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Enfermería Clínica (English Edition) Decision tree classifier in predicting high risk of suicide in nursing students ...
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Vol. 35. Issue 6.
(November - December 2025)
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Vol. 35. Issue 6.
(November - December 2025)
Original Article

Decision tree classifier in predicting high risk of suicide in nursing students after COVID-19 pandemic

Predicción mediante un árbol de decisión del riesgo alto de suicidio en estudiantes de enfermería después de la pandemia por COVID-19
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Guillermo Morenoa,b,
Corresponding author
guimoren@ucm.es

Corresponding author.
, Pedro Cuesta-Álvaroc, Marina Martín-Núñeza,d, Leyre Rodriguez-Leala,e, Jennifer P. López-Ovandoa,f, L. Iván Mayor-Silvaa
a Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
b Grupo de Investigación Cardiovascular Multidisciplinar Traslacional (GICMT), Área de Investigación Cardiovascular, Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
c Unidad de Apoyo a la Investigación, Universidad Complutense de Madrid, Madrid, Spain
d Hospital Universitario 12 de Octubre, Madrid, Spain
e Escuela Universitaria Cruz Roja, Madrid, Spain
f Hospital de Emergencias Enfermera Isabel Zendal, Madrid, Spain
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Abstract
Objective

Suicide is the fourth leading cause of death among people aged 15−29. The aim of this study is to measure the risk of suicide among nursing students after the COVID-19 pandemic and to identify the factors associated with the risk of suicidal ideation.

Methods

A cross-sectional study was carried out with nursing students. A convenience sample was selected with all first-year undergraduate students from a single university center in Madrid, Spain (n = 196). Suicide risk (Plutchik scale) was measured as a dependent variable, and sex, age, emotional regulation (ERQ questionnaire), resilience (RS-14 scale), personality traits (BPI inventory) and quality of life (EQ-5D questionnaire) as independent variables. A predictive model was created using a classification tree algorithm to identify the most important predictors of high suicide risk.

Results

The results showed that a total of 16.4% of the students were at high risk for suicide. The independent predictors of high suicide risk were age (OR 1.10), responsibility (OR 0.83), neuroticism (OR 1.64), and quality of life (OR 0.98). In the classification tree prediction model, neuroticism increased suicide risk (62.5%) and responsibility decreased suicide risk.

Conclusions

Around 16% of the nursing students are at high risk of suicide after the COVID-19 pandemic. This prevalence may change when considering neuroticism and responsibility personality traits.

Keywords:
Suicide
Nursing students
COVID-19
Decision trees
Neuroticism
Resumen
Objetivo

El suicidio es la cuarta causa principal de muerte entre las personas de 15 a 29 años. El objetivo de este estudio es medir el riesgo de suicidio entre los estudiantes de enfermería después de la pandemia de COVID-19 e identificar los factores asociados con el riesgo de ideación suicida.

Método

Se realizó un transversal con estudiantes de enfermería. Se seleccionó una muestra de conveniencia con todos los alumnos de primer año de carrera de un único centro universitario en Madrid, España (n = 196). Se midió el riesgo de suicidio (escala de Plutchik) como variable dependiente, y el sexo, la edad, la regulación emocional (cuestionario ERQ), la resiliencia (escala RS-14), los rasgos de personalidad (inventario BPI) y la calidad de vida (cuestionario EQ-5D) como variables independientes. Se creó un modelo predictivo utilizando un algoritmo de árbol de clasificación para identificar los predictores más importantes de alto riesgo de suicidio.

Resultados

Los resultados mostraron que un total del 16,4% de los estudiantes tenían un alto riesgo de suicidio. Los predictores independientes de alto riesgo de suicidio fueron la edad (OR 1,10), la responsabilidad (OR 0,83), el neuroticismo (OR 1,64) y la calidad de vida (OR 0,98). En el modelo de predicción del árbol de clasificación, el neuroticismo aumentó el riesgo de suicidio (62,5%) y la responsabilidad disminuyó el riesgo de suicidio.

Conclusiones

En torno al 16% de los estudiantes de enfermería corren un alto riesgo de suicidio después de la pandemia de COVID-19. Esta prevalencia puede cambiar al considerar algunos rasgos de personalidad como el neuroticismo y la responsabilidad.

Palabras clave:
Suicidio
Estudiantes de enfermería
COVID-19
Árboles de decisión
Neuroticismo

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References
[1]
WHO. Suicide 2023 [accessed 9 Sep 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide.
[2]
A. Crosby, L. Ortega, C. Melanson.
Self-directed violence surveillance: uniform definitions and recommended data elements.
[3]
L.M. Demenech, L. Neiva-Silva, S.M.S. Brignol, S.R. Marcon, S.M. Lemos, R.M. Tassitano, et al.
Suicide risk among undergraduate students in Brazil in the periods before and during the COVID-19 pandemic: results of the SABES-Grad national survey.
Psychol Med., 53 (2023), pp. 4977-4989
[4]
J. Gao, F. Wang, S. Guo, F. Hu.
Mental health of nursing students amid coronavirus disease 2019 pandemic.
Front Psychol., 12 (2021),
[5]
I. Mendez-Pinto, M. Antuña-Casal, M.P. Mosteiro-Diaz.
Psychological disorders among Spanish nursing students three months after COVID-19 lockdown: a cross-sectional study.
Int J Ment Health Nurs., 32 (2023), pp. 479-489
[6]
Y. Marcén-Román, A. Gasch-Gallen, I.I. Vela Martín de la Mota, E. Calatayud, I. Gómez-Soria, B. Rodríguez-Roca.
Stress perceived by university health sciences students, 1 year after COVID-19 pandemic.
Int J Environ Res Public Health., 18 (2021), pp. 5233
[7]
S. Reverté-Villarroya, L. Ortega, A. Lavedán, O. Masot, M.D. Burjalés-Martí, D. Ballester-Ferrando, et al.
The influence of COVID-19 on the mental health of final-year nursing students: comparing the situation before and during the pandemic.
Int J Ment Health Nurs., 30 (2021), pp. 694-702
[8]
N.P. Allan, M. Volarov, B. Koscinski, K.L. Pizzonia, K. Potter, C. Accorso, et al.
Lonely, anxious, and uncertain: critical risk factors for suicidal desire during the COVID-19 pandemic.
Psychiatry Res., 304 (2021),
[9]
S. Farooq, J. Tunmore, M. Wajid Ali, M. Ayub.
Suicide, self-harm and suicidal ideation during COVID-19: a systematic review.
Psychiatry Res., 306 (2021),
[10]
M. Shah, M. Roggenkamp, L. Ferrer, V. Burger, K.J. Brassil.
Mental health and COVID-19: the psychological implications of a pandemic for nurses.
Clin J Oncol Nurs., 25 (2021), pp. 69-75
[11]
H. Abdollahpour Ranjbar, M. Bakhshesh-Boroujeni, S. Farajpour-Niri, I. Hekmati, M. Habibi Asgarabad, M. Eskin.
An examination of the mediating role of maladaptive emotion regulation strategies in the complex relationship between interpersonal needs and suicidal behavior.
Front Psychiatry., 15 (2024),
[12]
N. Le, Y.B. Belay, L.K.D. Le, J. Pirkis, C. Mihalopoulos.
Health-related quality of life in children, adolescents and young adults with self-harm or suicidality: a systematic review.
Aust N Z J Psychiatry., 57 (2023), pp. 952-965
[13]
M. Takahashi, K. Imahara, Y. Miyamoto, K. Myojo, M. Yasuda.
Association between the Big Five personality traits and suicide-related behaviors in Japanese institutionalized youths.
PCN Rep., 3 (2024), pp. e186
[14]
M. Vimalanathane, P. Abhilasha, A. Prasad, A.S. Ramachandran, K. Subramanian.
Suicidal behavior and its association with psychological distress, coping mechanisms, and resilience: a cross-sectional study.
Cureus., 16 (2024),
[15]
E. von Elm, D.G. Altman, M. Egger, S.J. Pocock, P.C. Gøtzsche, J.P. Vandenbroucke.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.
Lancet., 370 (2007), pp. 1453-1457
[16]
R. Plutchik, H.M. van Praag, H.R. Conte, S. Picard.
Correlates of suicide and violence risk 1: the suicide risk measure.
Compr Psychiatry., 30 (1989), pp. 296-302
[17]
M.A. Santana-Campas, F. Santoyo Telles.
Propiedades psicométricas de la escala riesgo suicida de Plutchik en una muestra de jóvenes mexicanos privados de la libertad.
Av Psicol., 26 (2018), pp. 57-64
[18]
J. Pérez-Sánchez, A.R. Delgado, G. Prieto.
Psychometric properties of the test scores most used in the assesment of emotion regulation.
Pap Psicol., 41 (2020), pp. 116-124
[19]
J.J. Gross, O.P. John.
Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being.
J Pers Soc Psychol., 85 (2003), pp. 348-362
[20]
D. Sánchez-Teruel, M.A. Robles-Bello.
14-item Resilience Scale (RS-14): PSYCHOMETRIC PROPERTIES of the Spanish version.
Rev Iberoam Diagn Ev., 40 (2015), pp. 103-113
[21]
G.M. Wagnild, H.M. Young.
Development and psychometric evaluation of the Resilience Scale.
J Nurs Meas., 1 (1993), pp. 165-178
[22]
L. Torreblanca.
Desarrollo de un nuevo instrumento de evaluación: El Cuestionario Breve de Personalidad (CBP).
_Doctoral Thesis., 180 (2017),
[23]
M. Herdman, X. Badia, S. Berra.
EuroQol-5D: a simple alternative for measuring health-related quality of life in primary care [Article in Spanish].
Aten Primaria., 28 (2001), pp. 425-430
[24]
B. Seoane, F. de la Iglesia, R. Nicolás, V. Ramos, C. Pellicer, F. Diz-Lois.
Análisis factorial de la calidad de vida relacionada con la salud de pacientes que ingresan en una unidad de corta estancia médica.
Rev Méd Chile., 137 (2009), pp. 1163-1172
[25]
M.C. Torrejón-Guirado, I. San Martín-Erice, L. San Martín-Rodríguez, M. Lima-Serrano.
Methodological and strategic insights for online survey studies: an analysis based on the CHERRIES checklist.
Enferm Clin., 34 (2024), pp. 207-213
[26]
J.N. Mandrekar.
Receiver operating characteristic curve in diagnostic test assessment.
J Thorac Oncol., 5 (2010), pp. 1315-1316
[27]
S.M.A. Braga Moraes, V.F. Bezerra Barbosa, A.C. Silva Alexandre, S.C. dos Santos, F.J. Guimarães, J.L. de Araujo Veras.
Risk of suicide among nursing students.
Rev Bras Enferm., 74 (2021),
[28]
P. Ferrara, S. Terzoni, F. Ruta, A.D. Poggi, A. Destrebecq, O. Gambini, et al.
Nursing students’ attitudes towards suicide and suicidal patients: a multicentre cross-sectional survey.
Nurse Educ Today., 109 (2022),
[29]
E.N.B. Quarshie, H.V. Cheataa-Plange, F. Annor, W. Asare-Doku, J.K.S. Lartey.
Prevalence of suicidal behaviour among nursing and midwifery college students in Ghana.
Nurs Open., 6 (2019), pp. 897-906
[30]
A. Aradilla-Herrero, J. Tomás-Sábado, J. Gómez-Benito.
Associations between emotional intelligence, depression and suicide risk in nursing students.
Nurse Educ Today., 34 (2014), pp. 520-525
[31]
J. Montes-Hidalgo, J. Tomás-Sábado.
[Self-esteem, resilience, locus of control and suicide risk in nursing students].
Enferm Clin., 26 (2016), pp. 188-193
[32]
H. Asfaw, N. Yigzaw, Z. Yohannis, G. Fekadu, Y. Alemayehu.
Prevalence and associated factors of suicidal ideation and attempt among undergraduate medical students of Haramaya University, Ethiopia. A cross-sectional study.
PLoS One., 15 (2020),
[33]
E. Engin, D. Cuhadar, E. Ozturk.
Healthy life behaviors and suicide probability in university students.
Arch Psychiatr Nurs., 26 (2012), pp. 43-53
[34]
L.Y. Anny Chen, C.Y. Wu, M.B. Lee, L.T. Yang.
Suicide and associated psychosocial correlates among university students in Taiwan: a mixed-methods study.
J Formos Med Assoc., 119 (2020), pp. 957-967
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