TAM Li HOC SINH Ll HOC LUA TU6l PHATHIEN SOM NGUYCaTirSATQfTREVITHANH NIlN TS T R A N TH! M Y L U O N G ThS NGUYEN D A N G TRUNG'''' m dl nam tren the gidi cd gan mdt trieu ngudi I chet do tuluiJJ), tUdn[.]
TAM Li HOC - SINH Ll HOC LUA T U l PHATHIEN SOM NGUYCaTirSATQfTREVITHANH NIlN TS T R A N TH! M Y L U O N G - ThS N G U Y E N D A N G TRUNG' m dl nam tren the gidi cd gan mdt trieu ngudi I chet tuluiJJ), tUdng duong vdi ti le 16/ 100.000 ngudi, tiic la cii 40 giay trdi qua lai cdmptea ttitu Theo dieu tra qud'egia vevj nien (VTN}vathanh nien VielNam lan thii2 {do Bd Y te, Tdng cgc Thdng ke, WHO toehiie nam 2010} tren 10.000 thie'u nien, thuc hien tai 63 tinh thanh: cd tdi 409 ngudi{4,1%)edydjnhTT Cdn theo ket qua dieu tra ctia cac bae si Benh vien Nhi dong 1: sdcac trudng hop TT thi 65,8% odd tuoi 14-15 va tl le cae em gai nhieu hdn cae be trai gan 61 % Tuy nhien, van de phdng ehd'ng nguy co tu sat d Ilia tud'i thie'u nien v l n chua dupc quan lam mdl each Ihda dang Nude ta ehua cd hethd'ng phdng ehd'ng TT mdl each ehuyen nghiep, eung nhu chua ed nhieu td' chiic, ehUdng trinh hoat ddng ITnh vuc phdng chong TT, dae biet dd'i vdi Ire VTN 1.Khainiem t t f t u Theo TiJ dien Tieng Viet:" TThaytusatla ti/giet minh Hay TTla tugietcheiminh mptcich cdy, dong nghia vditusit, tuvarf (1) Theo http:/A/i wikipedia.org: "TT^Wan V'leteonghJa a tug'ief, tieng Anh: suicide, bStngudn tutiengLa tinh nghia la 'giet chinh minh") hay tti sit, tt/ van la hanh dqng cua mdt ngudi edy gay cai chet cho chinh minlf {2) Theo PGS Cao Tien Ode (Benh vien 103): TT tu sit, tu vin hay tu ket liiu deu li nhi/ng td ngd chi ehung mot hien tugng ngudi thuc hien hinh vi tu gayra cai chet ddi vdi ban than minh 061a mot si/ lua chon co chu tam suy nghi, cdy tu lam hai ban Mn minh vdi mong mudn duae chet Theo dinh nqhiacuaVJ HO, TTIi hinh dpng edy giet ban than minh Cac ye'u to nguy co ciia TT bao gom cac rdi loan tam liva mpt so benh the chat nhu ung thu HIV, v.v Nhung hanh vi TT gay nguy hiem cho nan nhan va thudng de lai nhieu dicliung Iren co the, chan thuong tam li lau dai Trong Tam li hpc, cd nhieu quan diem khac veTT Theo nha Tam li hoc ngudi MT.E.Shneidman, TT la hanh dpng tu lam ton thuong, cd' y cham diit 16 Tap chi Gido dye so 305 smh mang cua ban than.TT khdng phai la mdl chiing benh, khdng phai su bait binh thudng ve mat sinh hpc, nd eung khdng phai la mpt hanh ddng vd dao due va khdng phai la mot hanh vi pham phap a hau hel cac qud'c gia tren the gidi Waller Hurst-nha Tamlihpc ngucri New Zealand cho ring, viec dua quyet djnh TT thudng bj thiJc day bdi y mud'n cham diit si/sdng hon la mud'n chert TT la mdtsulua chon phai ddi dien vdi ndi dau khd' Cling cue, dudng nhuvuplqua mtic chju dung cua ca nhan vati/than khdng the nao giaiquyet dupc Trong cud'n sach Definition of Suicide xua't ban nam 1985, E.ShnekJman da dinh nghla TT nhusau: TT la m dt hanh ddng tu ket liiu st/ song cua ban than mdt each cd y thiic day, ngudi ta phai dd'i mdt vcri mdt linh canh vd cting khdkhan, phtic tap va hp nh^n thay ring, TT la giai phap td't nha't de glai quyet kho khan dd Trong khudn kho bai bao nay, chiing toi li/a chpn stidung khai niem cua E Shneidman TT la hanh vi tt; huy hoai eudc sd'ng ctia chinh minh, nhin ehung dd la van de cdtinh lieu ct/c rat ldn, lam anh hudng den tam li xa hdi Loai ngudi luon hudng den susd'ng, suton lai, nhung hanh viTT lai dl nguoe vdi dieu dd Day la mot dang dae biet eua hanh vi lech chuan, cd the xep vao loai lech chuan tu xam hai Tuy nhien, tu sat la cap dp cao nhat cua tt/ xam hai ban than Co che va nguyen nhan cua hanh vi TT a tre VTN 1) Ca checua hanh vi TT Trude nhiing hien lucftig xay hang va n h i ^ g tae ddng lii hien tht/e khaeh quan, ngudi Ihudng xu li dua theo quan linh tam li hoae nhung kinh nghiem duoc tieh luy tiicudc sd'ng, sugiao due, day dd cua nhung ngt/di di trudc Nhung cac tac dpng vupl qua su kiem soal tam li cua ca nhan thi cd che tuve se phal sinh Cache tuve tam //la he thd'ng dieu chinh dSc biet de on dmh nhan each, hudng de'n viee lam giam tdimuc Ihap nhailtinh trang lo au, lien quan de'n xung dot npi * Klioa Tim tl - Giao dnc, Tnrting Dai hQC sir pham Ha N^i -(kil-3/2013) tam muc dd nhat dmh, co che l u v e dem lai tac dpng tich cue, giiip ngudi dieu chinh va giu thang b i n g eho ddi sd'ng tinh than Nhung lai cd nhiing hinh thiictuvemang tinh lieu cue vaTTIamdthinhth lie lu ve rail lieu ciicdtre VTN Dieu naycOngdlhieuvidliia luoi nay,kinh nghiem va kTnang song ciia cac em edn han hep vi thenhutig suy nghl sai lech d l dang day cac em den hinh thiic tuve tieu cue mtic dp nhe, chi la nhirng hanh vi di ngupc lai vdi mong moi, nguyen vpng cua ngudi Idn, trd'n tranh thue tai bang thai dp bat can vdi cupc sd'ng Mtic dd eao nha'tia hanh ban than, suy nghTve cai chet va ed the thue hien hanh vi TT Ngoai ra, mdt co che cua hanh vi TT d tre VTN nualado/f/7dng/f/emsoa7tfu'oc////7.Dacdiemtamli ciia Ilia tud'i VTN Ihudng bdt phat nhanh theo cam xiic, it dupe kiem soal kT ve mat li tri, vay nen diing tn/de nhiing tac ddng nhu cha me m i n g nang ldi that bgi Irong hpc lap, quan he ban be, v.v thi mdt sd'em edthetim de'n eai chetnhumptsugiaithoat tinh huong, 2) Cd nhieu nguyen nhan dan den hanh vi TT dtre ^r/V,edthephan tich qua cac each tiep can sau; Tiep can Sinh hgc liia tud'i VTN la giai doan ma tinh dde lap eua tre Ihay the tinh trang phu thupc vao cha mpvanhiing ngudi Idn Soi day rang liupcvdigia dinh gian eac em danh nhieu thdi gian hon eho cupc sdng ben ngoai gia dinh Cac em cd nhu cau ve tinh ban than, mud'n dugc ban be eung trang ltia chap nhan va tan thudng Do dd, cac em rail lo scf bi ban be tay chay Ngoai ra, giai doan d cac em cdn ed su bien doi Idn ve sinh li (hien tUdng day thi) nen rat nhay cam, d l bj td'n thuong Nhan thtic ve xa hdi eung sau s^c hdn nen thich tranh cai, phan khang ngudi idn Cac yeu tdtren ket hgp lai khien nguy cdTT dtre VTN cdxu hudng sinh Ben cgnh dd, yeu td'di truyen TT cung duge minh chi/ng nhu Irong gia dinh ciia nha van MT E Hemingway (nha van, bo dng, va chau gai deu TT) Cdthe giai thieh nguon gd'c cua hien tuong la su anh hudng lien quan de'n tinh di tnjyen mdt so benh li nhu benh tam than, tram earn, nghien n/gu,matuy,v.v Tfl^ can xi hoi hgc cac nha xa hpi hge cho ring, mdl ch ting ta deu thude vempi nhdm xahoi nao ddva chiing ta ludn ednhu cau dugc mgi ngudi nhdm chSip nhan nhung gia trj cua minh Dae biet irong giai doan tudi VTN, nhu cau dugc ngudi khac chap nhan vatanlhuong ration Mdtsd'emlha hisinh cupc sd'ng chii khdng chiu chap nhan s i ; choi bo, che bai ciia ngudi khac M§t khac, mot so em lai thu hut suchu y tan thudng ctia ngudi khac bang chinh hanh viTT Vi dij, bao ehi ram rd dua tin ve mpt hanh vi TT nao dd, tre bdng nghT, nd TT, nd eung dugc quan lam ehiiynhulhe Ngoai ra, ap luc xa hpi cung la nguyen nhan chinh d i n den hanh vi TT Hanh vi TT eiia tre VTN la dudng cucSCling dephan khang lai nhiing ap luc dd Vi du: TT thi ta/gt dai hpc, bi bat nat hpc dudng, v.v Mdt so nhung he luy tu nhiing tieu cue ciia xa hdi nhu su phan biet dang caip, cac luong thdng tin xa'u {nhu cac trang web day each tu sat) eung la nguyen nhan ciia hanh vi lusat dire VTN Vi tre VTN rat quan lam den xual than cua minh, cac em d l mac cam, tu ti bat chudc, lay nhilm eac te nan xa hdi Tiep can y hoe cho rang, nguyen nhan chu yeu dan de'n TT la benh tram cam Nhung tre tram cam thudng cd chat ye'u khdthieh nghi, tram buon, cd linh le thuoc eao, de bi suy sup vdi nhung tac dpng bat loi nhuhalhiii that bai Benh eo thecung la yeu Id dikem Ihudng gap cuaTT, nhubenh HIV,tam than, Theo tiep ean giao ducnguyen nhan gay TT la su thieu hut eac kT nang xa hpi, kl nang giai quyel van de Dting Irudc mau thuin khd khan, dp khdng ed kT nang giai quyet vain de nen cae em trd nen be tic Mat khac khdng cd kTnang xahoi nen cacem khdng the huy dpng cac nguon trg giiip Su be tae va ed don giai doan khung hoang eiia It/a tuoi gdp phan lam nguy co TT tang cao Theo tiep can tim Hhgc nhi/ng tre VTN TT thudng cd quan diem, niem tin suy nghT sai lech ve thegidi va chinh dieu ddtao nen nhiing cam xiic tieu cue, dan den hanh vitieucue dcae em Chang han, tre VTN Ihudng cdxu hudng tram trpng hda van de(vi borne mang ma ket luan ring bd' me khdng yeu Ihuong minh, vi mpt diem thap ma eho rang minh khdng ed kha nang hge mdn dd) hoae la tu am thj minh khdng ed kha nang chiu dung dugc that bai Tat ca nhiing thcri diem nhu vay, dtre d l xay nhung hanh vi dai dot Nguy eo TT eung cd the xay tre khdng tim dugc y nghTa ciia cudc sd'ng, cam Ihay minh vd lich su, vd gia trj hoae Ire gap phai nhung khd khan cudcsd'n^ Bieu hien ctia hanh vl TT Thdng thudng, hanh viTT phattrien theo cacgiai doan: - Ytudng TTthe hien ynghTmud'n chet nhung chua thuc hien hanli ddng Phan Idn nhung tre chiedy tuong TT ma chua hinh dung xem minh seTT nhuthenao v a b i n g each nao; - Kehoach TJ (hay muu dd TT): y tuong TT hinh thanh, tre b i t dau tiCT sau hon ntia, mdt kehoach thuc hien ytudng Tap chi Gido due so 305 (ki 1-3/2013)- 17 TT bit dau hinh lam tri tre Bat d i u suy nghT, lua chpn, tim kiem eac each khac dethuc hien hanh viTT, tham chi xay dung mdt kehoach chi liet dugc thuc hien tam tri; - Toan tusii: bao gom cac hanh vi khac nhau, cd gang nhiing thao tae detugietchetminh nhung khdng dat Viee phat hien mdt ngudi toan tu sated vaitro cue ki quan trpng vied the ngan ngiia tinh trang xa'u nha'l (TT edng) va cd nhiing hd trg kip thcri giiip ngudi dd xem xet lai quyet dinh ctia minh va ngan ehan viec tai phat hanh VI; - TT thinh cong: cae budc chuan bi hoan tat, dd mau thuin, khung hoang len tdi dinh diem va khong the thao gd, chu the se thuc hien hanh vi tusat, Thudng lhi tre da len ke hoach chi tiet, cy the lhi hanh vitt/sated tile tuvong rat cao Phat hien sdm nguy c o t u sat d tre VTN Nhu da phan tich, de can thiep kip thdi va hieu qua doivdi nguy CO tusatdtre VTN, yeu toquan nhatlaphathien sdm, Nhungdau hieu sau day cdthe la nguon thdng tin dau lien giup bo me, ngucri than, ban be, thay ed nhan biet nguy co tu sal d tre: - Trd'n tranh ban be, gia dinh, bd nhiing thoi quen thudng nhat; - Co hanh dpng cue c i n hoae bd trd'n khoi nha; • Cau tha each an mac; • Thay dol ca tinh mpt each dae biet;-Thay doi each an ud'ng, nghi ngoi;Thudng xuyen to chan nan, khdng lap trung, tti chdi di hpe; - Hay phan nan ve nhiing ddn dau the xac; - Mail hdng ve nhung thu vui ca nhan nhu xem phim, choi game; • Phan nan minh la mpt ngudi xa'u; - Thmh thpang ndi ring "con se khdng lam phien nua dau" hay "con chang cdn gap nda dau"; • Ndi hoae diia veviec seTT; - Cd hanh vi huy hoai, tuxam hai minh; • Sap xep, phan phat dae ca nhan va cho di vat sd huu cd gia trj; - Ndi tam biet vdi ban be, viet thu tuyet menh de lai cho gia dinh Ben eanh dd bo me, thay cd, ngudi than cdthesii dt/ng cae phuong phap phdng ngiia, nhu: ehia se thudng xuyen vdt tre ve cac suy nghT, van de etja tre; tao niem tin cho tre ve ban than va ngudi than cua minh; gitip tre hieu nang luc, tdn trpng cae gia tri ctia ban than minh Dd'i vdi nhiing tre VTN bi phat hien cd muu TT hoae toan tu sat thi rat can ed su can thiep ctia cae nha tam li tri lieu Tiiy thupc vao mtic dp bieu hien ma eae chuyen gia cdthe lua ehpn stidung cac phuong phap can thiep phti hop nhu tham van hay tri lieu theotiepean nhan van.than chiitrpng lam, Ching han, mue dieh cua liep can nhan van - hien sinh la nhan manh den linh trach nhiem suiuquyet vdl quan diem "chinh chiing la la tac gia ciia cude ddi minh" 18 Tap chi Gido due so 305 odi vtji viec tri lieu eho tre VTN cd nguy co tusat, cac chuyen gia cdthe thuc hien tri iieu theo cae budc: • Bude 1: Can thiep lap tuc bao gom: thiet lap trang thai can bang; sudung cac kT thuat "chdng d ? nham giam lo au mac cam tdi ldi tinh trang cang thang, cung cap nhiing hdtrcf ve mat cam xiic; tranh nhung hau qua bat hanh, nguy hiem (duy tri suho trg, kiem soat lien tuc va can thiep khan cap); - Budc 2: Xic dinh ngudn gdc eua hinh vi, nham tim nguyen nhan thdng qua tham dd tim hieu qua khii, danh gia nhung nhuoc diem cua Ire va phat hien nhi/ng stic manh, xac dinh nhu cau liic thdi ciia tre; tao dieu kien thuan Igi hay ddng vai trd hudng dan viee giiip 6d\xe;-Bude3:Limting,thucdayhivgng\ianY\m^ mong dgitichcucdtrenhim ddng vien, khuye'n khich tre giai quyet, vuot qua van de cua chinh minh TT la van de cd the phdng tranh duoe, nhung nhiJng ngudi lien quan vdi tre lai ehua ed dti kT nang de phat hien va ngan ehan, nhat !a doivdi giai doan tre VTN cdn cd nhifng ndng ndi bdt phat hanh vi Mdt mat, ehiing la can tang cudng kha nang duong dau vol nhiing khd khan ciia Ire, xaydung moi quan he gia dinh, ttiay trd, ban be tren linh than tot dep, cffi md, hop tae; giiip tre hoan thien ngudi xa hpi Ngoai ra, s u h d trg cua gia dinh, thay cd, cac to chtic xa hpi la nhung giai phap hieu qua hdtrp cai thien stic khde tam than ciia tre.3 {1) Hoang Phe Tur dien Tieng Vifit NXB Dd Ndng, 2003 (2) hup:// vi.wikipedia org Tai lieu tham khao Truang Van VI TLT ttr nhu la mpt hSinh vi l$ch lac - Quan dicm cua Emile Durkheim v£ sai I6ch chu^n muc xa hai" Tap chi Phdt triin Khoa hpc vd cdng nghi.so 1/2011 Peler Smith Professor of Psychology al the University of Sheffield, directed the Sheffield AnnB u l l y i n g I n t e r v e n t i o n Project, funded by the Department for Educalion (2004) http://benhviennhi.org.vn Teenage is an agegroup that tends to lead to the highest suicide In all agegroups Nevertheless, prevenUon and anli-suicide have yet been sufTiClenUy aware in Vietnam In order lo restrain and anti-suicide effectively that we need to detect early, ihis play an extremely innportant role In this eassy we will discuss causes, characters, indications as well as offer several solutions to combat this Issue -(kil-3/2013) ... eung la nguyen nhan ciia hanh vi lusat dire VTN Vi tre VTN rat quan lam den xual than cua minh, cac em d l mac cam, tu ti bat chudc, lay nhilm eac te nan xa hdi Tiep can y hoe cho rang, nguyen... lhi hanh vitt/sated tile tuvong rat cao Phat hien sdm nguy c o t u sat d tre VTN Nhu da phan tich, de can thiep kip thdi va hieu qua doivdi nguy CO tusatdtre VTN, yeu toquan nhatlaphathien sdm,... xiic; tranh nhung hau qua bat hanh, nguy hiem (duy tri suho trg, kiem soat lien tuc va can thiep khan cap); - Budc 2: Xic dinh ngudn gdc eua hinh vi, nham tim nguyen nhan thdng qua tham dd tim