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HOME > J Korean Acad Community Health Nurs > Volume 26(3); 2015 > Article
Original Article
The Effects of a Positive Psychology Improvement Program on Elders' Depression and Death Anxiety
Seung Joo Lim, Hung Sa Lee, Chunmi Kim, Young Go
Journal of Korean Academy of Community Health Nursing 2015;26(3):238-247.
DOI: https://doi.org/10.12799/jkachn.2015.26.3.238
Published online: September 30, 2015

1Department of Nursing, Hoseo University, Research Institute for Basic Science, Asan, Korea.

2Department of Nursing Science, Sunmoon University, Asan, Korea.

3Department of Nursing, Gachon University, Incheon, Korea.

• Received: July 18, 2015   • Revised: September 14, 2015   • Accepted: September 21, 2015

© 2015 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was conducted to investigate the effects of a positive psychology improvement program on elders' depression and death anxiety.
  • Methods
    This was conducted as a quasi-experimental study with non-equivalent control group pretest-posttest design. The participants were community elders aged over 65 recruited by convenient sampling. A total of 94 elders (32 in the individual experimental group, 32 in the collective experimental group, and 30 in the control group) participated. Data were collected between April and September, 2012 and analyzed by using SPSS/WIN 21.
  • Results
    The individual and group approach experimental groups had significantly lower scores of depression than the control group after the treatment (F=7.50, p=.001). For death anxiety, however, only the individual experimental group had a significantly lower score compared to the control group (F=4.56, p=.013).
  • Conclusion
    These results indicate that the positive psychology improvement program was effective in decreasing depression and death anxiety in the elderly. Therefore, the program needs to be applied in a customized way fittingly to the characteristics of the elderly in community, and individually and/or collectively according to its purposes.
Figure 1

Change in depression before and after referring the interaction of economic status.

jkachn-26-238-g001.jpg
Table 1

The Contents of Positive Psychology Improvement Program for the Subjects

Week Subject Contents Methods
Exp. I Exp. II
1st Introduction 1. Introduce program goal and contents. Group approach Individual approach
2. Talking about processing of the program, and a rule.
3. Sign the contract of attending program.
2nd Find the personal strengths 1. Talking about last week daily life. Writing & speaking Writing & talking
2. Finding the personal strengths.
3. Planning the one day schedule in which they use their strengths.
3rd To thank for their family 1. Introduce the last week life using positive thinking. Walking · Writing & speaking Walking · Writing & talking
2. Thinking about thankful things during walking.
3. To write a thanks letter for family.
4th Recall happy experiences 1 1. Remembering the sad experience, and expressing that feeling to positively. Writing & speaking Writing & speech
2. To know the effects of the positive thinking to express good feeling.
5th Recall happy experiences 2 1. See the photos or objects, and talking about good memory with that. Writing & speaking Writing & talking
2. Writing that good feeling and happy experience.
6th Recall happy experiences 3 1. Speaking about the happy time when they felt happiness with their family. Writing & speaking Writing & talking
2. Writing their emotional change.
7th To improve positive thinking 1. To think about the negative experiences of the past time. Speaking & singing Talking & singing
2. Think back to past negative emotions into positive, & Sing together.
8th To do friendly things for family 1. Establish plan to help family members. Writing & speaking Talking
2. Writing their planning helping them.
3. Learning about volunteering.
9th Making bucket list 1. Thinking about 10 things to do that they want (Bucket List). Speaking Talking
2. Speaking feel if they realize the bucket list.
10th Final ceremony 1. Speaking about the personal feeling after finishing the program. Certificate ceremony Certificate ceremony
2. To promise trying to keep the positive thinking and happy mind.
3. Give a certificate.

Exp.=experimental group.

Table 2

Homogeneity of General Characteristics before Intervention (N=94)

Characteristics Categories Exp. I Exp. II Cont. x2 or t p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Age (year) 75.8±6.01 74.5±4.84 75.3±7.20 0.56 .568
Literacy Able 28 (87.5) 27 (84.4) 23 (76.7) 1.35 .508
Unable 4 (12.5) 5 (15.6) 7 (23.3)
Living with family Yes 10 (31.3) 12 (37.5) 15 (50.0) 2.35 .309
No 22 (68.8) 20 (62.5) 15 (50.0)
Economic status Not poor 10 (31.3) 14 (43.8) 19 (63.3) 6.50 .039
Poor 22 (68.8) 18 (56.3) 11 (36.7)
Number of disease 3.0±1.60 2.8±1.51 2.0±0.83 5.31 .007
Disease Hypertension 31 (96.9) 28 (87.5) 21 (70.0)
Diabetes mellitus 15 (46.9) 14 (43.8) 6 (20.0)
Arthritis 29 (90.6) 23 (71.9) 18 (60.0)
CAD 3 (9.4) 2 (6.3) 6 (2.0)
Others 11 (34.4) 12 (37.5) 8 (26.7)
Total 32 (100.0) 32 (100.0) 30 (100.0)

Exp.=experimental group; Cont.=control group; CAD=coronary artery disease.

Table 3

Homogeneity of Depression and Death Anxiety before Intervention (N=94)

Variables Exp. I Exp. II Cont. F p
M±SD M±SD M±SD
Depression 7.6±1.73 7.6±1.94 8.1±2.51 0.40 .670
Death anxiety 39.2±5.53 37.7±6.24 40.3±5.12 1.67 .193

Exp.=experimental group; Cont.=control group; CAD=coronary artery disease.

Table 4

Differences of Depression and Death Anxiety before and after Intervention

Variables Categories Before After Difference before and after ANOVA F (p) F (p) for PE
M±SD M±SD M±SD 95% CI p
Depression Exp. Ia 7.6±1.73 6.0±2.55 -1.6±0.25 -2.19~-1.18 <.001 5.94 (.004)
a, b>c
7.50 (.001)
a, b>c
Exp. IIb 7.6±1.84 6.4±2.61 -1.2±0.27 -1.82~-0.74 <.001
Cont.c 8.1±2.51 8.1±2.56 0.0±0.20 -0.38~0.44 .869
Death anxiety Exp. Ia 39.2±5.53 37.5±3.59 -1.7±0.91 -3.51~0.20 .079 7.17
(.001)
a, b<c
4.56 (.013)
b<c
Exp. IIb 37.7±6.24 37.0±5.37 -0.7±1.33 -3.41~2.03 .610
Cont.c 40.3±5.12 41.4±5.63 1.1±6.62 -1.41~3.53 .385

Exp.=experimental group; Cont.=control group; The absolute program effect among experimental group I, experimental group II, and control group with economic status (ANCOVA: The baseline value and the number of disease were used as covariables and economic status as fixed factors).

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