The Effects of Socio-demographic Factors, Acculturation Stress and Resilience on Depression among Mothers-in-law in Multicultural Families

Dong-Hee Kim; Sang-Hwa Lee; Young-Sil Bae; Yi-Kyung Ha

doi:10.12799/jkachn.2015.26.3.221

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Original Article
The Effects of Socio-demographic Factors, Acculturation Stress and Resilience on Depression among Mothers-in-law in Multicultural Families: Dong-Hee Kim, Sang-Hwa Lee, Young-Sil Bae, Yi-Kyung Ha; Journal of Korean Academy of Community Health Nursing 2015;26(3):221-229.
DOI: https://doi.org/10.12799/jkachn.2015.26.3.221
Published online: September 30, 2015

Collage of Nursing, Pusan National University, Yangsan, Korea.

• Received: June 17, 2015 • Revised: September 3, 2015 • Accepted: September 14, 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 factors influencing depression among mothers-in-law in multicultural families.
Methods
For this study, 159 participants from multicultural familieswere recruited through administrative units of the B. & U. Metropolitan City and G. Province. Data related to acculturation stress, resilience, and depression were collected fromApril to August 2014 and analyzed through t-test, one-way ANOVA, Pearson correlation coefficients, and regression analysis with the SPSS/WIN 22.0 for Windows program.
Results
The participants had a moderate level of acculturation stress (2.43±0.75: range 1~5) and resilience (4.74±1.14: range 1~7). About 58% of the participants had depression. The results of stepwise multiple regression analysis indicated that mothersin-law's depression was affected by resilience (β=-1.17, p<.001), acculturation stress (β=0.85, p=.026), perceived economic level (β=-0.83, p=.016), difficulty in physical activity (β=-0.62, p=.027), relationship satisfaction (β=-0.51, p=.035), and education level (β=-0.48, p=.033). The explanatory power of these factors was 35%.
Conclusion
The findings indicated the need to lower the level of depression by enhancing resilience and reducing acculturation stress among mothers-in-law in multicultural families. Future research to reduce depression among mothers-in-law inmulticultural families should consider how to enhance resilience and reduce acculturation stress.
Key Words: Elderly; Depression; Acculturation; Psychological resilience

Table 1

General Characteristics (N=159)

Characteristics	Categories	n (%) or M±SD
Residence	Metropolis	90 (56.6)
	Micropolis	21 (13.2)
	Rural	48 (30.2)
Age (year)		69.4±7.42
	≤64	40 (25.2)
	65~70	48 (30.2)
	≥71	71 (44.6)
Education level	None	39 (24.5)
	Elementary school	69 (43.4)
	≥Middle school	51 (32.1)
Perception of economic level	Highly	12 (7.5)
	Average	99 (62.3)
	Lower	48 (30.2)
Chronic disease	No	31 (19.5)
Chronic disease	Yes	128 (80.5)
Difficulty in physical activity	No	57 (35.8)
Difficulty in physical activity	Yes	102 (64.2)
Meeting time with someone (time/yr)	≤6	18 (11.3)
	7~12	33 (20.8)
	≥13	108 (67.9)
Cohabitation period (month)		44.0±40.45
	≤12	38 (23.9)
	13~60	79 (49.7)
	≥61	42 (26.4)
Daughter-in-law's Korean-level	High	65 (40.9)
	Moderate	36 (22.6)
	Low	58 (36.5)
Relationship with daughter-in-law	Satisfied	70 (44.0)
	Somehow	53 (33.3)
	Unsatisfied	36 (22.6)
Ethnocentrism	Disagree	18 (11.3)
	Somehow	105 (66.0)
	Agree	36 (22.7)

Table 2

Level of Acculturation Stress, Resilience, and Depression (N=159)

variable	n (%)	M±SD	Range
Acculturation stress		2.4 ±0.75
Inconveniences of living		2.4 ±0.79	1~5
Perceived discrimination		2.3 ±0.91	1~5
Conflict due to value differences		2.4 ±0.75	1~5
Resilience		4.7 ±1.14	1~7
Personal competence		4.8 ±1.17	1~7
Acceptance of self and life		4.7 ±1.18	1~7
Very high	6 (3.8)	91.0 ±0.00	91~98
High	8 (5.0)	84.5 ±2.51	82~90
Moderate high	26 (16.4)	77.2 ±2.10	74~81
Moderate low	34 (21.4)	69.4 ±2.88	65~73
Low	27 (17.0)	61.0 ±2.49	57~64
Very low	58 (36.5)	46.1 ±7.86	14~56
Depression		5.5 ±3.65
Normal	66 (41.5)	2.0 ±1.40	1~4
Mild depression	65 (40.9)	6.7 ±1.34	5~9
Sever depression	28 (17.6)	11.1 ±1.35	10~15

Table 3

Differences of Acculturative Stress, Resilience, and Depression according to General Characteristics (N=159)

Characteristics	Categories	n (%) or M±SD	Acculturation stress (1~5)		Resilience (1~7)		Depression (0~15)
Characteristics	Categories	n (%) or M±SD	M±SD	x² or t or F (p)	M±SD	x² or t or F (p)	M±SD	x² or t or F (p)
Residence	Metropolis	90 (56.6)	2.4±0.70	0.96 (.385)	4.7±1.07	0.61 (.543)	3.5±0.37	1.21 (.385)
	Micropolis	21 (13.2)	2.3±0.65		4.5±1.00		3.7±0.81
	Rural	48 (30.2)	2.5±0.87		4.9±1.33		3.8±0.55
Age (year)		69.37±7.42		1.76 (.176)		0.41 (.664)		0.20 (.817)
	≤64	40 (25.2)	2.6±0.81		4.9±1.16		5.3±3.41
	65~70	48 (30.2)	2.3±0.74		4.7±1.13		5.4±3.90
	≥71	71 (44.6)	2.4±0.71		4.7±1.15		5.7±3.65
Education level	None	39 (24.5)	2.5±0.64	0.78 (.462)	4.5±0.98	1.43 (.243)	6.7±3.51^a	3.60 (.030) a>c
	Elementary school	69 (43.4)	2.5±0.78		4.9±1.20		5.4±3.87^b
	Others	51 (32.1)	2.3±0.79		4.7±1.16		4.7±3.25^c
Perception of economic level^†	Highly	12 (7.5)	2.1±0.88^a	10.16 (.006) a>b>c	4.9±1.02	0.29 (.865)	2.8±2.13^a	13.14 (.001) a>b>c
	Average	99 (62.3)	2.3±0.68^b		4.8±1.18		5.2±3.66^b
	Lower	48 (30.2)	2.7±0.78^c		4.7±1.10		6.8±3.51^c
Chronic disease	No	31 (19.5)	2.5±0.73	0.40 (.689)	4.7±1.15	-0.16 (.874)	5.2±3.74	-0.49 (.624)
Chronic disease	Yes	128 (80.5)	2.4±0.76	0.40 (.689)	4.8±1.14	-0.16 (.874)	5.6±3.64	-0.49 (.624)
Difficulty in physical activity	No	57 (35.8)	2.4±0.70	0.48 (.632)	4.8±1.13	-0.60 (.547)	4.5±3.48	2.70 (.008)
Difficulty in physical activity	Yes	102 (64.2)	2.5±0.78	0.48 (.632)	4.7±1.15	-0.60 (.547)	6.1±3.64	2.70 (.008)
Meeting time with someone (time/year)^†	≤6	18 (11.3)	2.2±0.79^a	2.90 (.235)	5.3±0.86^a	6.27 (.044) a>b	5.1±3.59	0.94 (.624)
	7~12	33 (20.8)	2.5±0.45^b		4.4±1.17^b		5.9±3.35
	≥13	108 (67.9)	2.5±0.81^c		4.8±1.15^c		5.5±3.77
Cohabitation period (month)	≤12	38 (23.9)	2.4±0.53	0.36 (.697)	4.3±1.03	3.52 (.052)	5.6±3.51	0.77 (.465)
	13~60	79 (49.7)	2.5±0.84		4.9±1.18		5.2±3.79
	≥61	42 (26.4)	2.4±0.75		4.9±1.09		6.1±3.54
Daughter in law's Korean-level	Low	58 (36.5)	2.7±0.72^a	7.91 (.001) a>c	4.5±1.14	2.85 (.061)	6.2±3.64	2.24 (.110)
	Moderate	36 (22.6)	2.4±0.71^b		4.9±1.15		5.6±3.65
	High	65 (40.9)	2.2±0.72^c		4.9±1.11		4.8±3.60
Relationship satisfaction	Unsatisfied	36 (22.6)	3.1±0.79^a	24.93 (<.001) a>b>c	4.4±1.12	2.49 (.087)	7.7±3.54^a	10.57 (<.001) a>b>c
	Somehow	53 (33.3)	2.4±0.57^b		4.9±1.05		5.5±3.52^b
	Satisfied	70 (44.0)	2.1±0.65^c		4.8±1.19		4.4±3.35^c
Ethnocentrism^†	Disagree	18 (11.3)	2.0±0.95^a	8.08 (.018) a<b	4.9±1.51	6.10 (.047)	5.1±3.76	0.52 (.771)
	Somehow	105 (66.0)	2.5±0.71^b		4.6±1.07		5.5±3.73
	Agree	36 (22.7)	2.5±0.72^c		5.1±1.07		5.8±3.43

a, b, c=Scheffé test; ^†Kruskal wallis.

Table 4

Relationship among Acculturative Stress, Resilience, and Depression (N=159)

Variables	Acculturative stress	Resilience
Variables	r (p)	r (p)
Depression	.39 (<.001)	-.43 (<.001)
Acculturative stress		-.25 (.002)

Table 5

Factors Predicting Depression (N=159)

Predictors	B	SE	β	t	p
(Constant)	15.45	2.33		6.63	<.001
Resilience	-1.17	0.21	-0.37	-5.51	<.001
Acculturative stress	0.85	0.38	0.18	2.25	.026
Difficulty in physical activity	-0.62	0.28	-0.15	-2.23	.027
Perception of economic level	-0.83	0.34	-0.16	-2.43	.016
Education level of mother-in-law	-0.48	0.22	-0.14	-2.15	.033
Relationship satisfaction	-0.51	0.24	-0.16	-2.13	.035
	R²=.38, Adj. R²=.35, F=15.43, p<.05

Durbin-Watson=1.78; SE=standard error; Adj. R²=adjusted R².

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

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The Effects of Socio-demographic Factors, Acculturation Stress and Resilience on Depression among Mothers-in-law in Multicultural Families

Characteristics	Categories	n (%) or M±SD
Residence	Metropolis	90 (56.6)
	Micropolis	21 (13.2)
	Rural	48 (30.2)
Age (year)		69.4±7.42
	≤64	40 (25.2)
	65~70	48 (30.2)
	≥71	71 (44.6)
Education level	None	39 (24.5)
	Elementary school	69 (43.4)
	≥Middle school	51 (32.1)
Perception of economic level	Highly	12 (7.5)
	Average	99 (62.3)
	Lower	48 (30.2)
Chronic disease	No	31 (19.5)
Chronic disease	Yes	128 (80.5)
Difficulty in physical activity	No	57 (35.8)
Difficulty in physical activity	Yes	102 (64.2)
Meeting time with someone (time/yr)	≤6	18 (11.3)
	7~12	33 (20.8)
	≥13	108 (67.9)
Cohabitation period (month)		44.0±40.45
	≤12	38 (23.9)
	13~60	79 (49.7)
	≥61	42 (26.4)
Daughter-in-law's Korean-level	High	65 (40.9)
	Moderate	36 (22.6)
	Low	58 (36.5)
Relationship with daughter-in-law	Satisfied	70 (44.0)
	Somehow	53 (33.3)
	Unsatisfied	36 (22.6)
Ethnocentrism	Disagree	18 (11.3)
	Somehow	105 (66.0)
	Agree	36 (22.7)

variable	n (%)	M±SD	Range
Acculturation stress		2.4 ±0.75
Inconveniences of living		2.4 ±0.79	1~5
Perceived discrimination		2.3 ±0.91	1~5
Conflict due to value differences		2.4 ±0.75	1~5
Resilience		4.7 ±1.14	1~7
Personal competence		4.8 ±1.17	1~7
Acceptance of self and life		4.7 ±1.18	1~7
Very high	6 (3.8)	91.0 ±0.00	91~98
High	8 (5.0)	84.5 ±2.51	82~90
Moderate high	26 (16.4)	77.2 ±2.10	74~81
Moderate low	34 (21.4)	69.4 ±2.88	65~73
Low	27 (17.0)	61.0 ±2.49	57~64
Very low	58 (36.5)	46.1 ±7.86	14~56
Depression		5.5 ±3.65
Normal	66 (41.5)	2.0 ±1.40	1~4
Mild depression	65 (40.9)	6.7 ±1.34	5~9
Sever depression	28 (17.6)	11.1 ±1.35	10~15

Characteristics	Categories	n (%) or M±SD	Acculturation stress (1~5)		Resilience (1~7)		Depression (0~15)
Characteristics	Categories	n (%) or M±SD	M±SD	x² or t or F (p)	M±SD	x² or t or F (p)	M±SD	x² or t or F (p)
Residence	Metropolis	90 (56.6)	2.4±0.70	0.96 (.385)	4.7±1.07	0.61 (.543)	3.5±0.37	1.21 (.385)
	Micropolis	21 (13.2)	2.3±0.65		4.5±1.00		3.7±0.81
	Rural	48 (30.2)	2.5±0.87		4.9±1.33		3.8±0.55
Age (year)		69.37±7.42		1.76 (.176)		0.41 (.664)		0.20 (.817)
	≤64	40 (25.2)	2.6±0.81		4.9±1.16		5.3±3.41
	65~70	48 (30.2)	2.3±0.74		4.7±1.13		5.4±3.90
	≥71	71 (44.6)	2.4±0.71		4.7±1.15		5.7±3.65
Education level	None	39 (24.5)	2.5±0.64	0.78 (.462)	4.5±0.98	1.43 (.243)	6.7±3.51^a	3.60 (.030) a>c
	Elementary school	69 (43.4)	2.5±0.78		4.9±1.20		5.4±3.87^b
	Others	51 (32.1)	2.3±0.79		4.7±1.16		4.7±3.25^c
Perception of economic level^†	Highly	12 (7.5)	2.1±0.88^a	10.16 (.006) a>b>c	4.9±1.02	0.29 (.865)	2.8±2.13^a	13.14 (.001) a>b>c
	Average	99 (62.3)	2.3±0.68^b		4.8±1.18		5.2±3.66^b
	Lower	48 (30.2)	2.7±0.78^c		4.7±1.10		6.8±3.51^c
Chronic disease	No	31 (19.5)	2.5±0.73	0.40 (.689)	4.7±1.15	-0.16 (.874)	5.2±3.74	-0.49 (.624)
Chronic disease	Yes	128 (80.5)	2.4±0.76	0.40 (.689)	4.8±1.14	-0.16 (.874)	5.6±3.64	-0.49 (.624)
Difficulty in physical activity	No	57 (35.8)	2.4±0.70	0.48 (.632)	4.8±1.13	-0.60 (.547)	4.5±3.48	2.70 (.008)
Difficulty in physical activity	Yes	102 (64.2)	2.5±0.78	0.48 (.632)	4.7±1.15	-0.60 (.547)	6.1±3.64	2.70 (.008)
Meeting time with someone (time/year)^†	≤6	18 (11.3)	2.2±0.79^a	2.90 (.235)	5.3±0.86^a	6.27 (.044) a>b	5.1±3.59	0.94 (.624)
	7~12	33 (20.8)	2.5±0.45^b		4.4±1.17^b		5.9±3.35
	≥13	108 (67.9)	2.5±0.81^c		4.8±1.15^c		5.5±3.77
Cohabitation period (month)	≤12	38 (23.9)	2.4±0.53	0.36 (.697)	4.3±1.03	3.52 (.052)	5.6±3.51	0.77 (.465)
	13~60	79 (49.7)	2.5±0.84		4.9±1.18		5.2±3.79
	≥61	42 (26.4)	2.4±0.75		4.9±1.09		6.1±3.54
Daughter in law's Korean-level	Low	58 (36.5)	2.7±0.72^a	7.91 (.001) a>c	4.5±1.14	2.85 (.061)	6.2±3.64	2.24 (.110)
	Moderate	36 (22.6)	2.4±0.71^b		4.9±1.15		5.6±3.65
	High	65 (40.9)	2.2±0.72^c		4.9±1.11		4.8±3.60
Relationship satisfaction	Unsatisfied	36 (22.6)	3.1±0.79^a	24.93 (<.001) a>b>c	4.4±1.12	2.49 (.087)	7.7±3.54^a	10.57 (<.001) a>b>c
	Somehow	53 (33.3)	2.4±0.57^b		4.9±1.05		5.5±3.52^b
	Satisfied	70 (44.0)	2.1±0.65^c		4.8±1.19		4.4±3.35^c
Ethnocentrism^†	Disagree	18 (11.3)	2.0±0.95^a	8.08 (.018) a<b	4.9±1.51	6.10 (.047)	5.1±3.76	0.52 (.771)
	Somehow	105 (66.0)	2.5±0.71^b		4.6±1.07		5.5±3.73
	Agree	36 (22.7)	2.5±0.72^c		5.1±1.07		5.8±3.43

Variables	Acculturative stress	Resilience
Variables	r (p)	r (p)
Depression	.39 (<.001)	-.43 (<.001)
Acculturative stress		-.25 (.002)

Predictors	B	SE	β	t	p
(Constant)	15.45	2.33		6.63	<.001
Resilience	-1.17	0.21	-0.37	-5.51	<.001
Acculturative stress	0.85	0.38	0.18	2.25	.026
Difficulty in physical activity	-0.62	0.28	-0.15	-2.23	.027
Perception of economic level	-0.83	0.34	-0.16	-2.43	.016
Education level of mother-in-law	-0.48	0.22	-0.14	-2.15	.033
Relationship satisfaction	-0.51	0.24	-0.16	-2.13	.035
	R²=.38, Adj. R²=.35, F=15.43, p<.05

Table 1 General Characteristics (N=159)

Table 2 Level of Acculturation Stress, Resilience, and Depression (N=159)

Table 3 Differences of Acculturative Stress, Resilience, and Depression according to General Characteristics (N=159)

a, b, c=Scheffé test; ^†Kruskal wallis.

Table 4 Relationship among Acculturative Stress, Resilience, and Depression (N=159)