Life Stress, Social Support, and Antepartum Depression among Married Immigrant Women from Southeast Asia

Hyeon Hee Shin; Yeong Hee Shin

doi:10.12799/jkachn.2015.26.2.108

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Original Article
Life Stress, Social Support, and Antepartum Depression among Married Immigrant Women from Southeast Asia: Hyeon Hee Shin, Yeong Hee Shin; Journal of Korean Academy of Community Health Nursing 2015;26(2):108-118.
DOI: https://doi.org/10.12799/jkachn.2015.26.2.108
Published online: June 30, 2015

¹Graduate School, Department of Nursing, Keimyung University, Daegu, Korea.

²College of Nursing, Keimyung University, Daegu, Korea.

• Received: January 19, 2015 • Revised: April 16, 2015 • Accepted: June 15, 2015

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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Abstract

Abstract

Purpose
The purpose of this study was to investigate life stress, social support, and antepartum depression among Southeast Asian immigrant women married to Korean men.
Methods
Ninety-three subjects were recruited from local women's clinics and multicultural family support centers in D City. The instruments used were the life stress scale, social support scale, and K-EPDS. All the instruments were translated into their corresponding mother languages (Vietnamese, Cambodian, and Philippine) and notarized.
Results
The item mean scores of life stress and social support were 2.65 and 3.17, respectively, on a 5-point Likert scale. The mean score of antepartum depression was 10.16, indicating that they were generally in a depressive state. A positive correlation was observed between life stress and antepartum depression (r=.59, p<.001). Social support was negatively correlated with life stress (r=-.42, p<.001) and antepartum depression (r=-.39, p<.001). The best predictors for antepartum depression were life stress, marital satisfaction, and emotional support, and they explained 43% of the variance.
Conclusion
Antepartum depression in Southeast Asian immigrant brides was significantly associated with life stress as well as lack of emotional support. Emotional support may reduce their life stress and antepartum depression.
Key Words: Pregnant women; Immigrants; Life stress; Social support; Depression

Table 1

Demographic and Pregnancy related Characteristics of Subjects (N=93)

Variables	Characteristics	Categories	n (%) or M±SD	Range
Demographics	Country of birth	Vietnam	65 (69.9)
		Cambodia	19 (20.4)
		Philippines	9 (9.7)
	Length of stay (month)		31.0±33.14	3~147
		0~12	44 (47.3)
		13~24	11 (11.8)
		25~36	10 (10.8)
		≥37	28 (30.1)
	Age (year)		25.6±4.2	19~39
	Education	<Middle school	31 (33.3)
		High school	50 (53.8)
		Community college	8 (8.6)
		≥College	4 (4.3)
	Marital status	Married	86 (92.4)
	Marital status	Divorce, separation, & cohabiting	7 (7.6)
	Family monthly income (10,000 won)	≥100	17 (18.3)
		101~200	44 (47.3)
		201~300	24 (25.8)
		≥301	8 (8.6)
	Employment	Not employed	85 (91.4)
	Employment	Employed	8 (8.6)
	Religious affiliation	Buddhism	58 (62.4)
		Catholic	11 (11.8)
		None	23 (24.7)
		Others	1 (1.1)
	Marital satisfaction	Always satisfied	21 (22.6)
		Satisfied	45 (48.4)
		Occasionally satisfied	27 (29.0)
		Not satisfied	0 (0.0)
	Co-habitants	Husband	34 (36.6)
		Husband & child	23 (24.7)
		Husband & in-laws	21 (22.6)
		Husband, child, & in-laws	5 (5.3)
		Husband, child, in-laws, & relatives	10 (10.8)
Pregnancy-related	Gestational age (week)	1st trimester (1~13)	29 (31.2)	5~40
		2nd trimester (14~26)	32 (34.4)
		3rd trimester (27~40)	32 (34.4)
	No of pregnancy	1st	58 (62.4)
		2nd	28 (30.1)
		3rd	7 (7.5)
	Planned pregnancy	Yes	74 (79.6)
	Planned pregnancy	No	19 (20.4)
	High risk pregnancy^†	Yes	4 (4.3)
	High risk pregnancy^†	No	89 (95.7)

^†Hypertension, gestational DM, twins, irregular uterine contraction, medical problems.

Table 2

Levels of Life Stress, Social Supports, and Antepartum Depression of the Subjects (N=93)

Variables	Categories	n (%)/ Item-M±SD
Life stress	Pregnancy & Child rearing (8 items)	3.0±0.43
	Language & Cultural barriers (7 items)	2.8±0.49
	Financial problems (4 items)	2.6±0.46
	Pastime (3 items)	2.4±0.16
	Relationships (6 items)	2.2±0.27
	Health (2 items)	2.7±0.72
	Grand total item mean	2.7±0.50
Social supports	Instrumental supports (7 items)	3.1±0.34
	Emotional supports (4 items)	3.3±0.31
	Grand total item mean	3.2±0.34
Antepartum depression (scores)	Normal (0~9)	46 (49.5)
	Borderline (10~12)	16 (17.2)
	Severe (>13)	31 (33.3)
	Grand total mean	10.2±5.22

Table 3

Life Stress, Social Supports, and Antepartum Depression in relation to Demographic and Pregnancy related Characteristics of the Subjects (N=93)

Variables	Categories	n	Life stress		Social supports		Antepartum depression
Variables	Categories	n	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Country of birth	Vietnam	65	78.6±22.57	0.35 (.705)	34.3±8.85	1.65 (.197)	9.7±5.40	0.91 (.406)
	Cambodia	19	80.7±16.57		34.4±8.15		11.1±4.09
	Philippine	9	84.6±19.82		39.8±7.12		11.7±6.08
Length of stay (month)	0~12	44	75.4±16.33	2.13 (.103)	36.4±8.71	1.67 (.178)	9.4±4.72	1.89 (.137)
	13~24	11	74.2±15.59		31.3±9.32		8.1±4.35
	25~36	10	88.1±27.71		36.5±8.38		11.4±5.10
	>37	28	85.3±25.41		33.1±8.00		11.7±6.02
Education	<Middle school	31	84.4±22.85	1.08 (.361)	32.5±9.33	2.12 (.103)	10.0±5.83	0.35 (.793)
	High school	50	77.2±20.56		35.1±8.40		10.1±5.01
	Community college	8	73.0±14.69		39.9±5.77		9.8±3.99
	>College	4	84.5±23.57		39.2±5.74		12.8±6.34
Marital status	Married	86	78.7±21.02	2.08 (.153)	35.3±8.35	3.38 (.609)	9.9±5.22	3.31 (.072)
Marital status	Divorce, separation, & cohabiting	7	90.6±20.44	2.08 (.153)	29.1±10.71	3.38 (.609)	13.6±4.24	3.31 (.072)
Family monthly income (10,000 won)	≥100^a	17	83.2±19.57	3.44 (.020)	37.1±9.03	0.89 (.450)	11.1±4.64	3.46 (.020) b>a, c, d^†
	101~200^b	44	84.7±23.76		33.6±8.99		11.5±5.68
	201~300^c	24	72.2±15.58		34.6±7.06		7.6±4.30
	≥301^d	8	65.6±10.35		37.2±10.25		8.6±3.58
Employed	Yes	8	96.8±29.43	2.47 (.015)	31.9±10.68	-1.02 (.312)	12.6±8.00	1.40 (.164)
Employed	No	85	78.0±19.62	2.47 (.015)	35.1±8.44	-1.02 (.312)	9.9±4.89	1.40 (.164)
Religious affiliation	Christianity & others	12	79.4±19.36	0.73 (.484)	39.7±6.67	2.37 (.099)	10.5±6.04	0.37 (.694)
	Buddhism	58	81.4±22.11		33.8±9.08		10.4±5.22
	None	23	75.1±19.47		35.0±7.75		9.4±4.94
Marital satisfaction	Always satisfied^a	21	73.5±17.48	5.37 (.006) a, b<c^†	36.1±10.05	3.15 (.047)	8.0±4.53	9.84 (<.001) a, b<c^†
	Satisfied^b	45	76.0±18.14		36.3±6.90		9.2±4.54
	Occasionally satisfied^c	27	90.2±24.83		31.4±9.40		13.5±5.34
Co-habitants	Husband	34	74.3±16.25	2.01 (.100)	37.0±7.44	2.58 (.043)	8.6±3.74	2.07 (.092)
	Husband & child	23	85.9±26.53		32.7±8.96		12.3±6.00
	Husband & in-laws	21	75.0±14.34		36.7±6.25		9.6±5.32
	Husband, child, & in-laws	5	87.0±24.57		34.6±11.80		10.8±4.92
	Husband, child, in-laws, & relatives	10	88.8±27.58		28.6±11.59		11.6±6.48
Gestational age (week)	1st trimester (1~13)	29	82.7±17.58	0.80 (.454)	34.7±8.43	0.01 (.991)	9.9±5.00	0.11 (.898)
	2nd trimester (14~26)	32	76.0±24.75		34.8±8.59		10.1±5.42
	3rd trimester (27~40)	32	80.3±20.19		35.0±9.12		10.5±5.38
Nor of pregnancy	1st	58	75.8±16.83	2.52 (.086)	35.7±8.64	0.89 (.413)	9.2±4.58	3.00 (.055)
	2nd	28	85.8±26.71		33.1±8.57		11.8±5.80
	3rd	7	86.0±23.86		34.6±9.00		12.1±6.41
Planned pregnancy	Yes	74	79.6±19.97	0.00 (1.000)	34.7±9.03	-0.33 (.744)	9.8±4.94	-1.18 (.241)
Planned pregnancy	No	19	79.6±25.69	0.00 (1.000)	35.4±7.08	-0.33 (.744)	11.4±6.20	-1.18 (.241)
High risk pregnancy^‡	Yes	4	97.8±26.18	1.78 (.078)	32.0±13.49	-0.67 (.504)	11.8±7.50	0.62 (.537)
High risk pregnancy^‡	No	89	78.8±20.66	1.78 (.078)	35.0±8.45	-0.67 (.504)	10.1±5.15	0.62 (.537)

^†Scheffétest; ^‡Hypertension, gestational DM, twins, irregular uterine contraction, medical problems.

Table 4

Relationships among Life Stress, Social Supports, and Antepartum Depression (N=93)

Variables	Life stress	Social supports	Antepartum depression
Life stress	1	-.42 (<.001)	.59 (<.001)
Social supports		1	-.39 (<.001)
Antepartum depression			1

Table 5

Best Predictors of Antepartum Depression (N=93)

Factors	β	t	p
Life stress	.45	5.03	<.001
Marital satisfaction	-.22	-2.62	.010
Emotional support	-.18	-2.08	.040
	R²=.43, F=22.17, p<.001

This study was a partial fulfillment for the requirement of the master of science in nursing for the first author.

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Parity and Psychosocial Risk Factors Increase the Risk of Depression During Pregnancy Among Recent Immigrant Women in Canada
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Journal of Immigrant and Minority Health.2022; 24(3): 570. CrossRef
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Life Stress, Social Support, and Antepartum Depression among Married Immigrant Women from Southeast Asia

Variables	Characteristics	Categories	n (%) or M±SD	Range
Demographics	Country of birth	Vietnam	65 (69.9)
		Cambodia	19 (20.4)
		Philippines	9 (9.7)
	Length of stay (month)		31.0±33.14	3~147
		0~12	44 (47.3)
		13~24	11 (11.8)
		25~36	10 (10.8)
		≥37	28 (30.1)
	Age (year)		25.6±4.2	19~39
	Education	<Middle school	31 (33.3)
		High school	50 (53.8)
		Community college	8 (8.6)
		≥College	4 (4.3)
	Marital status	Married	86 (92.4)
	Marital status	Divorce, separation, & cohabiting	7 (7.6)
	Family monthly income (10,000 won)	≥100	17 (18.3)
		101~200	44 (47.3)
		201~300	24 (25.8)
		≥301	8 (8.6)
	Employment	Not employed	85 (91.4)
	Employment	Employed	8 (8.6)
	Religious affiliation	Buddhism	58 (62.4)
		Catholic	11 (11.8)
		None	23 (24.7)
		Others	1 (1.1)
	Marital satisfaction	Always satisfied	21 (22.6)
		Satisfied	45 (48.4)
		Occasionally satisfied	27 (29.0)
		Not satisfied	0 (0.0)
	Co-habitants	Husband	34 (36.6)
		Husband & child	23 (24.7)
		Husband & in-laws	21 (22.6)
		Husband, child, & in-laws	5 (5.3)
		Husband, child, in-laws, & relatives	10 (10.8)
Pregnancy-related	Gestational age (week)	1st trimester (1~13)	29 (31.2)	5~40
		2nd trimester (14~26)	32 (34.4)
		3rd trimester (27~40)	32 (34.4)
	No of pregnancy	1st	58 (62.4)
		2nd	28 (30.1)
		3rd	7 (7.5)
	Planned pregnancy	Yes	74 (79.6)
	Planned pregnancy	No	19 (20.4)
	High risk pregnancy^†	Yes	4 (4.3)
	High risk pregnancy^†	No	89 (95.7)

Variables	Categories	n (%)/ Item-M±SD
Life stress	Pregnancy & Child rearing (8 items)	3.0±0.43
	Language & Cultural barriers (7 items)	2.8±0.49
	Financial problems (4 items)	2.6±0.46
	Pastime (3 items)	2.4±0.16
	Relationships (6 items)	2.2±0.27
	Health (2 items)	2.7±0.72
	Grand total item mean	2.7±0.50
Social supports	Instrumental supports (7 items)	3.1±0.34
	Emotional supports (4 items)	3.3±0.31
	Grand total item mean	3.2±0.34
Antepartum depression (scores)	Normal (0~9)	46 (49.5)
	Borderline (10~12)	16 (17.2)
	Severe (>13)	31 (33.3)
	Grand total mean	10.2±5.22

Variables	Categories	n	Life stress		Social supports		Antepartum depression
Variables	Categories	n	M±SD	t or F (p)	M±SD	t or F (p)	M±SD	t or F (p)
Country of birth	Vietnam	65	78.6±22.57	0.35 (.705)	34.3±8.85	1.65 (.197)	9.7±5.40	0.91 (.406)
	Cambodia	19	80.7±16.57		34.4±8.15		11.1±4.09
	Philippine	9	84.6±19.82		39.8±7.12		11.7±6.08
Length of stay (month)	0~12	44	75.4±16.33	2.13 (.103)	36.4±8.71	1.67 (.178)	9.4±4.72	1.89 (.137)
	13~24	11	74.2±15.59		31.3±9.32		8.1±4.35
	25~36	10	88.1±27.71		36.5±8.38		11.4±5.10
	>37	28	85.3±25.41		33.1±8.00		11.7±6.02
Education	<Middle school	31	84.4±22.85	1.08 (.361)	32.5±9.33	2.12 (.103)	10.0±5.83	0.35 (.793)
	High school	50	77.2±20.56		35.1±8.40		10.1±5.01
	Community college	8	73.0±14.69		39.9±5.77		9.8±3.99
	>College	4	84.5±23.57		39.2±5.74		12.8±6.34
Marital status	Married	86	78.7±21.02	2.08 (.153)	35.3±8.35	3.38 (.609)	9.9±5.22	3.31 (.072)
Marital status	Divorce, separation, & cohabiting	7	90.6±20.44	2.08 (.153)	29.1±10.71	3.38 (.609)	13.6±4.24	3.31 (.072)
Family monthly income (10,000 won)	≥100^a	17	83.2±19.57	3.44 (.020)	37.1±9.03	0.89 (.450)	11.1±4.64	3.46 (.020) b>a, c, d^†
	101~200^b	44	84.7±23.76		33.6±8.99		11.5±5.68
	201~300^c	24	72.2±15.58		34.6±7.06		7.6±4.30
	≥301^d	8	65.6±10.35		37.2±10.25		8.6±3.58
Employed	Yes	8	96.8±29.43	2.47 (.015)	31.9±10.68	-1.02 (.312)	12.6±8.00	1.40 (.164)
Employed	No	85	78.0±19.62	2.47 (.015)	35.1±8.44	-1.02 (.312)	9.9±4.89	1.40 (.164)
Religious affiliation	Christianity & others	12	79.4±19.36	0.73 (.484)	39.7±6.67	2.37 (.099)	10.5±6.04	0.37 (.694)
	Buddhism	58	81.4±22.11		33.8±9.08		10.4±5.22
	None	23	75.1±19.47		35.0±7.75		9.4±4.94
Marital satisfaction	Always satisfied^a	21	73.5±17.48	5.37 (.006) a, b<c^†	36.1±10.05	3.15 (.047)	8.0±4.53	9.84 (<.001) a, b<c^†
	Satisfied^b	45	76.0±18.14		36.3±6.90		9.2±4.54
	Occasionally satisfied^c	27	90.2±24.83		31.4±9.40		13.5±5.34
Co-habitants	Husband	34	74.3±16.25	2.01 (.100)	37.0±7.44	2.58 (.043)	8.6±3.74	2.07 (.092)
	Husband & child	23	85.9±26.53		32.7±8.96		12.3±6.00
	Husband & in-laws	21	75.0±14.34		36.7±6.25		9.6±5.32
	Husband, child, & in-laws	5	87.0±24.57		34.6±11.80		10.8±4.92
	Husband, child, in-laws, & relatives	10	88.8±27.58		28.6±11.59		11.6±6.48
Gestational age (week)	1st trimester (1~13)	29	82.7±17.58	0.80 (.454)	34.7±8.43	0.01 (.991)	9.9±5.00	0.11 (.898)
	2nd trimester (14~26)	32	76.0±24.75		34.8±8.59		10.1±5.42
	3rd trimester (27~40)	32	80.3±20.19		35.0±9.12		10.5±5.38
Nor of pregnancy	1st	58	75.8±16.83	2.52 (.086)	35.7±8.64	0.89 (.413)	9.2±4.58	3.00 (.055)
	2nd	28	85.8±26.71		33.1±8.57		11.8±5.80
	3rd	7	86.0±23.86		34.6±9.00		12.1±6.41
Planned pregnancy	Yes	74	79.6±19.97	0.00 (1.000)	34.7±9.03	-0.33 (.744)	9.8±4.94	-1.18 (.241)
Planned pregnancy	No	19	79.6±25.69	0.00 (1.000)	35.4±7.08	-0.33 (.744)	11.4±6.20	-1.18 (.241)
High risk pregnancy^‡	Yes	4	97.8±26.18	1.78 (.078)	32.0±13.49	-0.67 (.504)	11.8±7.50	0.62 (.537)
High risk pregnancy^‡	No	89	78.8±20.66	1.78 (.078)	35.0±8.45	-0.67 (.504)	10.1±5.15	0.62 (.537)

Variables	Life stress	Social supports	Antepartum depression
Life stress	1	-.42 (<.001)	.59 (<.001)
Social supports		1	-.39 (<.001)
Antepartum depression			1

Factors	β	t	p
Life stress	.45	5.03	<.001
Marital satisfaction	-.22	-2.62	.010
Emotional support	-.18	-2.08	.040
	R²=.43, F=22.17, p<.001

Table 1 Demographic and Pregnancy related Characteristics of Subjects (N=93)

^†Hypertension, gestational DM, twins, irregular uterine contraction, medical problems.

Table 2 Levels of Life Stress, Social Supports, and Antepartum Depression of the Subjects (N=93)

Table 3 Life Stress, Social Supports, and Antepartum Depression in relation to Demographic and Pregnancy related Characteristics of the Subjects (N=93)

^†Scheffétest; ^‡Hypertension, gestational DM, twins, irregular uterine contraction, medical problems.

Table 4 Relationships among Life Stress, Social Supports, and Antepartum Depression (N=93)