The Effect of Abuse Experience and Coping Styles on Suicidal Ideation in the Elderly

Jeong Hee Jeong; Jung Soon Kim

doi:10.12799/jkachn.2015.26.1.42

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Original Article
The Effect of Abuse Experience and Coping Styles on Suicidal Ideation in the Elderly: Jeong Hee Jeong, Jung Soon Kim; Journal of Korean Academy of Community Health Nursing 2015;26(1):42-51.
DOI: https://doi.org/10.12799/jkachn.2015.26.1.42
Published online: March 31, 2015

¹Department of Nursing, Daedong College, Busan, Korea.

²College of Nursing, Pusan National University, Yangsan, Korea.

• Received: February 11, 2015 • Revised: March 19, 2015 • Accepted: March 24, 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 aim of this study is to determine the impact of abuse experience and coping styles on suicidal ideation in Korean elders.
Methods
Data were collected from the 2011 Korean National Survey on the Elderly. The participants were 10,537 elders aged 65 or older who had replied to the question on suicidal ideation. Socio-demographic and health related factors, abuse experience, and coping style were included as the influence factors of suicidal ideation. Data were analyzed using x2-test and logistic stepwise regression with the SPSS/WIN 21.0 program.
Results
The prevalence of abuse experience among the elders was 12.7% and that of suicidal ideation was 11.2%. Elders with abuse experience (OR=2.79, 95% CI=2.39~3.26) were more likely to have suicidal ideation but those with an active coping style (OR=0.69, 95% CI=0.57~0.84) were less likely to have suicidal ideation even with other influence factors controlled.
Conclusion
Abuse experience of the elderly was a major risk factor that increased suicidal ideation, and active coping style was a protective factor that reduced suicidal ideation. These findings show that careful attention to elderly abuse and education for active coping style are necessary to reduce suicidal ideation among the elderly.
Key Words: Elder abuse; Suicidal ideation; Aged

Table 1

Differences in Suicidal Ideation according to Socio-demographics and Health related Factors, Abuse Experiences and Coping in Elderly (N=10,537)

Characteristics	Categories	n (%)	Suicidal ideation		χ²	p
Characteristics	Categories	n (%)	Yes	No	χ²	p
Suicidal ideation	Yes	1,180 (11.2)
Suicidal ideation	No	9,357 (88.8)
Abuse experiences	Yes	1,335 (12.7)	350 (26.2)	985 (73.8)	346.58	<.001
	Physical abuse	52 (0.5)
	Emotional abuse	990 (9.4)
	Financial abuse	153 (1.5)
	Neglect (caring)	145 (1.4)
	Neglect (financial)	262 (2.5)
	No	9,200 (87.3)	830 (9.0)	8,370 (91.0)
Coping with abuse	Passive (patience)	3,820 (36.5)	476 (12.5)	3,344 (87.5)	33.63	<.001
	Active (asking help)	2,364 (22.6)	186 (7.9)	2,178 (92.1)
	Aggressive (accusation)	4,281 (40.9)	500 (11.7)	3,781 (88.3)
Gender	Male	4,546 (43.1)	449 (9.9)	4,097 (90.1)	14.04	<.001
Gender	Female	5,991 (56.9)	731 (12.2)	5,260 (87.8)	14.04	<.001
Age (year)	65~74	5,892 (55.9)	654 (11.1)	5,238 (88.9)	0.14	.705
Age (year)	≥75	4,641 (44.1)	526 (11.3)	4,115 (88.7)	0.14	.705
Educational level	None	3,323 (31.5)	440 (13.2)	2,883 (86.8)	20.80	<.001
	Elementary school	3,743 (35.5)	375 (10.0)	3,368 (90.0)
	≥Middle school	3,471 (32.9)	365 (10.5)	3.106 (89.5)
Family type	Elderly couple	5,119 (48.6)	472 (9.2)	4,647 (90.8)	55.01	<.001
	Live alone	2,086 (19.8)	315 (15.1)	1,771 (84.9)
	Children living together	2,845 (27.0)	328 (11.5)	2,517 (88.5)
	Others	487 (4.6)	66 (13.6)	421 (86.4)
Spouse	Yes	7,118 (67.6)	704 (9.9)	6,414 (90.1)	37.81	<.001
Spouse	No	3,418 (32.4)	476 (13.9)	2,942 (86.1)	37.81	<.001
Economic status	1 (low)	2,111 (20.0)	345 (16.3)	1,766 (83.7)	97.08	<.001
	2	2,121 (20.1)	249 (11.7)	1,872 (88.3)
	3	2,100 (19.9)	227 (10.8)	1,873 (89.2)
	4	2,112 (20.0)	214 (10.1)	1,898 (89.9)
	5 (high)	2,093 (19.9)	145 (6.9)	1,948 (93.1)
Frequency of meeting families	Everyday	381 (3.6)	40 (10.5)	341 (89.5)	47.90	<.001
	2 to 3 times a week	578 (5.5)	50 (8.7)	528 (91.3)
	1 to 2 times a month	3,524 (33.6)	299 (8.5)	3,225 (91.5)
	1 to 2 times a year	6,014 (57.3)	776 (12.9)	5,238 (87.1)
Frequency of meeting friends	Everyday	4,558 (43.3)	480 (10.5)	4,078 (89.5)	42.62	<.001
	2 to 3 times a week	3,472 (33.0)	350 (10.1)	3,122 (89.9)
	1 to 2 times a month	1,723 (16.4)	205 (11.9)	1,518 (88.1)
	1 to 2 times a year	762 (7.2)	137 (18.0)	625 (82.0)
Depression	Yes	3,068 (29.2)	794 (25.9)	2,274 (74.1)	936.31	<.001
Depression	No	7,448 (70.8)	385 (5.2)	7,063 (94.8)	936.31	<.001
Number of chronic diseases	≤1	3,162 (30.0)	202 (6.4)	2,960 (93.6)	143.75	<.001
	2~3	4,597 (43.6)	529 (11.5)	4,068 (88.5)
	≥4	2,778 (26.4)	450 (16.2)	2,328 (83.8)
Restriction of activity	Yes	1,090 (10.3)	226 (20.7)	864 (79.3)	111.15	<.001
Restriction of activity	No	9,447 (89.7)	954 (10.1)	8,493 (89.9)	111.15	<.001

Table 2

Impact of Abuse Experiences and Coping on Suicidal Ideation in Elderly (N =10,537)

Characteristics	Categories	Step 1		Step 2		Step 3
Characteristics	Categories	OR	95% CI	OR	95% CI	OR	95% CI
Abuse experiences	No	1		1		1
Abuse experiences	Yes	3.54	3.07~4.09^***	3.21	2.77~3.72^***	2.79	2.39~3.26^***
Coping with abuse	Passive (patience)	1		1		1
	Active (asking help)	0.62	0.52~0.74^***	0.68	0.56~0.81^***	0.69	0.57~0.84^***
	Aggressive (accusation)	0.94	0.82~1.08	1.02	0.89~1.18	1.09	0.94~1.27
Gender	Male			1		1
Gender	Female			1.22	1.04~1.42^*	1.12	0.95~1.32
Educational level	None			1		1
	Elementary			0.93	0.79~1.09	1.06	0.90~1.26
	≥Middle			1.07	0.88~1.28	1.45	1.20~1.77^***
Family type	Elderly couple			1		1
	Live alone			1.41	1.06~1.88^*	1.42	1.05~1.90^*
	Children living together			1.84	1.49~2.26^***	1.49	1.19~1.86^***
	others			1.41	1.03~1.93^*	1.21	0.87~1.68
Spouse	Yes			1		1
Spouse	No			0.84	0.66~1.07	0.81	0.63~1.04
Economic status	1 (low)			3.13	2.38~4.10^***	1.78	1.33~2.38^***
	2			2.37	1.83~3.07^***	1.53	1.17~2.01^**
	3			2.22	1.73~2.84^***	1.71	1.31~2.21^***
	4			1.71	1.35~2.17^***	1.44	1.12~1.84^**
	5 (high)			1		1
Frequency of meeting families	Everyday			0.79	0.54~1.14	0.89	0.61~1.31
	2 to 3 times a week			0.80	0.59~1.09	0.96	0.69~1.32
	1 to 2 times a month			0.73	0.63~0.85^***	0.90	0.77~1.05
	1 to 2 times a year			1		1
Frequency of meeting friends	Everyday			0.58	0.46~0.73^***	0.86	0.67~1.09
	2 to 3 times a week			0.57	0.45~0.72^***	0.78	0.61~0.99^*
	1 to 2 times a month			0.74	0.57~0.95^*	0.91	0.70~1.18
	1 to 2 times a year			1		1
Depression	No					1
Depression	Yes					5.05	4.35~5.85^***
Number of chronic diseases	0~1					1
	2~3					1.39	1.15~1.67^***
	≥4					1.61	1.32~1.96^***
Restriction of activity	No					1
Restriction of activity	Yes					1.28	1.06~1.53^**

^*p<.05; ^**p<.01; ^***p<.001.

This study was supported by the Research Institute of Nursing Science, Pusan National University.

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The Effect of Abuse Experience and Coping Styles on Suicidal Ideation in the Elderly

Characteristics	Categories	n (%)	Suicidal ideation		χ²	p
Characteristics	Categories	n (%)	Yes	No	χ²	p
Suicidal ideation	Yes	1,180 (11.2)
Suicidal ideation	No	9,357 (88.8)
Abuse experiences	Yes	1,335 (12.7)	350 (26.2)	985 (73.8)	346.58	<.001
	Physical abuse	52 (0.5)
	Emotional abuse	990 (9.4)
	Financial abuse	153 (1.5)
	Neglect (caring)	145 (1.4)
	Neglect (financial)	262 (2.5)
	No	9,200 (87.3)	830 (9.0)	8,370 (91.0)
Coping with abuse	Passive (patience)	3,820 (36.5)	476 (12.5)	3,344 (87.5)	33.63	<.001
	Active (asking help)	2,364 (22.6)	186 (7.9)	2,178 (92.1)
	Aggressive (accusation)	4,281 (40.9)	500 (11.7)	3,781 (88.3)
Gender	Male	4,546 (43.1)	449 (9.9)	4,097 (90.1)	14.04	<.001
Gender	Female	5,991 (56.9)	731 (12.2)	5,260 (87.8)	14.04	<.001
Age (year)	65~74	5,892 (55.9)	654 (11.1)	5,238 (88.9)	0.14	.705
Age (year)	≥75	4,641 (44.1)	526 (11.3)	4,115 (88.7)	0.14	.705
Educational level	None	3,323 (31.5)	440 (13.2)	2,883 (86.8)	20.80	<.001
	Elementary school	3,743 (35.5)	375 (10.0)	3,368 (90.0)
	≥Middle school	3,471 (32.9)	365 (10.5)	3.106 (89.5)
Family type	Elderly couple	5,119 (48.6)	472 (9.2)	4,647 (90.8)	55.01	<.001
	Live alone	2,086 (19.8)	315 (15.1)	1,771 (84.9)
	Children living together	2,845 (27.0)	328 (11.5)	2,517 (88.5)
	Others	487 (4.6)	66 (13.6)	421 (86.4)
Spouse	Yes	7,118 (67.6)	704 (9.9)	6,414 (90.1)	37.81	<.001
Spouse	No	3,418 (32.4)	476 (13.9)	2,942 (86.1)	37.81	<.001
Economic status	1 (low)	2,111 (20.0)	345 (16.3)	1,766 (83.7)	97.08	<.001
	2	2,121 (20.1)	249 (11.7)	1,872 (88.3)
	3	2,100 (19.9)	227 (10.8)	1,873 (89.2)
	4	2,112 (20.0)	214 (10.1)	1,898 (89.9)
	5 (high)	2,093 (19.9)	145 (6.9)	1,948 (93.1)
Frequency of meeting families	Everyday	381 (3.6)	40 (10.5)	341 (89.5)	47.90	<.001
	2 to 3 times a week	578 (5.5)	50 (8.7)	528 (91.3)
	1 to 2 times a month	3,524 (33.6)	299 (8.5)	3,225 (91.5)
	1 to 2 times a year	6,014 (57.3)	776 (12.9)	5,238 (87.1)
Frequency of meeting friends	Everyday	4,558 (43.3)	480 (10.5)	4,078 (89.5)	42.62	<.001
	2 to 3 times a week	3,472 (33.0)	350 (10.1)	3,122 (89.9)
	1 to 2 times a month	1,723 (16.4)	205 (11.9)	1,518 (88.1)
	1 to 2 times a year	762 (7.2)	137 (18.0)	625 (82.0)
Depression	Yes	3,068 (29.2)	794 (25.9)	2,274 (74.1)	936.31	<.001
Depression	No	7,448 (70.8)	385 (5.2)	7,063 (94.8)	936.31	<.001
Number of chronic diseases	≤1	3,162 (30.0)	202 (6.4)	2,960 (93.6)	143.75	<.001
	2~3	4,597 (43.6)	529 (11.5)	4,068 (88.5)
	≥4	2,778 (26.4)	450 (16.2)	2,328 (83.8)
Restriction of activity	Yes	1,090 (10.3)	226 (20.7)	864 (79.3)	111.15	<.001
Restriction of activity	No	9,447 (89.7)	954 (10.1)	8,493 (89.9)	111.15	<.001

Characteristics	Categories	Step 1		Step 2		Step 3
Characteristics	Categories	OR	95% CI	OR	95% CI	OR	95% CI
Abuse experiences	No	1		1		1
Abuse experiences	Yes	3.54	3.07~4.09^***	3.21	2.77~3.72^***	2.79	2.39~3.26^***
Coping with abuse	Passive (patience)	1		1		1
	Active (asking help)	0.62	0.52~0.74^***	0.68	0.56~0.81^***	0.69	0.57~0.84^***
	Aggressive (accusation)	0.94	0.82~1.08	1.02	0.89~1.18	1.09	0.94~1.27
Gender	Male			1		1
Gender	Female			1.22	1.04~1.42^*	1.12	0.95~1.32
Educational level	None			1		1
	Elementary			0.93	0.79~1.09	1.06	0.90~1.26
	≥Middle			1.07	0.88~1.28	1.45	1.20~1.77^***
Family type	Elderly couple			1		1
	Live alone			1.41	1.06~1.88^*	1.42	1.05~1.90^*
	Children living together			1.84	1.49~2.26^***	1.49	1.19~1.86^***
	others			1.41	1.03~1.93^*	1.21	0.87~1.68
Spouse	Yes			1		1
Spouse	No			0.84	0.66~1.07	0.81	0.63~1.04
Economic status	1 (low)			3.13	2.38~4.10^***	1.78	1.33~2.38^***
	2			2.37	1.83~3.07^***	1.53	1.17~2.01^**
	3			2.22	1.73~2.84^***	1.71	1.31~2.21^***
	4			1.71	1.35~2.17^***	1.44	1.12~1.84^**
	5 (high)			1		1
Frequency of meeting families	Everyday			0.79	0.54~1.14	0.89	0.61~1.31
	2 to 3 times a week			0.80	0.59~1.09	0.96	0.69~1.32
	1 to 2 times a month			0.73	0.63~0.85^***	0.90	0.77~1.05
	1 to 2 times a year			1		1
Frequency of meeting friends	Everyday			0.58	0.46~0.73^***	0.86	0.67~1.09
	2 to 3 times a week			0.57	0.45~0.72^***	0.78	0.61~0.99^*
	1 to 2 times a month			0.74	0.57~0.95^*	0.91	0.70~1.18
	1 to 2 times a year			1		1
Depression	No					1
Depression	Yes					5.05	4.35~5.85^***
Number of chronic diseases	0~1					1
	2~3					1.39	1.15~1.67^***
	≥4					1.61	1.32~1.96^***
Restriction of activity	No					1
Restriction of activity	Yes					1.28	1.06~1.53^**

Table 1 Differences in Suicidal Ideation according to Socio-demographics and Health related Factors, Abuse Experiences and Coping in Elderly (N=10,537)

Table 2 Impact of Abuse Experiences and Coping on Suicidal Ideation in Elderly (N =10,537)

^*p<.05; ^**p<.01; ^***p<.001.