kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2016.16.1.1 kjhp-16-1 Original Article Factors Influencing Middle-aged Women's Depression LeeHung Sa 1 KimChunmi 1 LeeDohyun 2 Department of Nursing Science, College of Health Science, Sun Moon University, Asan, Korea School of Public Health, Indiana University, Bloomington, IN, USA Corresponding author: Dohyun Lee, MD School of Public Health, Indiana University, 1025 East 7th Street, Bloomington, IN, USA Tel: +1-41-530-2742, Fax: +1-41-530-2725 E-mail: dohylee@imail.iu.edu 01 2016 20 01 2016 16 1 1 10 31102015 29022016 Copyright © 2016 The Korean Society of Health Promotion and Disease Prevention 2016 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. Background

According to the 2013 statistics, The prevalence rate of depression of women was twice compare to man. Especially, about 53% of depression patients were women over age 40. So this study was conducted to analyze whether women's depression is influenced by their socio‐demographic characteristics, life stress, and social support.

 Methods

This study was a descriptive survey, and data were collected during the period from the 1st to 31st of August in 2015, using a self‐reporting questionnaire from 196 women aged between 40 and 60 who were sampled from an urban area through convenient sampling.

 Results

First, among the sub‐factors of life stress, health‐related & role conflict stress were highest. And life stress was higher when social support was low. Second, social support was higher when exercise was done regularly. Lastly, the results of structural equation modeling analysis showed that life stress and social support had a significant effect on depression. Life stress had a significant direct effect on social support, and social support had a significant direct effect on depression. Life stress had an indirect effect on depression through the medium of social support, and their explanatory power was R2＝0.68 and R2＝0.64, respectively.

 Conclusions

This study confirmed that depression was in a very close relationship with life stress and social support. This finding suggests that future health policies for managing middle‐aged women's depression should focus on reducing life stress and reinforcing their social support.

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Research model and standardized factor loading values. Model fit analysis by SEM; df＝23, χ2＝62.12, χ2/df＝2.70, GFI＝0.93, AGFI＝0.90, RMSEA＝0.09, NFI＝0.91, CFI＝0.94, TLI＝0.91.

Participants' general characteristics

Characteristics Total (N＝196) Mean (SD)
Age, y   48.16 (4.47)
40–49 129 (65.8)  
50–59 67 (34.2)  
Spouse
Yes 187 (95.4)  
No 9 (4.6)  
Education level    
Junior school 14 (7.1)  
High school 115 (58.7)  
College 67 (34.2)  
Monthly income (thousand won)
≤ 2,000 34 (17.3)  
2,001–4,000 96 (49.0)  
≥ 4,001 66 (33.7)  
Religion
No 76 (38.8)  
Yes 120 (61.2)  
Children
0–1 31 (15.9)  
2 125 (63.8)  
≥ 3 40 (20.4)  
Health status
Unhealthy 17 (8.7)  
Middle 123 (62.8)  
Healthy 56 (28.6)  
Job
No 85 (43.4)  
Yes 111 (56.6)  
Menopausal age, y   49.88 (3.63)
Menopause 54 (27.6)  
Not menopause 142 (72.4)  
Exercise
No 146 (74.5)  
Yes 50 (25.5)  

Abbreviation: SD, standard deviation. Values are presented as N (%) or mean (SD) unless otherwise indicated.

Differences of depression according to the genera characteristics (N＝196)

Characteristics Depression
Mean (SD) t (F) P
Age, y      
40–49 44.23 (12.72) –1.50 0.134
50–59 47.13 (12.98)    
Spouse      
Yes 44.82 (12.65) –1.87 0.501
No 53.44 (15.11)    
Education      
Junior school (A) 56.35 (12.64) 6.96 0.001
High school (B) 45.34 (11.96)   (A＞B)
College (B) 42.68 (12.28)    
Monthly income, thousand won      
≤ 2,000 44.61 (9.89) 2.31 0.101
2,001–4,000 46.20 (13.42)    
≥ 4,001 42.56 (13.07)    
Religion      
No 46.28 (12.66) 0.92 0.357
Yes 44.55 (12.98)    
Children      
0–1 44.16 (19.85) 0.20 0.814
2 45.43 (12.69)    
≥ 3 43.95 (13.44)    
Health status      
Unhealthy (A) 57.29 (13.29) 15.22 ＜0.001
Middle (B) 46.14 (11.39) ( A＞B＞C)
Healthy (C) 39.53 (12.91)    
Job      
No 45.75 (13.68) 0.50 0.616
Yes 44.81 (12.23)    
Menopause      
Yes 47.35 (13.54) 1.43 0.154
No 44.41 (12.53)    
Exercise      
No 44.97 (12.76) –0.45 0.650
Yes 45.94 (13.21)    
Total 45.22 (12.85)    

Abbreviation: SD, standard deviation. Calculated by t-test, ANOVA, and Scheffé test.

The scores of life stress and social support of subjects (N＝196)

Contents Score
Mean (SD)
Life stress 2.10 (0.58)
Family stress 2.03 (0.64)
Economy stress 2.07 (0.73)
Health stress 2.16 (0.70)
Role stress 2.15 (0.63)
Social support 3.68 (0.72)
Family support 3.79 (0.84)
My family helps me when I have problems. 3.90 (0.99)
Our family knows the friends of each other and helps well. 3.62 (0.98)
Our family want to be together with me at any time. 3.70 (1.01)
My family goes through very friendly with each other. 3.90 (0.92)
My family is very friendly each other. 3.88 (0.89)
I discuss with my family before I decide something. 3.81 (1.02)
Our family participate together to something to do. 3.72 (1.03)
Other's support 3.55 (0.75)
There is someone to talk with when I have problems. 3.87 (0.93)
I have someone to help chores. 3.60 (1.02)
I have someone to give me advices and information about children and husband. 3.52 (1.00)
There are people who spend a time in doing a hobby and leisure activities with me. 3.63 (1.01)
There are people who help me when I want to have social network. 3.52 (0.97)
There are people who support me economically. 3.21 (1.16)

Abbreviation: SD, standard deviation. Values are presented as mean (SD).

Correlations between study variables included in our research model (N＝196)

Variables Exercisea Menopausal age Life stress Social support Depression
r (P) r (P) r (P) r (P) r (P)
Exercise 1        
Menopausal age 0.16 (0.023) 1      
Life stress –0.08 (0.136) 0.04 (0.525) 1    
Social support 0.16 (0.012) –0.05 (0.460) –0.45 (0.001) 1  
Depression 0.04 (0.570) 0.10 (0.154) 0.61 (＜0.001) –0.45 (＜0.001) 1

Exercise was calculated by Spearman's correlation, others by Pearson's correlation coefficient.

Standardized regression weights and correlation

Constructs Standardized Standard errors Critical ratios P Squared multiple
Dependent variables Independent variables estimates (β) correlation (R2)
Life stress Exercise –0.09 0.44 –1.20 0.228  
  Menopausal age 0.05 0.43 0.70 0.481  
Social support Life stress –0.83 0.12 –5.43 ＜0.001 0.68
Depression Exercise 0.10 1.59 1.81 0.070 0.64
  Social support –0.80 0.88 –5.53 ＜0.001  
  Menopausal age 0.06 1.55 1.02 0.307  

Values are calculated by Structural Equation Model Analysis.