Research in Community and Public Health Nursing

Original Articles

[English] Physical Mobility and Life Satisfaction Among Urban Older Adults During Covid-19 Pandemic: Multiple Mediating Effects on Social Participation and Depression: Juah Kim, Hyori Kim, Jiyeon Ha; Res Community Public Health Nurs. 2026;37(1):113-124. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2026.01578

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Abstract PDF: Purpose
Life satisfaction, a key component of subjective well-being, is closely associated with successful aging and health in older adults. This study examined the effects of physical mobility on life satisfaction and investigated whether social participation and depression mediate this relationship among community-dwelling older adults during the COVID-19 pandemic.
Methods
A cross-sectional survey was conducted from December 2020 to January 2021 among 245 older adults aged 65 or older in urban South Korea. Standardized tools assessed physical mobility, social participation, depression, and life satisfaction. Correlation analyses and multiple mediation models using PROCESS macro v4.1 were employed.
Results
Physical mobility (r=.25, p<.001) and social participation (r=.18, p<.001) exhibited statistically significant positive correlations with life satisfaction. Conversely, depression (r=-.61, p<.001) was negatively correlated with life satisfaction. Notably, physical mobility did not directly influence life satisfaction; rather, its effect was mediated through increased social participation and reduced depression (B=0.01, bootstrap 95% CI: 0.00-0.02).
Conclusion
These findings underscore the need for comprehensive approaches that integrate physical, social, and mental health strategies to enhance life satisfaction in older adults—particularly in times of societal disruption such as COVID-19 pandemic.

[English] Associations of Biochemical Nutritional Indicators with Frailty Among Older Adults Using Community Welfare Centers: A Cross-Sectional Study: Eunjeong Nam, Jin Kyoung Park, Hye Seung Choi; Res Community Public Health Nurs. 2026;37(1):71-80. Published online March 31, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01438

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Abstract PDF: Purpose
Nutritional imbalance has been associated with frailty in older adults. This study aimed to examine the relationships between biochemical nutritional indicators and frailty among community-dwelling older adults, with the long-term goal of informing the development of frailty and exacerbation prevention programs.
Methods
Data were collected from 192 community-dwelling older adults aged ≥65 years across three cities from August to September, 2019. Anthropometric measures, blood tests, and structured questionnaires were used to collect data. Study variables included general characteristics, appetite, body mass index, biochemical nutritional indicators (protein, carbohydrates, vitamins, and electrolytes), and frailty. Data were analyzed using descriptive statistics, t-tests, ANOVA, and hierarchical regression.
Results
Frailty differed significantly according to age, number of chronic diseases, appetite, vitamin D, and calcium. These variables together explained 35% of the variance in frailty.
Conclusion
To prevent frailty in older adults, age, number of chronic diseases, appetite, vitamin D, and calcium levels should be continuously monitored, and nursing interventions that manage diet, provide nutritional supplements, and provide oral medication are needed to maintain normal vitamin D and calcium levels in community-dwelling older adults.

[English] How Many Older Koreans Are at Risk? National Estimates of Food Insecurity and Sarcopenia Risk Based on ESPEN Guidelines: Dasom Kim; Res Community Public Health Nurs. 2026;37(1):61-70. Published online February 26, 2026; DOI: https://doi.org/10.12799/rcphn.2025.01270

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Abstract PDF: Purpose
Food insecurity and inadequate nutrient intake are major public health concerns in aging populations. Sarcopenia is influenced by nutrition and socioeconomic status. This study aimed to estimate the prevalence of food insecurity and sarcopenia risk among Korean older adults and examine associations with socioeconomic and lifestyle factors.
Methods
A cross-sectional analysis of the 2019 Korea National Health and Nutrition Examination Survey (KNHANES) was conducted using a complex sample design. A total of 1,365 adults aged ≥65 years were included. Food insecurity, nutrient adequacy per European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines, and sarcopenia risk (defined by low handgrip strength) were assessed. Logistic regression determined associations with socioeconomic status, diet, and exercise.
Results
Food insecurity affected 15.7% of older adults (weighted percentage). An estimated 40.9% had inadequate nutrient intake, and 24.6% were at risk of sarcopenia. Lower income was significantly associated with sarcopenia risk; compared to the lowest quintile, those in the second quintile had lower odds (OR = 0.61, 95% CI: 0.43–0.87). Lower education also increased risk, with high school graduates showing lower odds (OR = 0.45, 95% CI: 0.26–0.78) compared to those with elementary education or less. Notably, nutrient adequacy based on ESPEN guidelines was not significantly associated with sarcopenia risk. Resistance exercise ≥3 days/week was protective (OR = 0.48, 95% CI: 0.28–0.82).
Conclusions
Socioeconomic disadvantage and physical inactivity are primary determinants of sarcopenia risk in Korean older adults. The lack of association between ESPEN-based nutrient adequacy and sarcopenia risk highlights the need to address structural socioeconomic determinants beyond simple nutrient supplementation.

[English] Factors Associated with Work Engagement of Home-Visit Care Workers Based on Job Demands–Resources Model: A Quantitative Cross-Sectional Study: Hanyi Lee, Hyeon Sik Chu; Res Community Public Health Nurs. 2025;36(4):396-406. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01221

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Abstract PDF: Purpose
The aim of this study is to identify the factors associated with work engagement among home-visit care workers in South Korea, the Job Demands–Resources (JD-R) model was used as a guiding theoretical framework. Methods: This descriptive correlational study used secondary data from the 2020 Survey on the Service Environment of Home Care Workers by the Korea Institute for Health and Social Affairs. Participants were 509 certified home-visit care workers from Seoul and Chungcheong, each caring for one recipient. Measures included emotional labor, self-rated health, relationship quality with care recipients, and work engagement. Data were analyzed using hierarchical multiple regression. Results: Work engagement was negatively associated with emotional labor and positively associated with self-rated health, relationship quality with care recipient, and satisfaction with the care environment. Emotional labor remained a significant negative relationship, while self-rated health and relationship quality with care recipients emerged as key positive relationships. The final model explained 17.0% of the variance. Conclusions: These findings support the applicability of the JD-R model in understanding work engagement among home-visit care workers. Although job demands such as emotional labor may hinder engagement, individual and relational resources play protective and motivating roles. The diminished influence of physical and environmental factors in the presence of strong personal resources highlights the importance of a balanced approach that strengthens the emotional, physical, and relational capacities to support sustainable engagement.

[English] Impact of Leisure Activities on Physical, Mental, and Cognitive Function Among Older Adults: Gyeong-Suk Jeon, Kyungwon Choi; Res Community Public Health Nurs. 2025;36(4):420-434. Published online December 31, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01165

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Abstract PDF Supplementary Material: Purpose
This study aimed to classify types of leisure activity and examine their associations with self-rated health, depression and cognitive function among older adults in Korea.
Methods
Data were drawn from 7,804 participants in the 2020 National Survey of Older Koreans. Types of leisure activity were identified through K-means cluster analysis using respondents' first and second choices of leisure activities. Multivariable logistic regression analyses, adjusted for sociodemographic and health-related covariates were conducted to assess the primary associations between leisure types and dichotomized health outcomes.
Results
Five distinct groups were identified: religious activity-oriented, varied physical activity-oriented, walking and rest-oriented, gardening and sedentary activity-oriented, and social activity-oriented. Compared to the religious activity-oriented group, the varied physical activity-oriented (OR=0.71, 95% CI=0.59–0.85), walking and rest-oriented (OR=0.55, 95% CI=0.39–0.77), and social activity-oriented groups (OR=0.46, 95% CI=0.29–0.72) showed significantly lower odds of poor self-rated health. All four types exhibited significantly lower odds of depression; notably, the social activity-oriented (OR=0.40, 95% CI=0.28–0.57) and walking and rest-oriented (OR=0.40, 95% CI=0.28–0.57) groups showed the strongest protective effect. None of the leisure groups showed a significant link to cognitive function risk when compared with the religious activity-oriented group. Conclusions: Leisure patterns involving diverse physical activities and social engagement are strongly associated with favorable health outcomes. Health promotion strategies should prioritize accessible community-based programs that encourage diverse physical and socially engaging activities, while developing targeted interventions (e.g., combining cognitive stimulation with sedentary leisure) to reduce disparities and mitigate cognitive risk among older adults.

[English] The Mediating Effect of Depressive Symptoms on the Relationship between Activity Engagement and Cognitive Function among Older Adults: Da Eun Kim, Bokyoung Kim; Res Community Public Health Nurs. 2025;36(3):328-338. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01179

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Abstract PDF: Purpose
Engaging in activities in later life is beneficial for maintaining cognitive function. This study examined whether depressive symptoms mediate the relationship between activity engagement and cognitive function among older adults. Methods: A secondary data analysis was conducted using the 2022 Health and Retirement Study (HRS), including 2,741 participants aged 65 years and older. Mediation analyses were performed using SPSS PROCESS Macro Model 4 with bootstrapping. Results: A partial mediating effect of depressive symptoms was identified in the relationship between different types of activity engagement (e.g., physical, cognitive, and social activities) and cognitive function. The standardized indirect effects of depressive symptoms were β=.02 (95% boot CI=0.01 to 0.03) for physical activity, β=.01 (95% boot CI=0.01 to 0.02) for cognitive activity, and β=.02 (95% boot CI=0.01 to 0.03) for social activity. Conclusion: These findings suggest that activity engagement may enhance cognitive function by reducing depressive symptoms among older adults. The results highlight the importance of developing and strengthening community-based physical, cognitive, and social activity programs that incorporate depressive symptom management as practical strategies to prevent cognitive decline in older adults.

[English] Path Analysis of Factors Influencing Health-Related Quality of Life for Community-Dwelling Vulnerable Older Adults with Chronic Diseases in Korea: Hyun-Ju Lee; Res Community Public Health Nurs. 2025;36(3):315-327. Published online September 30, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01067

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Abstract PDF: Purpose
This study aims to construct and verify a path model for the factors affecting health-related quality of life (HRQoL) in community-dwelling vulnerable older adults with chronic diseases in Korea. Methods: The sample included 195 community-dwelling vulnerable adults aged 65 years and above with chronic diseases in Korea. Structured questionnaires were collected from April to June 2022. Data were analyzed using SPSS 28.0 and AMOS 28.0 programs. Results: The hypothesized path model significantly explained HRQoL in community-dwelling vulnerable older adults with chronic diseases, with a high explanatory power (48.0%). Self-rated health (SRH) and self-efficacy for managing chronic disease (SEMCD) had a significant direct effect on HRQoL. The number of diseases, depressive symptoms, social support, and digital literacy indirectly affected HRQoL. Conclusion: To improve HRQoL in community-dwelling vulnerable older adults with chronic diseases, integrated community health-management programs should focus on enhancing SEMCD and SRH, while incorporating depression screening, social support, and digital literacy education.

[English] The Effect of Digital Health Literacy, Self-Efficacy on Self-Care Behaviors among Community-Dwelling Elderly: Focusing on Gyeongsangbuk-do: Hyojin Son, Youngran Han; Res Community Public Health Nurs. 2025;36(1):59-72. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00801

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4 Citations

Abstract PDF

Purpose
This study aimed to explore the relationship between digital health literacy, self-efficacy, and self-care behaviors, and to identify the effects of digital health literacy and self-efficacy on self-care behaviors among the community-dwelling elderly.
Methods
This descriptive study used self-reported questionnaires and was conducted from January to April 2024. This study included 197 participants aged 65 or older, residing in nine cities and counties within Gyeongsangbuk-do. Data were analyzed using SPSS/WIN 23.0, employing descriptive statistics, t-test, One-way ANOVA, Scheffé tests, Pearson correlation coefficients, and hierarchical regression analysis.
Results
The average scores were as follows: digital health literacy, 21.97±8.38 (out of 40 points); self-efficacy, 3.27±0.72 (out of 5 points); and self-care behaviors, 70.22±10.55 (out of 96 points). Self-efficacy (β=.32, p<.001) was identified as the primary factor influencing self-care behaviors. Additionally, job (β=-.20, p=.002) and gender (β=-.18, p=.007) were also significant factors. These factors explained 22.8% of the variance of self-care behaviors.
Conclusion
Based on the above study results, we found that to promote self-care behaviors of community-dwelling elderly people, developing and implementing training programs that enhance self- efficacy are imperative. Furthermore, efforts should be made to overcome regional disparities by developing and implementing various policies and programs at the government, local government, and community levels to enhance the digital health literacy of the elderly.

Citations

Citations to this article as recorded by

The effect of mothers' digital health literacy on fever management: The mediating role of perceived maternal self-efficacy
Fatoş Uncu, Hasan Evcimen, Elanur Bulut
Journal of Pediatric Nursing.2026; 87: 58. CrossRef
Anxiety and its associations with digital health literacy, self-efficacy and self-care habits among Indian university students
Brency A. Parekh, Ritu Sharma
Health Education.2026; : 1. CrossRef
The Influence of e-Health Literacy, Technostress, and Subjective Health Status on Health Promotion Behaviors among Older Adults
Whang Sun A
Journal of Korea Society for Simulation in Nursing.2025; 13(1): 71. CrossRef
Variables influencing digital health literacy in older adults: a systematic review and meta-analysis
Jin Hwa Park, Eun Ju Mun
Journal of Korean Academy of Nursing.2025; 55(4): 651. CrossRef

[English] Digital Health Literacy and Associated Factors Among Older Adults Living Alone in South Korea: A Cross-Sectional Study: Minhwa Hwang, Gahye Kim, Seonghyeon Lee, Yeon-Hwan Park; Res Community Public Health Nurs. 2024;35(4):389-400. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00766

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3 Citations

Abstract PDF

Purpose
This study aimed to examine the level of digital health literacy and identify factors associated with digital health literacy among older adults living alone in South Korea.
Methods
A cross-sectional study was conducted on 140 older adults aged 65 and above who live alone. Descriptive statistics and non-parametric methods were used to explore the relationship between digital health literacy and independent variables. A generalized linear model was used to identify factors associated with digital health literacy.
Results
Among 140 smartphone-owning older adults living alone, 52.1% were using the Internet via digital devices, and the participants’ average digital health literacy score was 6.64±7.46. Univariate analysis results showed significant differences in digital health literacy according to age, education level, and multimorbidity. The factors associated with digital health literacy were identified as gender (B=−0.36, p=.031), age (B=−0.06, p<.001), education level (B=0.12, p<.001), and sleep problems (B=−0.06, p=.006).
Conclusion
Despite widespread Internet and smartphone use, older adults living alone with chronic diseases showed low levels of digital health literacy, which were significantly associated with gender, age, education level, and sleep problems. Enhancing digital health literacy among vulnerable populations is crucial for the effective implementation of digital health services. Collaborative efforts, including tailored digital health interventions to enhance the digital health literacy of vulnerable populations and supportive policies, are essential to bridge the digital divide and promote health equity.

Citations

Citations to this article as recorded by

Explainable Machine Learning for Assessing Digital Health Literacy in Older Adults: Validation and Development of a Two-Stage Model Integrating Performance-Based and Self-Assessed Indicators
Choonghee Park, Jiyeon Park, Seora Kim, Ye Seul Bae, Jae-Heon Kang, Tae-Min Kim, Ji-Won Chun
JMIR Medical Informatics.2026; 14: e86171. CrossRef
Determinants of self-reported health literacy among older adults in South Korea: a cross-sectional study
Jieun Shin, Seunghui Baek
Frontiers in Public Health.2025;[Epub] CrossRef
Analysis of factors influencing digital literacy of rural elderly people-evidence from China
Zhaoting Zhang
BMC Public Health.2025;[Epub] CrossRef

[English] Malnutrition Risk in Community-Dwelling Older Adults with Dual Sensory Declines: Focusing on Social Determinants of Health: Ha Na Jeong; Res Community Public Health Nurs. 2024;35(4):325-338. Published online December 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00675

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1 Citations

Abstract PDF

Purpose
As the number of older adults with dual sensory declines is increasing, they face a higher risk of malnutrition compared to those without these declines. Although social determinants of health can influence malnutrition, there has been limited research on this population. This study aimed to explore the association between malnutrition risk and social determinants of health among older adults with dual sensory declines.
Methods
The study is a cross-sectional analysis using data from the 2020 National Survey of Older Koreans. Binomial logistic regression analysis was conducted to examine the association between malnutrition risk and social determinants of health. These determinants include structural determinants, social capital, and intermediary determinants among older adults with dual sensory declines.
Results
1,771 with dual sensory declines were included in the analysis. Among the structural determinants, women (odds ratio [OR]=1.75, 95% confidential interval [CI] 1.19~2.57) and national basic livelihood security system recipients (OR=1.87, 95% CI 1.13~3.07) were significantly associated with malnutrition risk. In social capital, social non-participation (OR=1.33, 95% CI 1.03~1.73) and social network size (OR=0.95, 95% CI 0.92~0.98), Among intermediary determinants, living dissatisfaction (OR=1.61, 95% CI 1.16~2.23), environmental satisfaction (OR=0.95, 95% CI 0.92~0.99), household debt (OR=1.59, 95% CI 1.02~2.49) and comorbidity (OR=3.85, 95% CI 2.98~4.97) were significantly related to malnutrition risk.
Conclusion
These findings highlight the critical need to address key social determinants of health to enhance nutritional outcomes for older adults with dual sensory declines.

Citations

Citations to this article as recorded by

Disability Acceptance as a Mediator Between Social Network Size and Disaster Response Capacity in Adults With Physical Disabilities in South Korea: Findings From the National Survey
Ha Na Jeong, Sun Ju Chang, Gi Won Choi
Journal of Contingencies and Crisis Management.2025;[Epub] CrossRef

[English] Analysis of Educational Needs of Home Care Nurses: Utilizing Borich’s Needs Assessment and the Locus for Focus Model: Dasom Kim, Hyeongsu Kim, Young Ko; Res Community Public Health Nurs. 2024;35(3):240-253. Published online September 30, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00605

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2 Citations

Abstract PDF

Purpose
This study analyzed educational needs of home care nurses to improve the quality of home care service and identify priority educational subjects.
Methods
This study analyzed the training priorities of 54 home care nurses working at community service centers or public health centers in Seoul, Korea, using the Borich Needs Assessment and the Locus of Focus model. The home care nurses’ tasks were categorized into 21 tasks and 85 task elements.
Results
Six priority educational subjects were identified: 1) health assessment and monitoring, 2) nursing records and information management, 3) health education and counseling techniques, 4) home care supplies management, 5) recipient identification and communication skills, and 6) care recipient classification and management. Activities related to one-on-one health management, such as health screening, measurements, and disease management counseling, were found to be high priorities. In contrast, small group program planning and operation were rated as a low priority.
Conclusion
This study underscores the importance of incorporating identified educational needs into training curricula for home care nurses. Regular assessment and integration of these needs into educational programs are crucial for enhancing nursing competence and service quality.

Citations

Citations to this article as recorded by

Simulation Needs Assessment Project (SNAP): Use of the Borich Model in Undergraduate Medical Education
Samantha Wong, Bradson Serikawa, Meliza Roman, Nicole Hada, Jannet Lee-Jayaram, Benjamin W. Berg
International Medical Education.2025; 4(4): 42. CrossRef
Analysis of Educational Needs Based on Job Competencies among Public Health Center Personnel Involved in Integrated Health Promotion Programs
Bongjeong Kim, Jooeun Hyun, Guna Lee
Journal of Korean Public Health Nursing.2025; 39(3): 293. CrossRef

[English] Prediction model of health checkup and cancer screening experience of elderly population using 2021 Community Health Survey: Myeunghee Han; Res Community Public Health Nurs. 2024;35(2):140-155. Published online June 28, 2024; DOI: https://doi.org/10.12799/rcphn.2024.00500

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Abstract PDF: Purpose
This study was conducted to build a decision tree model composed of factors that predict whether or not the elderly population underwent health or cancer screening using the 2021 community health survey.
Methods
This study included 74,434 and 74,417 subjects who answered for experience of health checkup or cancer screening, respectively. This study used Chi-squared test, independent t-tests, and decision tree analysis to analyze the data.
Results
Regarding the health checkup, 78.1% of women received a health checkup, and among women, those aged 65-74 years who were not recipients of the basic livelihood service showed the highest participation rate of 85.0%. In case of men, those who were married and had no problems in daily activity showed the highest participation rate of 81.4%. In the case of cancer screening, for women, those who were 65-74 years old and were nonrecipients of basic livelihood benefits showed the highest participation rate of 75.3%. For men, the cancer screening rate was the highest at 74.3% in those who had no problems with mobility and were married.
Conclusion
It was found that the general and health characteristics of the elderly had a great influence on the health checkup and cancer screening. In order to develop a more improved screening system, screening rates and effects should be continuously observed and studied.

[English] Factors influencing dementia preventive behaviors of older adults at high risk of dementia: Application of extended health belief model: So Hee Jung, Mee Ock Gu; Res Community Public Health Nurs. 2024;35(1):22-36. Published online March 29, 2024; DOI: https://doi.org/10.12799/rcphn.2023.00402

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Abstract PDF: Purpose
The purpose of this study was to identify the factors influencing dementia preventive behaviors of older adults at high risk of dementia based on extended health belief model.
Methods
The subjects were 140 older adults at high risk of dementia living in H-gun, Gyeongsangnam-do, Republic of Korea. The data was collected from April 21 to May 28, 2021 by using structured questionnaires. The data was analyzed using t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical multiple regression by SPSS/WIN 24.0 program.
Results
The mean score of dementia preventive behaviors of older adults at high risk of dementia was 3.47±0.49 (range 1-5). The factors influencing dementia preventive behaviors were self-efficacy (β=.82, p<.001), cues to action(β=.17, p=.013), ages 75-79 (β=0.35, p=.003; reference: ages 65-69), ages ≥80 (β=0.27, p=.021; reference: ages 65-69), which together explained 82.0% of total variance in dementia preventive behaviors (F=25.21, p<.001).
Conclusion
Based on the results of this study, it is highly recommended to develop and apply the dementia prevention program that can increase self-efficacy and cues to action for improving dementia preventive behavior of older adults at high risk of dementia.

[English] Experience Related to Acceptance of Illness among People with Early-Stage Dementia: A Phenomenological Study: Jaewon Park; Res Community Public Health Nurs. 2023;34(4):241-254. Published online December 29, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00157

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Abstract PDF: Purpose
This study aims to describe the structure of the experience related to acceptance of illness among people with early-stage dementia (PWED).
Methods
Participants were six people who had Alzheimer’s disease or vascular dementia. Their clinical dementia rating scores were 0.5 or 1. Data were collected from individual in-depth interviews. The collected qualitative data were analyzed based on Giorgi’s descriptive phenomenological method.
Results
The five constituents and eight sub-constituents were derived from the experience related to acceptance of illness among PWED; ‘Facing the changed me’, ‘Facing changes in roles and relationships with others’, ‘Conflict between recognizing and denying dementia in daily life’, ‘Perceiving the limits and accepting dementia’, and ‘Reconstructing daily life for the prolongation of the current health status’.
Conclusion
This study contributes to the expansion of the in-depth understanding of the experience related to acceptance of illness among PWED. The results of the study will be helpful as basic data for community health nurses to develop interventions to improve acceptance of illness of PWED.

[English] Gender Differences in Older Adults’ Muscle Strength and Depressive Symptoms: A Relationship Mediated Through Perceived Stress: Gyeong A Kang, Jihye Shin, Ju Young Yoon; Res Community Public Health Nurs. 2023;34(3):196-204. Published online September 27, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00164

6,265 View
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3 Citations

Abstract PDF

Purpose
Preventing the effects of physical vulnerability is a practical approach to improving older adults’ depressive symptoms. This study aims to examine the relationship between gender differences related to muscle strength and depressive symptoms mediated by perceived stress.
Methods
In this cross-sectional study, data from 2,705 older adults (65 years old or older) from the Korea National Health and Nutrition Examination Survey VII 2016 and 2018 were analyzed. The moderated mediation model was developed; the outcome, independent, mediation, and moderated mediation variables in the literature-based research model were depressive symptoms, muscle strength, perceived stress, and gender, respectively.
Results
Perceived stress had a mediating effect on the relationship between muscle strength and depressive symptoms. The indirect effect of muscle strength on depressive symptoms mediated by perceived stress was β = -.02 (95% CI:-0.03~-0.01). The moderated mediation model demonstrated that the interaction term of handgrip strength and gender negatively affected perceived stress, which indicated that gender moderated the mediating model of perceived stress on the association of muscle strength and depressive symptoms (β = -.01, p <.05). The conditional indirect effect model was insignificant in the male group (β = -.00, 95% CI:-0.01~0.01) but significant in the female group (β = -.01, 95% CI: -0.02~0.00). Conclusions: Perceived stress mediated the relationship between muscle strength and depressive symptoms. However, the effect differed by gender. A stress-mediated depressive symptoms intervention program for older adults should be developed to consider women’s needs.

Citations

Citations to this article as recorded by

Baseline Measurement of Grip Strength in a Sample of Nepali Nursing Staff and Students: A Cross‐Sectional Study
Tara Jung Gurung, Lisa R. Roberts, Safiye Sahin, Dibyaswori Lakhe, Rubi Pradhan, Neha Shrestha, Uma Thapa Magar, Sangita Shrestha, Radha Pandey Acharya
Health Science Reports.2026;[Epub] CrossRef
Exploring patients’ understanding of behavioral risk factors for non-communicable diseases: a study on diabetes and hypertension in Bushbuckridge, South Africa
Thabo D. Pilusa, Cairo B. Ntimana, Mahlodi P. Maphakela, Eric Maimela
BMC Public Health.2025;[Epub] CrossRef
Associations between muscle-strengthening exercise and depressive and anxiety symptoms in children and adolescents
Lubo Zhai, Zhengyang Yang, Xingyi Yang, Sitong Chen
BMC Public Health.2025;[Epub] CrossRef

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