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The Death Anxiety and Depressive Symptoms among Poor Older Women in Rural Areas: The Moderating Effect of Social Support

Article information

Res Community Public Health Nurs. 2017;28(4):440-449
Publication date (electronic) : 2017 December 12
doi : https://doi.org/10.12799/jkachn.2017.28.4.440
Seung Joo Lim1, Young Ko,2, Chunmi Kim3, Hung Sa Lee3
1Department of Nursing, Research Institute for Basic Science, Hoseo University, Asan, Korea
2Department of Nursing, Gachon University, Incheon, Korea
3Department of Nursing Science, Sunmoon University, Asan, Korea
Corresponding author: Ko, Young College of Nursing, Gachon University, 191 Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea. Tel: +82-32-820-4208, Fax: +82-32-820-4201, E-mail: camassia@naver.com
Received 2017 May 26; Revised 2017 November 15; Accepted 2017 November 15.

Abstract

Abstract

Purpose

This study was conducted to identify the moderate effect of social support on the relationship between death anxiety and depressive symptoms among poor older women in rural areas.

Methods

This was a secondary analysis of the data from 209 women who were participated in the intervention study to evaluate the effectiveness of depression prevention program. Data were collected between April and September 2012. The data were analyzed using moderate multiple regressions.

Results

Among these poor older women, depressive symptoms were associated with death anxiety and social support. Self-esteem support had a moderating effect on the relationship between death anxiety and depressive symptoms.

Conclusion

The results indicate that the self-esteem support was effective in decreasing depressive symptoms and death anxiety in poor older women. In order to reduce their depression and make positive changes in their lives, self-esteem improvement programs are needed.

Keywords: Elderly; Anxiety; Depression; Social support; Self esteem; Death

Death Anxiety, Depressive Symptoms and Social Support (N=209)

Death Anxiety, Depressive Symptoms and Social Support by General Characteristics (N=209)

Correlation among Death Anxiety, Depressive Symptoms, and Social Support (N=209)

Factors related to Depressive Symptoms: Moderating Effect of Social Support (N=209)

Factors related to Depressive Symptoms: Moderating Effect of Self-esteem Support (N=209)

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Table 1.

Death Anxiety, Depressive Symptoms and Social Support (N=209)

Variables Range Min Max M±SD
Death anxiety 0~15 0 15 8.74±3.20
Depressive symptoms 0~15 0 14 7.43±3.32
Social support 20~80 22 70 39.40±9.70
 Informational support 1~5 1.00 3.33 1.85±0.57
 Material support 1~5 1.00 3.60 2.06±0.58
 Emotional support 1~5 1.00 4.00 2.00±0.58
 Self-esteem support 1~5 1.00 4.00 1.86±0.59

Table 2.

Death Anxiety, Depressive Symptoms and Social Support by General Characteristics (N=209)

Variables n (%) or M±SD Death anxiety Depressive symptoms Social support
M±SD t or F or r (p) M±SD t or F or r (p) M±SD t or F or r (p)
Age (year) 65~74 105 (50.2) 8.66±3.23 -0.34 7.04±3.35 -1.90 39.19±9.78 0.70
≥75 104 (49.8) 8.81±3.18 (.734) 7.88±3.09 (.059) 38.30±8.63 (.485)
74.6±5.97
Subjective economic status Not hard 99 (47.3) 8.52±3.27 -0.98 6.55±3.33 -4.00 42.64±9.65 6.22
Hard 110 (52.6) 8.93±3.13 (.328) 8.28±2.95 (＜.001) 35.24±7.21 (＜.001)
Health literacy No 43 (20.6) 9.07±3.20 0.77 7.72±3.40 .59 36.40±8.98 -1.89
Yes 166 (79.4) 8.66±3.20 (.443) 7.39±3.21 (.554) 39.36±9.20 (.060)
Living with someone No one 111 (53.1) 8.94±2.89 -1.01 7.74±3.16 1.33 37.30±9.02 -2.45
Yes 98 (46.9) 8.52±3.49 (.315) 7.14±3.33 (.186) 40.39±9.19 (.015)
Burden of medical service expense Yesa 124 (59.3) 9.01±3.12 2.90 8.27±2.93 12.75 36.90±8.29 6.72
So sob 60 (28.7) 8.71±3.42 (.057) 5.83±3.40 (＜.001) 40.97±9.61 (.001)
Noc 25 (12.0) 7.43±2.77 7.32±2.94 c＜a 42.56±10.53 a＜c
Comorbidity 2.56±1.18 -0.04 .18 -0.17
(.553) (.008) (.010)
Pain (0~10) 5.68±2.16 0.06 .03 -0.05
(.361) (.639) (.504)
Experience of death of significant one Yes 176 (75.5) 8.80±3.17 -0.56 7.08±2.77 -1.00 38.49±10.81 -0.21
No 57 (24.5) 8.53±3.32 (.574) 7.59±3.39 (.320) 38.83±8.64 (.835)

Table 3.

Correlation among Death Anxiety, Depressive Symptoms, and Social Support (N=209)

Variables Death anxiety Depressive symptoms
r (p) r (p)
Depressive symptoms .17 (.008)
Social support -.10 (.134) -.29 (＜.001)
Informational support .01 (.880) -.10 (.117)
Material support -.10 (.142) -.20 (.002)
Emotional support -.13 (.047) -.37 (＜.001)
Self-esteem support -.16 (.012) -.30 (＜.001)

Table 4.

Factors related to Depressive Symptoms: Moderating Effect of Social Support (N=209)

Variables Model 1 Model 2 Model 3
β p β p β p
Subjective economic status-hard .18 .012 .12 .109 .12 .102
Burden of medical service expense-yes .01 .927 .01 .928 .02 .319
Burden of medical service expense-so so -.25 .010 -.24 .011 -.23 .402
Comorbidity .11 .091 .09 .137 .08 .192
Death anxiety .16 .007 .18 .003 .17 .007
Social support -.16 .012 -.16 .013
Death anxiety*social support .08 .173
R2 (%) 19.01 21.24 21.89
△R2 (%) 2.23 0.65
F (p) 10.66 (＜.001) 10.16 (＜.001) 9.01 (＜.001)
△F (p) 6.41 (.012) 1.87 (.173)

Table 5.

Factors related to Depressive Symptoms: Moderating Effect of Self-esteem Support (N=209)

Variables Model 1 Model 2 Model 3
β p β p β p
Subjective economic status-hard .18 .012 .11 .122 .13 .085
Burden of medical service expense-yes .01 .927 -.00 .982 -.00 .983
Burden of medical service expense-soso -.25 .010 -.24 .011 -.24 .009
Comorbidity .11 .091 .10 .098 .09 .142
Death anxiety .16 .007 .17 .005 .14 .017
Self-esteem Support -.18 .005 -.18 .004
Death anxiety*self-esteem Support .16 .008
R2 (%) 19.01 21.18 23.79
△R2 (%) 2.17 2.61
F (p) 10.66 (＜.001) 10.12 (＜.001) 10.03 (＜.001)
△F (p) 6.22 (.013) 7.70 (.002)