DOI: 10.5061/dryad.djh9w0wcf
title: Exploring patient-centered perspectives on suicidal ideation: A mixed methods investigation in gastrointestinal cancer care

description: 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.
description: # Exploring patient-centered perspectives on suicidal ideation: A mixed
 methods investigation in gastrointestinal cancer care Dataset DOI:
 [10.5061/dryad.djh9w0wcf](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.