Research in Community and Public Health Nursing

Original Articles

A Path Analysis for Health-related Quality of Life in Long-term Care Insurance In-home Service Users: Je Hyun Kim, Seung Mi Park; Res Community Public Health Nurs. 2023;34(1):1-11. Published online March 31, 2023; DOI: https://doi.org/10.12799/rcphn.2022.00283

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Abstract PDF: Purpose
The purpose of this study is to construct and verify a path model for the factors affecting on quality of life in long-term care insurance in-home service users.
Methods
Total 246 participants using long-term care insurance in-home service were recruited from long-term care agencies. Data collection was conducted using a structured questionnaire from March 1st to March 31st 2021. The collected data were analyzed using SPSS 26 and AMOS 26 programs.
Results
The hypothetical path model was suitable for explaining the health-related quality of life in long-term care insurance in-home service users and has an explanatory power of 39.8%. Long-term care grade, depression, perceived health status, social support, age and living arrangement had a significant total effect on the quality of life in long-term care insurance in-home service users.
Conclusion
Long-term care insurance in-home service policies need to be expanded, such as screening and relieving depression, strengthening social support, and fostering a positive perception of health to improve the quality of life of the elderly.

Effects of Depression, Social Support of Tuberculosis Patients on Self-care: Go Un Lee, Hye Kyung Lee; J Korean Acad Community Health Nurs. 2022;33(4):456-464. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.456

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Abstract PDF: Purpose
The purpose of this study was by understanding the correlation between the depression, social support and self-care of tuberculosis patients and by identifying the factors that influence the self-care. Methods: The study subjects were 119 outpatients who were diagnosed with pulmonary and respiratory tuberculosis at a university hospital in D city. The survey questions measured depression, social support, self-care. Using the SPSS/WIN 23.0 program, the collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlations and multiple regression analysis. Results: As a result of correlation analysis, there was a statistically significant negative correlation between self-care and depression (r=-.53, p<.001), and there was a significant positive correlation between self-care and social support (r=.68, p<.001). Factors affecting self-care of the subjects were social support (β=.51, p<.001), depression (β=-.32, p<.001), drug discontinuation experience (β=-.30, p<.001) and drug resistance (β=-.14, p<.001). These factors explained 62% of the variance. Conclusion: In order to improve the self-care ability of tuberculosis patients, it is necessary to develop education and nursing intervention programs that can lower patients' depression and strengthen social support.

Factors Associated with Depression in Older Adults Living Alone during the COVID-19 Pandemic: Eun Hye Hong, Kyung Hee Lee; J Korean Acad Community Health Nurs. 2022;33(4):418-431. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.418

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Abstract PDF: Purpose
The aims of this study were to examine the rate of depression among older adults living alone and to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Methods: A secondary data analysis was performed using data from the 2020 Korea Community Health Survey. The study participants were 18,824 older adults aged 65 years and over living alone. The data of the complex sample design was analyzed with consideration for weights, stratification, and clustering. Complex sample multiple logistic regression was conducted to identify factors associated with depression in older adults living alone during the COVID-19 pandemic. Results: The results showed that the rate of depression in older adults living alone was 6.3%. Older adults living alone with decreased physical activity, decreased hours of sleep, and an increased or similar frequency of meeting with friends or neighbors were found to be more likely to have depression. In terms of factors related to the practice of COVID-19 infection prevention and control rules, not disinfecting regularly and not wearing a mask indoors were related to depression. For health-related factors, fair or poor self-rated health status, not having breakfast every day, and feeling stressed were related to depression. Conclusion: It is recommended to develop tailored interventions to prevent depression among older adults living alone by considering the factors related to their depression during the COVID-19 pandemic.

Latent Classes of Depressive Symptom Trajectories of Adolescents and Determinants of Classes: Eun Joo Kim; J Korean Acad Community Health Nurs. 2022;33(3):299-311. Published online September 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.3.299

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Abstract PDF

Purpose
Untreated depression in adolescents affects their entire life. It is important to detect and intervene early depression in adolescence considering the characteristics of adolescent’s depressive symptoms accompanied by internalization and externalization. The aim of this study was to identify latent classes of depressive symptom trajectories of adolescents and determinants of classes in Korea. Methods: The three time-point (2018~2020) data derived from the Korean Children and Youth Panel Survey 2018 were used (N=2,325). Latent Growth Curve Modeling (LGCM) was conducted to explore the depressive symptom trajectories in all adolescents, and Latent Class Growth Modeling (LCGM) was conducted to identify each latent class. Multinomial logistic regression analysis was performed to confirm the determinants of each latent class. Results: The LGCM results showed that there was no statistically significant change in all adolescents' depressive symptoms for 3 years. However, the LCGM results showed that four latent classes showing different trajectories were distinguished: 1) Low-stable (intercept=14.39, non-significant slope), 2) moderate-increasing (intercept=19.62, significantly increasing slope), 3) high-stable (intercept=26.30, non-significant slope), and 4) high-rapidly decreasing (intercept=26.34, significantly rapidly decreasing slope). The multinomial logistic regression analysis showed that the significant determinants (i.e., gender, self-esteem, aggression, somatization, peer relationship) of each latent class were different. Conclusion: When screening adolescent’s depression, it is necessary to monitor not only direct depression symptoms but also self-esteem, aggression, somatization symptoms, and peer relationships. The findings of this study may be valuable for nurses and policy makers to develop mental health programs for adolescents.

Citations

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Factors Influencing Depression in Adolescents Focusing on the Degree of Appearance Stress
Mihye Lim, Myoungjin Kwon
Nursing Reports.2023; 13(1): 518. CrossRef
How final year high school students’ depression develop during COVID-19 in China? A latent class growth modeling analysis
Xinyu Zhang, Guangdong Zhou
Current Psychology.2023;[Epub] CrossRef

Influencing Factors on Health-related Quality of Life among Japanese Middle-aged Marriage-based Immigrant Women in South Korea: A Cross-Sectional Study: Keiko Asami, Duck Hee Chae; J Korean Acad Community Health Nurs. 2022;33(2):188-195. Published online June 30, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.2.188

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Abstract PDF: Purpose
With the first generation of marriage-based immigrant women in East Asia now reaching their middle or old age, the need to focus investigations on their health-related quality of life has arisen. This study aimed to examine the extent to which physical and mental health, and psychosocial variables can predict health-related quality of life among Japanese middle-aged immigrant women. Methods This study has a descriptive cross-sectional design. A convenience sample of 197 Japanese middle-aged marriage-based immigrant women from two regions of South Korea were recruited between December 2017 and March 2018. Participants completed self-administered questionnaires on health-related quality of life, menopausal symptoms, depression, perceived health status, disease morbidity, social support, and acculturation. The data were analyzed using hierarchical multiple regression. Results Depression was the strongest predictor of health-related quality of life, followed by perceived health status, social support, and household income. Menopausal symptoms, presence of disease, and acculturation appeared to have no additional impact on participant’s health-related quality of life. Conclusion In times of rapid growth of global migration and the aging of immigrants in new destination countries, nursing interventions and public health policies for aging marriage-based immigrant women should be prioritized to improve their mental health by facilitating social support and disease management. In addition, social and employment policies that can help immigrant women transition to a healthy midlife are needed.

The Effect of Instrumental Activities of Daily Living and Depression on the Life Satisfaction of the Elderly Living Together during the Daytime in the Rural Areas: Jin Kim, Jeong In Bae, Nam Hyun Cha; J Korean Acad Community Health Nurs. 2022;33(1):96-104. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.96

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Abstract PDF

Purpose
The purpose of this study is to identify the factors affecting the life satisfaction during the communal life of the elderly in rural areas.
Methods
A total of 143 subjects were selected through convenient sampling. Data were collected in self-reporting questionnaires from 1 August to 30 August 2019. The data were analyzed with SPSS/WIN 23.0.
Results
The Instrumental Activities of Daily Living (IADL) was significantly different according to age, education, and cohabitation. Depression was significantly different according to gender, age, education, and cohabitation. Life satisfaction was significantly different according to age, education, religion, and cohabitation. There was a positive correlation between Instrumental Activities of Daily Living and depression, except for life satisfaction. 41.0% of life satisfaction was explained by depression, religion, and IADL.
Conclusion
The results of this study may be useful in understanding the life satisfaction level of elderly communal life and developing more specific programs for mental activity programs, and depression management strategies are required.

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Dual Mediating Effect of Electronic Device Utilization and Life Satisfaction on the Relationship between Instrumental Activities of Daily Living and Depression in Older Adults
Hwa-Soo Koong, Mihye Lim, Kawoun Seo
International Journal of Environmental Research and Public Health.2022; 19(17): 10617. CrossRef

The Mediating Effects of Health Concern and Depression in the Relation between Self-quarantined People’s COVID-19 Stress and Fatigue: Sun Hwa Shin, Eun Hye Lee; J Korean Acad Community Health Nurs. 2022;33(1):43-52. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.43

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Abstract PDF: Purpose
This study was to investigate the mediating effects of health concern and depression on the stress and fatigue of COVID-19 self-quarantine.
Methods
This was a cross-sectional study. A total of 227 people with COVID-19 self-quarantine experience were recruited during May 2021. Participants were invited to complete self-reported questionnaires that measure stress, health concern, depression, fatigue and demographic information. The data obtained were analyzed using multiple regression and dual mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval.
Results
This study analyzed the direct effects of COVID-19 stress on the health concern, depression and fatigue. And COVID-19 stress had indirect effects on their fatigue via health concern and depression. Both health concern and depression had dual mediating effects in the influence of COVID-19 stress on fatigue. In the relationship between COVID-19 stress and fatigue, the mediating effect of depression was significant.
Conclusion
Fatigue due to prolonged COVID-19 can be alleviated by managing stress and mediating health concern and depression, and so therefore active nursing intervention is required.

The Effect of Depression on Quality of Life in Patients with Parkinson's Disease: Mediating Effect of Family Function: Eun Sook Bae, Hye Seung Kang; J Korean Acad Community Health Nurs. 2022;33(1):105-113. Published online March 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.1.105

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Abstract PDF

Purpose
The purpose of this study is to explore the roles and function of family in mediating the relationship between depression and quality of life of patients with Parkinson’s disease (PD). Most studies have found that depression is particularly common in patients with PD and further associated with poor quality of life. Family function, as a mediator, is based on a strength orientation perspective that emphasizes not only their responsibilities and risks but also recuperative powers and growth potential.
Methods
Overall 157 adults with idiopathic Parkinson’s disease were enrolled in this study via outpatient clinic and completed a set of assessment to measure depression using BDI, family APGAR questionnaire, and patients’ quality of life using PDQ-8. Hierarchical multiple regression analysis was conducted to examine the mediating role of family APGAR score in the relationship between BDI and PDQ-8.
Results
Patients' depression, gait disturbance, duration of illness, and family function were statistically significant on quality of life. These factors accounted for 60% of the variance in quality of life. Family function has a partial mediating effect on the relationship between depression and quality of life.
Conclusion
Findings from the study suggest that although PD patients' depression impacts their quality of life, by having strong family function, the extent to which depression impacts the quality of life can be favorably mitigated. Additionally, these outcomes have important implications for future model development regarding PD patients.

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Factors Influencing Suicidal Ideation in Middle Aged Adults: Focused on Gender Differences
Jaerin Kim, Kuem Sun Han
Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(1): 45. CrossRef

The Effect of Senior Elementary School Students’ Emotional Perception Clarity, Emotion Regulation, and Family Relationship on Non-Suicidal Self-Injury and Depression: Ji-hye Shin, Suk-Sun Kim; J Korean Acad Community Health Nurs. 2021;32(4):457-466. Published online December 31, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.4.457

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Abstract PDF: Purpose
The purpose of this study was to examine the correlations among emotional perception clarity, emotion regulation, family relationship, non-suicidal self-injury, and depression, and to determine associated factors of non-suicidal self-injury and depression for senior elementary school students.
Methods
Data were collected from 150 early adolescences in K region, Korea. A self-report questionnaire consisted of Trait Meta-Mood Scale, Cognitive Emotion Regulation Questionnaire, Family Relationship Assessment Scale, Functional Assessment of Self-Mutilation, and Children's Depression Inventory. The data were analyzed using t-test, Pearson’s correlation coefficient, logistic regression, and multiple regression analysis. Results: Non-suicidal self-injury and depression were positively associated with maladaptive emotion regulation strategy and family conflict, but negatively related to emotional perception clarity and family support. Adaptive emotion regulation strategy and family togetherness were only significantly correlated with depression. In logistic regression analysis, significant predictors of non-suicidal self-injury were emotional perception clarity, maladaptive emotion regulation strategy, and family support. Multiple regression analysis found that significant factors of depression were adaptive and maladaptive emotion regulation strategies, which explained 38.0% of the variance.
Conclusion
Our study findings suggest that targeted intervention to reinforce the adaptive emotion regulation strategy and family relationship may prevent non-suicidal self-injury, and depression for senior elementary school students.

Associated Factors of Depression and Suicidal Behaviors among Korean Adolescents: Web-based Survey of the Korea Youth Risk Behavior in 2015~2017: Hyun A Choi, Hye Jin Yang; J Korean Acad Community Health Nurs. 2021;32(3):292-302. Published online September 30, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.3.292

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Abstract PDF

Purpose
Suicide among adolescents is a serious problem worldwide, and especially, the suicide rate of teenagers is increasing rapidly in South Korea. This study was conducted to investigate the factors affecting the respective suicidal behavior in terms of home-environment characteristics, health behavior characteristics, and psychological health characteristics in Korean adolescents.
Methods
The data of the Web-based Survey of the Youth Risk Behavior from 2015 to 2017 collected by the Korea Centers for Disease Control and Prevention (KCDC) was analyzed using multivariable logistic regression analysis.
Results
The influential factors by depression and suicidal behavior (suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA)) were female(adjusted odds ratios [aOR], 1.45, 1.69, 1.30, 2.19), age (aOR 1.03, 0.98, 0.97, 0.90), no family members (aOR 1.21, 1.36, 2.11, 2.32), living with only the father (aOR 1.05, 1.06, 1.07, 1.11), high economic status (aOR 1.15, 1.22, 1.34, 1.46), residence in relatives’ home (aOR 1.6, 1.36, 2.34, 1.97), drinking experience (aOR 1.35, 1.47, 1.57, 1.76), smoking experience (aOR 1.28, 1.30, 1.31, 1.94), hospital treatment experience due to violence (aOR 2.18, 3.33, 6.24, 8.40), bad health status (aOR 1.23, 1.48, 2.00, 2.15), unhappiness (aOR 2.49, 6.14, 6.72, 8.89), and a lot of stress (aOR 6.05, 10.40, 4.86, 5.52).
Conclusion
The suicidal behavior risk screening and prevention program for adolescents should be developed considering the subjective happiness and hospital treatment experience status due to violence that affects suicidal behavior.

Citations

Citations to this article as recorded by

Predictors of suicide ideation among South Korean adolescents: A machine learning approach
Hayoung Kim Donnelly, Yoonsun Han, Suna Kim, Dong Hun Lee
Journal of Affective Disorders.2023; 329: 557. CrossRef
The influences of mental health problem on suicide-related behaviors among adolescents: Based on Korean Youth Health Behavior Survey
Eunok Park
The Journal of Korean Academic Society of Nursing Education.2023; 29(1): 98. CrossRef

Music Program Development Using the Ukulele in Community-dwelling Old Adults and Its Effect: Gyeong Hye Kang, Nam Joo Je; J Korean Acad Community Health Nurs. 2021;32(2):220-231. Published online June 30, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.2.220

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Abstract PDF: Purpose
This study is a pseudo-experimental study of design before and after the non-equivalent control group, which was attempted to verify that the application of the ukulele to the elderly has the effects of reducing depression, improving self-efficacy, strengthening social bonding, and improving cognitive function.
Methods
46 (23 in the experimental group and 23 in the control group) participants were selected. The experimental group was provided with three sessions of a music program using eight Ukuleles for the elderly, while the control group was provided with three sessions for the elderly. IBM SPSS 25.0 was used for data analysis, and the independent t-test, x² -test, and Fisher's exact probability test were performed to verify the homogeneity of the subject's general characteristics. The effect verification after the experimental treatment was analyzed by Fisher's exact probability test, Friedman test, and Mann-Whitney U test.
Results
Depression showed a statistically significant difference between the two groups (F=39.88, p<.001), self-efficacy showed a statistically significant difference between the two groups (z=-4.96, p<.001), social bonding showed a statistically significant difference between the two groups (z=-5.19, p<.001), and cognitive function showed a statistically significant difference between the two groups (z=-3.98, p<.001).
Conclusion
It was found that the ‘Music Program using the Ukulele’ was effective in reducing depression of the elderly, improving self-efficacy, reinforcing social bonding, and improving cognitive function. We hope that the Music Program using the Ukulele can be used in the elderly nursing curriculum in the future, and we suggest it should be applied as a nursing intervention to those who are experiencing cognitive decline.

The Effects of College Students’ Dual Use of Electronic Cigarette and Conventional Cigarette on Depression: Hee Jin Kim, Bok Im Lee, Min Kyung Song, Jin Hwa Lee; J Korean Acad Community Health Nurs. 2021;32(2):186-194. Published online June 30, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.2.186

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Abstract PDF: Purpose
This study was conducted to find out the association between dual-use of the electronic cigarette (EC) and conventional cigarette (CC) and depression among undergraduate students. Methods: The participants of this study were 225 undergraduate students who were attending two universities located in Ulsan metropolitan city. Descriptive statistics and multiple regression were conducted to analyze the data.
Results
Nicotine dependence and depression were significantly higher in the dual-use group than in the single-use group. Dual-use of the EC and CC was significantly associated with depression among undergraduate students. In addition, quality of sleep was significantly associated with depression among undergraduate students.
Conclusion
In order to prevent depression among undergraduate students, it is necessary to improve the awareness of the danger of dual use of the EC and CC.

An Exploratory Study on How and Why Young and Middle-aged Adults Disclose Depressive Feelings to Others: Focusing on the Influence of Perception of Social Norms: Soon Tae An, Han Na Lee; J Korean Acad Community Health Nurs. 2021;32(1):12-23. Published online March 31, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.1.12

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Abstract PDF

Purpose
This study explored how and why young and middle-aged adults disclose depressive feelings to others. In particular, we investigated the role of social norms to see whether using mobile instant messaging (MIM) could lower the perceived barriers of emotional disclosure. Furthermore, the motivations of emotional disclosure via MIM were compared between young and middle-aged adults.
Methods
A total of 255 Koreans (128 middle-aged people, 127 young adults) participated in an online survey. Pearson’s correlation coefficients, paired t-tests, SPSS PROCESS macro, and exploratory factor analysis were used to examine the relationships among the key variables.
Results
The perceived social norms were found to be a significant deterrent in disclosing depressive feelings to others. However, there was a significant interaction effect between generations and perceived social norms. Although young adults with low social norm awareness were more likely to disclose depressive feelings via MIM, emotional disclosure among middle-aged adults increased with higher levels of perceived social norms. Also, different motivations were observed.
Conclusion
The results confirmed the significant effect of social norms as well as generational differences when using MIM as a channel of emotional disclosure.

Citations

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The necessity of emotion management for the general public: a comparison of diagnostic changes in two anger-related psychiatric disorders
Hyun Yoorim, You Myoungsoon
Archives of Psychiatry and Mental Health.2022; 6(1): 048. CrossRef

The Effects of Chronic Diseases, Sleep and Serotonin Concentration on Depression among Elderly People Living in the Community: Eun Jeong Nam, Jin Kyoung Park; J Korean Acad Community Health Nurs. 2020;31(4):472-480. Published online December 31, 2020; DOI: https://doi.org/10.12799/jkachn.2020.31.4.472

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Abstract PDF

Purpose
This study identified the effects of chronic disease number, quality of sleep and, serum serotonin concentration on the elderly’s depression in order to provide basic data for the development of intervention program to effectively prevent and manage depression of the elderly living in the community.
Methods
The study surveyed 207 people aged 65 or older living in the community. The general characteristics of the subjects, the number of chronic diseases, the quality of sleep (PSQI-K), the hematological test (Serotonin) and the depression (K-GDS) were statistically analyzed using SPSS/WIN 23.0.
Results
It was shown that the elderly’s depression differed significantly depending on the number of chronic diseases, the quality of sleep, and serum serotonin concentration, and that the variable that most affected depression was the quality of sleep. Next, the number of chronic diseases and serum serotonin levels were the variables affecting the depression of the elderly. Conclusion: In order to prevent and manage the depression of the elderly in the future, treatment and education for diseases and depression should be provided to the subjects. In particular, nursing interventions are needed to improve the quality of sleep for the elderly. Health care programs should also be provided, such as providing nutritional supplements to provide serotonin and increasing daytime activities.

Citations

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Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals
Young Mi Yoon, Jin Hee Park, Moon Sook Hwang
Journal of Korean Academy of Community Health Nursing.2022; 33(4): 357. CrossRef

The Effect of Unemployment in Depression by Age Group: Using 12 States' Data from the Behavioral Risk Factor Surveillance System: Kyung Mi Woo, Zhi Sun Zhang; J Korean Acad Community Health Nurs. 2020;31(4):436-446. Published online December 31, 2020; DOI: https://doi.org/10.12799/jkachn.2020.31.4.436

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Abstract PDF

Purpose
This study aims to explore the association between unemployment and depression in people from different age groups ranging from 18 to 65 years old.
Methods
This study used a cross-sectional design. We performed bivariate analysis and multivariable logistic regression on the 2010 Behavioral Risk Factor Surveillance System (BRFSS) data from 12 states in the United States.
Results
On a sample comprised of n=53,406 individuals, of whom 2,546 (7.8%) were identified as being depressed and 3,448 (10.6%) as unemployed, we found that individuals aged 61~65 years have a lower depression risk compared to those aged 18-25 after adjusting for other variables including employment status. However, people from 61~65 have higher increased risk of depression when unemployed compared to other age groups in all three models tested (3.95 times higher in unemployed people in model 1, and 2.81 times higher in model 2 and model 3).
Conclusion
Our findings indicate that there may need to be more focus on older adults who are unemployed, with associated support services for their mental health. The results of our study indicate that although older adults are less likely to be unemployed, there are more likely to experience depression if they are unemployed (once other confounding factors are taken into account) than younger adults. Policies and interventions can be developed to address not only the physical difficulties but also the mental challenges with which older adults can be at risk facing in case of unemployment.

Citations

Citations to this article as recorded by

Work-family trajectories and health: A systematic review
Vendula Machů, Iris Arends, Karin Veldman, Ute Bültmann
Advances in Life Course Research.2022; 52: 100466. CrossRef
Self-Rated Health, Demographic Factors and Depressive Symptoms Among Malaysian Adults
Nur Syahirah Mohd Shah, Nik Nur Wahidah Nik Hashim, Nadzirah Ahmad Basri, Siti Fauziah Toha
INTERNATIONAL JOURNAL OF CARE SCHOLARS.2022; 5(1): 29. CrossRef

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