{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T01:57:23Z","timestamp":1787882243835,"version":"build-2784847793"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,2,6]],"date-time":"2015-02-06T00:00:00Z","timestamp":1423180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"crossref","award":["6271-15-2010\/3970773"],"award-info":[{"award-number":["6271-15-2010\/3970773"]}],"id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We aim to concurrently examine risk and protective factors associated with intentional self\u2010harm among community\u2010residing older adults receiving home care services in Ontario, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Administrative health data from the home care sector were linked to hospital administrative data to carry out the analyses. Home care data are collected in Ontario using the Resident Assessment Instrument\u2014Home Care (RAI\u2010HC), an assessment tool that identifies strengths, preferences and needs of long\u2010stay home care clients. The sample included Ontario home care clients aged 60\u2009years or older assessed with the RAI\u2010HC between 2007 and 2010 (<jats:italic>N<\/jats:italic>\u2009=\u2009222,149). Multivariable analyses were performed using SAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hospital records of intentional self\u2010harm (ISH) were present in 9.3 cases per 1000 home care clients. Risks of ISH included younger age (60\u201374\u2009years; OR\u2009=\u20093.14, CI: 2.75\u20133.59), psychiatric diagnosis (OR\u2009=\u20092.29, CI: 2.06\u20132.54), alcohol use and dependence (OR\u2009=\u20091.69, CI: 1.34\u20132.14), psychotropic medication (OR\u2009=\u20091.94, CI: 1.75\u20132.15) and depressive symptoms (OR\u2009=\u20091.58, CI: 1.40\u20131.78). Protective effects were found for marital status and positive social relationships, yet these effects were more pronounced for men. Cognitive performance measures showed the odds of ISH 1.86 times higher for older adults with moderate to severe cognitive impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study based on provincial data points to tangible areas for preventative assessment by frontline home care professionals. Of interest were the risk and protective factors that differed by sex. As demand for home care in Canada is expected to increase, these findings may inform home care professionals' appraisal and approach to suicide prevention among community\u2010residing older adults. Copyright \u00a9 2015 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/gps.4259","type":"journal-article","created":{"date-parts":[[2015,2,6]],"date-time":"2015-02-06T14:46:13Z","timestamp":1423233973000},"page":"1032-1040","source":"Crossref","is-referenced-by-count":30,"title":["Risk and protective factors associated with intentional self\u2010harm among older community\u2010residing home care clients in Ontario, Canada"],"prefix":"10.1002","volume":"30","author":[{"given":"Eva","family":"Neufeld","sequence":"first","affiliation":[{"name":"Centre for Rural and Northern Health Research Laurentian University  Sudbury Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Hirdes","sequence":"additional","affiliation":[{"name":"School of Public Health and Health Systems University of Waterloo  Waterloo Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Perlman","sequence":"additional","affiliation":[{"name":"School of Public Health and Health Systems University of Waterloo  Waterloo Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Psychiatry and Family Medicine University of Vermont College of Medicine  Burlington VT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afq121"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2005.01378.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/13811119708258261"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/29.2.165"},{"key":"e_1_2_8_6_1","volume-title":"National Guidelines for Seniors Mental Health","author":"Canadian Coalition for Seniors Mental Health (CCSMH)","year":"2006"},{"key":"e_1_2_8_7_1","volume-title":"Portraits of Home Care in Canada","author":"Canadian Home Care Association","year":"2008"},{"key":"e_1_2_8_8_1","unstructured":"2004 CIHI Toronto (ON) Canadian Institute for Health Information (CIHI) National trauma registry analytic bulletin: Hospitalizations due to suicide attempts and self\u2010inflicted injury in Canada 2001\u20102002"},{"key":"e_1_2_8_9_1","unstructured":"Canadian Institute for Health Information.2012.Home Care Reporting System (HRCS). 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