농촌의학ㆍ지역보건 (Journal of agricultural medicine and community health)

한국농촌의학지역보건학회 (Korean Society for Rural Medicine and Community Health)
권호 표지
DOI QR코드

DOI QR Code

빈곤층 여성 노인의 우울에 미치는 영향요인

Factors Affecting the Depression of the Elderly Women in Poverty

  • Park, Eun-A (College of Nursing, Seoul National University) ;
  • Lee, In-Sook (College of Nursing, Seoul National University)
  • 발행 : 2009.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 65세 이상 빈곤층 여성 노인의 우울에 영향을 미치는 요인을 파악하기 위하여 방문건강 관리사업 대상자 중 노인 교육프로그램 대상에게 수집된 기초자료를 분석한 서술적 조사연구이다. 연구대상자는 방문건강관리사업 대상자로, 2008년 4월 1일부터 5월 30일까지 기초생활수급권자, 차상위계층, 건강보험료부과하위 20%에 속하는 빈곤층 여성 노인 1,410명을 임의표출하여 조사하였다. 방문간호사가 대상자에게 자료 수집 및 방문건강관리서비스 제공에 대하여 설명하고, 대상자가 동의한 이후에 구조화된 설문지를 이용하여 직접 면담을 통해 시행하였고 이 중 1,208명만이 최종분석에 포함되었다. 수집된 자료는 SPSS프로그램을 이용하여 서술적통계분석, Pearson correlation coefficients, $x^2$-test, 다변량 로지스틱 회귀분석을 통해 분석하였고, 연구결과를 요약하면 다음과 같다. 첫째, 연구대상자의 연령은 75~84세가 54.4%로 가장 많았고, 배우자가 없는 경우가 87.8%로 무 배우자 비율이 높고, 간접적 경제수준인 의료보장 유형에서 의료급여가 74.9%를 차지하였다. 교육수준은 무학이거나 초등학교 졸업이 92.4%로 조사되었다. 둘째, 주관적 건강상태가 ‘나쁨’이 72.7%, 보유 만성질환 수는 평균 2.81개, 인지기능이 13.51점 으로 나타났다. 셋째, 일반적 특성과 건강행태, 건강수준 변수들이 우울에 미치는 영향요인을 분석한 결과, 무배우자일수록(p<.05), 인지기능이 낮을수록(p<.01), 주관적 건강감이 낮을수록(p<.001) 우울한 것으로 나타났다. 연령, 교육수준, 건강행태, 일상생활수행능력, 도구적 일상생활수행능력, 보유 만성질환 수에서는 우울정도에 유의미한 차이를 보이지 않았다. 본 연구결과를 토대로 다음과 같이 제언하고자한다. 첫째, 사회적 지지 및 가족지지를 포함한 심리 사회적 요인이나, 영양, 질병특성을 고려하여 우울에 영향을 미치는 요인을 규명하는 심층연구가 필요하다. 둘째, 빈곤층 여성 노인을 대상으로 우울 감소를 위한 중재프로그램을 제공할 때 우선적으로 차별화된 맞춤식 중재가 요구되며 노인의 기초적인 생활보장문제와 인지기능과 주관적 건강상태를 고려한 지역사회 기반의 통합 프로그램의 개발 및 운영이 요구된다.

Objectives: This study was to investigate the factors affecting the depression of the elderly women in poverty in community. Methods: The subjects were 1,208 elderly women over 65 years who were enrolled in the Public Health Care Center from Apr. 2008 to Jun. 2008. Data were collected using questionnaires including general characteristics, health related behaviors and health status by nurses at the time of enrollment. The collected data were analyzed by descriptive statistics, $x^2$-test, Pearson correlation coefficients and multivariate logistic regression. Results: The major findings of this study are as follows : The elderly women in poverty show a tendency to have lower level in income, education, self-rated health, cognitive function compared with ordinary women in old age. The predictors of depression of the elderly women in poverty were spouse's existence or nonexistence, type of insurance, cognitive function, and self-rated health. Conclusion: These findings suggest the need to develop nursing strategies for decreasing depression in the elderly women in poverty. To decrease the depression of the elderly women, the above-mentioned major influencing factors should be considered.

키워드

참고문헌

  1. National Statistical Office. Statistics of aged. Seoul. The National Statistical office, 2008
  2. Korea Institute for Health and Social Affairs. Yearbook of Health and Welfare Statistics. Seoul, 2008
  3. Korea Institute for Health and Social Affairs. Statistics of poverty. Seoul, 2009
  4. Nourhashemi F, Andrieu S, Gillette-Guyonmet S, Vellas B, Albarede J, Grandjean H. Instrumental Activities of Daily Living as a Potential Marker of Frailty. The Journal of Gerontol 2001;56(7):448-450 https://doi.org/10.1093/gerona/56.7.M448
  5. Lee HS. Health status and utilization of long term care facility in the urban and rural aged. J of Korean Acad of Community Health Nurs 2008;19(2):260-269(Korean)
  6. Ki BS. Medication therapy of depression for the aged. Geriat Disease 2005;9:141-153(Korean)
  7. Lee KJ, Park, HS. A study on the perceived health status, depression, and activities of daily living for the elderly in urban areas. Korean J Women Health Nurs 2006;12(3):221-230(Korean)
  8. Konstein SG, Schatzberg AF, Thase ME, Yonkers KA, McCullough JP, Keintner GI. Gender differences in chronic major and double depression. J Affect Dosord 2000;60:1-11 https://doi.org/10.1016/S0165-0327(99)00158-5
  9. Hur JS, Yoo SH. Determinants of depression among elderly persons. Mental Health & Social Work 2002;13:7-35(Korean)
  10. Lee HJ, Kang SK, Lee JY. The effects of socioeconomic position and health behavior on geriatric depressive symptom. Journal of the Korean Gerontological Society 2008;28(4):1129-1145(Korean)
  11. Shin KL, Kim MY. The affecting factors of cognitive function and depression among the elderly in an island community. J of Gerontological Nurs 2001;3(1):32-41(Korean)
  12. Park SY. A study on depression, ADL, IADL, and QOL among community-dwelling low income elderly. J of korean Acad of Public health Nurs 2009;23(1):78-90(Korean)
  13. Jung YM. Korean health status and associated factors of depression according to depression in elderly women. J of the Korean Gerontol Soc 2007;27:71-86(Korean)
  14. Shin KR, Kang YH, Jung, DY, Choi KA. A study on the depression, somatic symptom, activities of daily living for the elderly women in an urban area. J Korean Acad Nurs 2007; 37(7):1131-1138(Korean) https://doi.org/10.4040/jkan.2007.37.7.1131
  15. Kim JY, Lee JM. The Relationship of Life-stress and depression between the poor elderly Women and ordinary elderly women - focus on control effect of self-esteem and social support-. J of Welfare for the Aged 2008;39:399-420(Korean)
  16. Korea Institute for Health and Social Affairs. 2008 Report of Customized Home Visiting Care Service, unpublished, Seoul, 2008
  17. Ki BS. A preliminary study for the standardization of geriatric depression scale short form-korean Version. J of korean neuropsychiat Association 1996;35(2):298-307 (Korean)
  18. Won CW, Rho YG, Kim SY, Cho BR, Lee YS. The validity and reliability of Korean Activities of Daily Living(K-ADL) Scale. J of the Korean Geriatr Soc 2002;6(2):98-106(Korean)
  19. Won CW, Rho YG, Sun WD, Lee YS. The validity and reliability of korean Instrumental Activities of Daily Living(K-IADL) Scale. J of the Korean Geriatr Soc 2002;6(4):273-280(Korean)
  20. Korea Institute for Health and Social Affairs. Development of asessement tool for public long-term care system. 2004, Retrieved Feb.2. 2009, from http://www.e-welfare.go.kr
  21. Lee TH, Ko IS, Lee KJ, Kang KH. Health status, health perception, and health promotion behaviors of Low-income community dwelling Elderly. J Korean Acad Nurs 2005;35(2):252-261(Korean) https://doi.org/10.4040/jkan.2005.35.2.252
  22. Lee YJ, Kim TH. A study on the buffering effect of social support on the stress of the elderly who lives alone. Journal of the Korea Gerontological Society 1999;19(3):79-93(Korean)
  23. Kim EJ. Poverty reduction effect and income redistribution effect of public income transfer among families headed by women. Soongsil University, 2004
  24. Suh KH, Kim YS. Self -Esteem and depression of the elderly people living alone. Korean Journal of Psychological and Social /issues, 2003;9(1):115-137(Korean)
  25. Robert RE, Shema SJ, kaplan GA, Strabridge WJ. Sleep complaints and depression in an aging cohort. Am J of Psychiat 2000;157(1):81-88 https://doi.org/10.1176/ajp.157.1.81
  26. Lee KJ, Yun JR, Ko LS, Lee TH, Ju YS, Bae SS, Oh JJ, Gweon SH. A prediction model of health promotion and illness prevention behaviors in the elderly. Unpublished report, Yonsei University & Ministry of Health & Welfare, 2001
  27. Kweon JH, Yun HJ, Moon HJ, Lee JM, Son YH, Park SH, Lee HK, Lee SG.. Dietary behavior and nutritional status of the elderly women attending at the health promotion program in the an urban community. Korean J Community Nutrition 2002;1(6):814-823(Korean)
  28. W JS, Kim KH. Evaluation of cognitive functions, depression, life satisfaction among the elderly receiving visiting nursing services, J Korean Acad Nurs 2008;38(1):1-10(Korean) https://doi.org/10.4040/jkan.2008.38.1.1
  29. Ko Y, Lee IS. Factors affecting the self rated health of vulnerable elderly. J of Korean Acad of Community Health Nurs 2009;20(1):31-40(Korean)

피인용 문헌

  1. Association of self-perceived oral health and depression in the elderly: the sixth Korea national health and nutrition examination survey(the 6th KNHANES) vol.16, pp.2, 2016, https://doi.org/10.13065/jksdh.2016.16.02.285
  2. Factors affecting unmet healthcare needs of older people in Korea vol.60, pp.4, 2013, https://doi.org/10.1111/inr.12055
  3. Factors related to Depression of Rural Elders vol.17, pp.1, 2015, https://doi.org/10.17079/jkgn.2015.17.1.56
  4. Prevalence and Correlates of Depression in Older Koreans: Comparison of Young-old and Old-old vol.21, pp.1, 2012, https://doi.org/10.12934/jkpmhn.2012.21.1.1
  5. Risk factors associated with depression and suicidal ideation in a rural population vol.31, 2016, https://doi.org/10.5620/eht.e2016018