MSN, RN, Doctoral Candidate, College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea.
J Nurs Res. 2019 Jun;27(3):e20. doi: 10.1097/jnr.0000000000000292.
BACKGROUND: Older adults who live alone are less physically and emotionally healthy and report higher levels of depression relative to those who do not live alone. Suicide is the most problematic health issue reported by older adults who live alone. In particular, vulnerable older adults who live alone experience difficulty obtaining self-care and medical services; therefore, early detection of depression is difficult, and there are few opportunities to implement suicide prevention strategies in this population. In addition, social support for depression is an important factor affecting illness and economic vulnerability in older adults who live alone. PURPOSE: This study aimed to examine the relationship between depression and suicidal ideation in vulnerable older Korean adults with hypertension and to explore the mediating effect of social support on this relationship. METHODS: The study used a cross-sectional design. Vulnerable older adults who were 65 years old or older with hypertension and who received home visit services from a public health center were invited to participate. The participants completed structured questionnaires, including the 15-item Short-Form Geriatric Depression Scale, 12-item Multidimensional Scale of Perceived Social Support, and 19-item Scale for Suicidal Ideation, and provided information regarding their demographic characteristics, health status, and economic status. Descriptive and correlation analyses were performed to examine the correlations among these variables. The three-step regression analysis method proposed by Baron and Kenny was used to examine the mediating effect of social support. RESULTS: The mean depression, social support, and suicidal ideation scores of participants were 23.64 (± 2.04), 35.94 (± 15.40), and 7.80 (± 7.73), respectively. In addition, depression was negatively correlated with social support (r = -.27) and positively correlated with suicidal ideation (r = .21), whereas social support was negatively correlated with suicidal ideation (r = -.35). Social support mediated the relationship between depression and suicidal ideation (Z = 2.69). CONCLUSIONS: Social support was identified as an important variable for older adults with chronic illness who lived alone. Interventions that include social support hold the potential to reduce depression and suicidal ideation in this population.
背景：独居的老年人在身体和情绪上不如那些不独居的老年人健康，抑郁水平也更高。独居的老年人报告的最严重的健康问题是自杀。特别是，独居的脆弱老年人在获得自我护理和医疗服务方面存在困难；因此，难以早期发现抑郁症，并且在该人群中实施预防自杀策略的机会很少。此外，社会对抑郁症的支持是影响独居老年人疾病和经济脆弱性的重要因素。
目的：本研究旨在检验患有高血压的脆弱韩国老年人中抑郁与自杀意念之间的关系，并探讨社会支持在这种关系中的中介作用。
方法：本研究采用横断面设计。邀请到公共卫生中心接受上门服务的年龄在 65 岁及以上的脆弱高血压老年人参加。参与者填写了结构化问卷，包括 15 项老年抑郁量表、12 项多维感知社会支持量表和 19 项自杀意念量表，并提供了他们的人口统计学特征、健康状况和经济状况的信息。进行描述性和相关性分析，以检验这些变量之间的相关性。采用 Baron 和 Kenny 提出的三步回归分析方法检验社会支持的中介作用。
结果：参与者的平均抑郁、社会支持和自杀意念得分分别为 23.64（±2.04）、35.94（±15.40）和 7.80（±7.73）。此外，抑郁与社会支持呈负相关（r=-.27），与自杀意念呈正相关（r=-.21），而社会支持与自杀意念呈负相关（r=-.35）。社会支持中介了抑郁与自杀意念之间的关系（Z=2.69）。
结论：社会支持被确定为独居慢性病老年人的一个重要变量。包含社会支持的干预措施有可能减少该人群的抑郁和自杀意念。
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