This study aims to identify the risk factors of suicide attempt from the viewpoint of suicide attempters and to define the protective factors of how to overcome suicide attempt.
Towards that end, eight suicide attempters, in their 20s to 50s, who were sampled from mental health promotion centers and emergency rooms in the Jeonbuk region, were interviewed, and thus 50 key statement sentences of risk factors of suicide and 53 statement sentences of protective factors suicide were derived from the interviews. Derived statements were put into cards, and were classified according to similar items, and were evaluated according to their importance levels by subjects. The data were put into similar matrix tables by group, and underwent ALSCAL analysis and cluster analysis. Based on this result, the concept map was created, and five clusters of risk factors of suicide and five clusters of protective factors were thus derived.
First, ALSCAL analysis of risk factors of suicide attempt revealed that statements, expressed on the 2D space, were recognized as 2 levels. Statements of external factors were placed on the right side of the X axis, and statements of internal factors were placed on the left side of it. On the top of Y axis, factors of relations with others were placed, and on the bottom of it, personal psychological factors of subjects were placed.
The cluster analysis of risk factors of suicide attempt revealed five clusters, which were named as follows. Cluster 1: frustration over difficulties of life, Cluster 2: No hope for and no meaning of life, Cluster 3: Negative perception of oneself and lowered self-esteem, Cluster 4: Escape from the pain of being socially alienated through death, and Cluster 5: feeling guilty for family and beloved ones. Also, subjects evaluated how much the statements would influence their suicide attempt. As a result, Cluster 1 and Cluster 2 were the most influenced.
Clusters were positioned on the concept map of risk factors of suicide attempt as follows. On the quadrant of external factors - factors of relations with others, Cluster 5 was placed. On the quadrant of external factors - personal psychological factors, Cluster 4 was placed. Also, on the quadrant of internal factors - factors of relations with others, Cluster 1 and Cluster 2 were placed, and on the quadrant of internal factors - personal psychological factors, Cluster 3 was placed. Second, ALSCAL analysis of protective factors of suicide attempt revealed this: on the right side of X axis, statements of communication-oriented factors were placed, and on the left side of it, statements of internal-oriented factors were placed. On the top of Y axis, statements of help factors of support system were placed, and on the bottom of it, statements of self-help factors were placed.
The cluster analysis of protective factors of suicide attempt derived five clusters, which were named as follows. Cluster 1: accepting one''s life and beginning to take care of oneself, Cluster 2: looking for reasons to live, Cluster 3: thinking of the remaining pain and finding methods of living, Cluster 4: making support systems, and Cluster 5: giving new meaning to life. Also, subjects evaluated how much helpful the statements would be to overcome suicide attempts: Cluster 3 was influenced the most. On the concept map of protective factors of suicide attempt, clusters'' positions were examined. On the quadrant of communication-oriented factors - help factors of support system, Cluster 4 and Cluster were placed. On the quadrant of communication-oriented factors - factors of self-help, Cluster 3 and Cluster 2 were placed. Also, on the quadrant of internal-oriented factors - help factors of support system, part of Cluster 1 and part of Cluster 5 were placed. On the quadrant of internal-oriented factors - factors of self help, Cluster 1 was placed.

Theoretical, policy and practical implications of this study are described below.
First, suicide attempters in their 20s - 50s, whose age range was less targeted in other similar studies, were sampled and examined, and from their internal viewpoint, risk factors and protective factors were derived. Also, protective factors of suicide attempters, which were less targeted in other similar studies, were examined. Unlike other similar studies involving an analysis of several limited variables of risk factors of suicide attempt and protective factors, comprehensive perception, behavior, and socio-environmental factors were defined herein based on subjects'' experiential characteristics. Also, research on suicide attempters requires a phenomenal and explorative study of subjects'' experiences per se, and to develop practical intervention strategies, ground-based research, using quantitative methodologies, is required. Thus, herein, using a qualitative methodology, risk factors and protective factors of suicide attempters were identified. Also, using the quantitative methodologies of ALSCAL analysis and cluster analysis, the factors were classified and the concept map was presented. Specifically, based on the key statements of suicide attempters, the previous vague understanding of the perception structure and characteristics of suicide attempters were more specifically defined based on their statements, and the quantitative findings of this study were presented. Thus, the resulting key statement sentences of suicide attempters'' risk factors and their evaluation data are expected to be used as basic questions for evaluating the risks of suicide, and the key sentences of protective factors and evaluation data may present the direction for effective involvement in preventing the suicide of suicide attempters.
Second, this study revealed that suicide attempts were the results of combining psychological factors such as depression, sense of loss, and sense of despair, and social factors such as economic difficulties and lack of sources of help. Thus, prevention of suicide requires combined efforts of psychological support, welfare policy, and social safety networks, and the expansion of budget and manpower for suicide prevention programs is imperative.
Third, the findings of this study are expected to better understand the risk factors and protective factors of suicide attempts for suicide prevention programs so that intervention plans can be established. Notably, this study implies that there is a need to develop intervention programs aimed at strengthening protective factors so as to ease suicide impulse even under vulnerable internal and environmental conditions, and to apply such programs to real situations so as to verify their suitability and effectiveness. In addition, the data are expected to be used to activate the intervention by families of suicide attempters and their self-help meetings.


Keywords : concept map, suicide attempt, risk factor, potective factor, ALSCAL analysis, cluster analysis