. The post-treatment recovery period was the most emotionally challenging.

Dataset DOI: 10.5061/dryad.djh9w0wcf

Description of the data and file structure

This dataset is an anonymous web-based survey consisting of patients with gastrointestinal cancer.

The survey contained validated questions adapted from the Columbia Suicide Severity Rating Scale (C-SSRS) and the Patient Health Questionnaire (PHQ-4). PHQ questions were reverse-coded, where a higher score indicates better mental health. Other variables, such as family burden, internet information utilization, and emotional support, were measured using a five-point Likert scale. The survey was accompanied by a detailed cover letter, an electronic consent form, and an invitation for an online follow-up interview. After reviewing the cover letter and consent form, individuals with gastrointestinal issues who agreed to participate were directed to the survey. Participant eligibility was determined through self-reported data.

The dataset consists of the actual Likert scale labels and not the scores. User can score them as per their convenience.

Files and variables

File: Cancer_Depression_-_ID12293838402_July_28__2025_07.31.xlsx

Description: Each column is a survey question with the actual response labels. "na" indicates not applicable. Note, these are not missing values.

Variables

Start Date: The date when participants took the survey [Data removed]
End date: When participants completed the survey [Data removed]
Duration (in seconds): Time to complete the survey
Could you please indicate which type of gastrointestinal cancer you have been diagnosed with by a healthcare professional?: GI cancer types participants had
Could you please indicate which type of gastrointestinal cancer you have been diagnosed with by a healthcare professional? - Other - Text: Any other GI cancer that was not listed earlier [Data removed]
Are you currently undergoing cancer treatment?: Yes/ No
When was your most recent treatment for GI cancer?: na is not applicable;
From the day of your GI cancer diagnosis to the last day of your cancer-related clinical visits, approximately how long were you undergoing treatment?: na is not applicable;
When were you first diagnosed with GI cancer?
For how long have you been receiving ongoing cancer treatment?
During your treatment, where you ever been clinically diagnosed with depression or any other mental distress?
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Have you thought about being dead or what it would be like to be dead?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Have you wished you were dead or wished you could go to sleep and never wake up?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Do you wish you weren’t alive anymore?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Have you thought about doing something to make yourself not alive anymore?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Have you had any thoughts about killing yourself?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Have you thought about how you would make yourself not alive anymore (kill yourself)?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - When you thought about killing yourself, did you think that this was something you might actually do?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - Please select one - Have you decided how or when you would kill yourself? Have you planned out how you would do it?: (Yes/No)
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Have you thought about being dead or what it would be like to be dead?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Have you wished you were dead or wished you could go to sleep and never wake up?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Do you wish you weren’t alive anymore?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Have you thought about doing something to make yourself not alive anymore?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Have you had any thoughts about killing yourself?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Have you thought about how you would make yourself not alive anymore (kill yourself)?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - When you thought about killing yourself, did you think that this was something you might actually do?: Likert scale
Since your last visit, or at any point during your treatment, have you experienced the following? - How many times have you had these thoughts? - Have you decided how or when you would kill yourself? Have you planned out how you would do it?: Likert scale
Thank you for sharing your emotions with us. I'm curious if you've experienced any similar thoughts or emotions in the past, before your cancer diagnosis?: Likert scale
I can imagine that receiving a cancer diagnosis can be an incredibly difficult and emotional experience. I'm wondering if you feel comfortable sharing whether your mental and emotional well-being has been affected since receiving your diagnosis?: Likert scale
What is the highest grade or level of schooling you completed?: Ordinal scale [Data removed]
With which of the following genders do you identify yourself as: nominal type [Data removed]
What is your annual household income: Ordinal scale [Data removed]
Including yourself, how many people live in your household?: Numeric integer type [Data removed]
What is your age (years)?: Ordinal type
Have you ever used the internet to learn about your cancer and treatment plan?: Likert scale
During the cancer treatment, did you ever share your thoughts and emotions with someone? : Likert scale
Cancer treatment can be emotionally taxing. During your cancer treatment, did you ever experience - Loneliness: Likert scale
Cancer treatment can be emotionally taxing. During your cancer treatment, did you ever experience - Hopelessness: Likert scale
Cancer treatment can be emotionally taxing. During your cancer treatment, did you ever experience - Nervousness: Likert scale
Cancer treatment can be emotionally taxing. During your cancer treatment, did you ever experience - Severe Sadness: Likert scale
Have you ever considered discontinuing your cancer treatment?: Likert scale
Many people find that cancer treatment can be difficult on both the patient and their family. Have you ever felt like your family was carrying a heavy burden because of your treatment?: Likert scale
Have you felt hopeless or had thoughts of giving up since your diagnosis?: Likert scale

Code/software

Microsoft excel, LibreOffice

Human subjects data

The study received ethical approval from the West Virginia University Institutional Review Board under protocol number 2212691613. The study qualified for the WVU Flexibility Review Model, as it involves minimal risk and adheres to the Belmont Report’s ethical principles. Approval was granted on 7 February 2023.