Lee, Kim, and Lee: Factors Influencing Middle-aged Women's Depression

Korean J Health Promot > Volume 16(1); 2016 > Article

Original Article

Korean Journal of Health Promotion 2016;16(1):1-10.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.1.1

Factors Influencing Middle-aged Women's Depression

¹Department of Nursing Science, College of Health Science, Sun Moon University, Asan, Korea

²School of Public Health, Indiana University, Bloomington, IN, USA

Hung Sa Lee¹, Chunmi Kim¹, Dohyun Lee^2,

Corresponding author: Dohyun Lee, MD School of Public Health, Indiana University, 1025 East 7th Street, Bloomington, IN, USA
Tel: +1-41-530-2742, Fax: +1-41-530-2725 E-mail: dohylee@imail.iu.edu

Received October 31, 2015 Accepted February 29, 2016

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.

요약

Background

According to the 2013 statistics, The prevalence rate of depression of women was twice compare to man. Especially, about 53% of depression patients were women over age 40. So this study was conducted to analyze whether women's depression is influenced by their socio‐demographic characteristics, life stress, and social support.

Methods

This study was a descriptive survey, and data were collected during the period from the 1^st to 31^st of August in 2015, using a self‐reporting questionnaire from 196 women aged between 40 and 60 who were sampled from an urban area through convenient sampling.

Results

First, among the sub‐factors of life stress, health‐related & role conflict stress were highest. And life stress was higher when social support was low. Second, social support was higher when exercise was done regularly. Lastly, the results of structural equation modeling analysis showed that life stress and social support had a significant effect on depression. Life stress had a significant direct effect on social support, and social support had a significant direct effect on depression. Life stress had an indirect effect on depression through the medium of social support, and their explanatory power was R²＝0.68 and R²＝0.64, respectively.

Conclusions

This study confirmed that depression was in a very close relationship with life stress and social support. This finding suggests that future health policies for managing middle‐aged women's depression should focus on reducing life stress and reinforcing their social support.

Keywords: Women, Stress, Social support, Depression

Figure 1.

Research model and standardized factor loading values. Model fit analysis by SEM; df＝23, χ²＝62.12, χ²/df＝2.70, GFI＝0.93, AGFI＝0.90, RMSEA＝0.09, NFI＝0.91, CFI＝0.94, TLI＝0.91.

Table 1.

Participants' general characteristics

Characteristics	Total (N＝196)	Mean (SD)
Age, y		48.16 (4.47)
40–49	129 (65.8)
50–59	67 (34.2)
Spouse
Yes	187 (95.4)
No	9 (4.6)
Education level
Junior school	14 (7.1)
High school	115 (58.7)
College	67 (34.2)
Monthly income (thousand won)
≤ 2,000	34 (17.3)
2,001–4,000	96 (49.0)
≥ 4,001	66 (33.7)
Religion
No	76 (38.8)
Yes	120 (61.2)
Children
0–1	31 (15.9)
2	125 (63.8)
≥ 3	40 (20.4)
Health status
Unhealthy	17 (8.7)
Middle	123 (62.8)
Healthy	56 (28.6)
Job
No	85 (43.4)
Yes	111 (56.6)
Menopausal age, y		49.88 (3.63)
Menopause	54 (27.6)
Not menopause	142 (72.4)
Exercise
No	146 (74.5)
Yes	50 (25.5)

Abbreviation: SD, standard deviation. Values are presented as N (%) or mean (SD) unless otherwise indicated.

Table 2.

Differences of depression according to the genera characteristics (N＝196)

Characteristics	Depression
Characteristics	Mean (SD)	t (F)	P
Age, y
40–49	44.23 (12.72)	–1.50	0.134
50–59	47.13 (12.98)
Spouse
Yes	44.82 (12.65)	–1.87	0.501
No	53.44 (15.11)
Education
Junior school (A)	56.35 (12.64)	6.96	0.001
High school (B)	45.34 (11.96)		(A＞B)
College (B)	42.68 (12.28)
Monthly income, thousand won
≤ 2,000	44.61 (9.89)	2.31	0.101
2,001–4,000	46.20 (13.42)
≥ 4,001	42.56 (13.07)
Religion
No	46.28 (12.66)	0.92	0.357
Yes	44.55 (12.98)
Children
0–1	44.16 (19.85)	0.20	0.814
2	45.43 (12.69)
≥ 3	43.95 (13.44)
Health status
Unhealthy (A)	57.29 (13.29)	15.22	＜0.001
Middle (B)	46.14 (11.39)	(	A＞B＞C)
Healthy (C)	39.53 (12.91)
Job
No	45.75 (13.68)	0.50	0.616
Yes	44.81 (12.23)
Menopause
Yes	47.35 (13.54)	1.43	0.154
No	44.41 (12.53)
Exercise
No	44.97 (12.76)	–0.45	0.650
Yes	45.94 (13.21)
Total	45.22 (12.85)

Abbreviation: SD, standard deviation. Calculated by t-test, ANOVA, and Scheffé test.

Table 3.

The scores of life stress and social support of subjects (N＝196)

Contents	Score
Contents	Mean (SD)
Life stress	2.10 (0.58)
Family stress	2.03 (0.64)
Economy stress	2.07 (0.73)
Health stress	2.16 (0.70)
Role stress	2.15 (0.63)
Social support	3.68 (0.72)
Family support	3.79 (0.84)
My family helps me when I have problems.	3.90 (0.99)
Our family knows the friends of each other and helps well.	3.62 (0.98)
Our family want to be together with me at any time.	3.70 (1.01)
My family goes through very friendly with each other.	3.90 (0.92)
My family is very friendly each other.	3.88 (0.89)
I discuss with my family before I decide something.	3.81 (1.02)
Our family participate together to something to do.	3.72 (1.03)
Other's support	3.55 (0.75)
There is someone to talk with when I have problems.	3.87 (0.93)
I have someone to help chores.	3.60 (1.02)
I have someone to give me advices and information about children and husband.	3.52 (1.00)
There are people who spend a time in doing a hobby and leisure activities with me.	3.63 (1.01)
There are people who help me when I want to have social network.	3.52 (0.97)
There are people who support me economically.	3.21 (1.16)

Abbreviation: SD, standard deviation. Values are presented as mean (SD).

Table 4.

Correlations between study variables included in our research model (N＝196)

Variables	Exercise^a	Menopausal age	Life stress	Social support	Depression
Variables	r (P)	r (P)	r (P)	r (P)	r (P)
Exercise	1
Menopausal age	0.16 (0.023)	1
Life stress	–0.08 (0.136)	0.04 (0.525)	1
Social support	0.16 (0.012)	–0.05 (0.460)	–0.45 (0.001)	1
Depression	0.04 (0.570)	0.10 (0.154)	0.61 (＜0.001)	–0.45 (＜0.001)	1

^a Exercise was calculated by Spearman's correlation, others by Pearson's correlation coefficient.

Table 5.

Standardized regression weights and correlation

Constructs		Standardized	Standard errors	Critical ratios	P	Squared multiple
Dependent variables	Independent variables	estimates (β)	Standard errors	Critical ratios	P	correlation (R²)
Life stress	Exercise	–0.09	0.44	–1.20	0.228
	Menopausal age	0.05	0.43	0.70	0.481
Social support	Life stress	–0.83	0.12	–5.43	＜0.001	0.68
Depression	Exercise	0.10	1.59	1.81	0.070	0.64
	Social support	–0.80	0.88	–5.53	＜0.001
	Menopausal age	0.06	1.55	1.02	0.307

Values are calculated by Structural Equation Model Analysis.

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