Influence of Spiritual Wellbeing and Social Support on Depression in Middle-aged Women

Je Eun Heo; Young Sook Tae

doi:10.7475/kjan.2014.26.2.181

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Influence of Spiritual Wellbeing and Social Support on Depression in Middle-aged Women

Je Eun Heo¹, Young Sook Tae²

Korean Journal of Adult Nursing 2014;26(2):181-190.
Published online: April 30, 2014

DOI: https://doi.org/10.7475/kjan.2014.26.2.181

¹College of Nursing, Kosin University, Busan

²College of Nursing, Kosin University, Busan, Korea

Corresponding author: Tae, Young Sook College of Nursing, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan 602-703, Korea. Tel: +82-10-2297-4241, Fax: +82-51-990-3970, E-mail: taehope@kosin.ac.kr

• Received: September 27, 2013 • Accepted: March 27, 2014

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
REFERENCES

Abstract

Purpose
This study was to identify the impact of spiritual wellbeing and social support on the depression among middle-aged women. Descriptive study design was used.
Methods
The subjects completed the structured questionnaires: the ‘Spiritual Wellbeing Scale’, developed by Paloutzian & Ellison, 'the Social Support Scale' developed by Park, and 'the CES-D Scale' developed by Radloff. Data were collected from 216 middle aged women in B metropolitan city and J city. The data were analyzed using t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and multiple regressions.
Results
Participants with higher depression had lower scores for spiritual wellbeing (r=-.57, p<.001) and lower scores for social support (r=-.49, p=.011). The influencing factors on depression were spiritual wellbeing, social support, and utilization of spare time. These variables were explained 46% of the variance in depression.
Conclusion
The depression of the middle-aged women can be reduced when spiritual wellbeing and social support are improved. Therefore, we suggested to develop nursing intervention programs in order to improve spiritual wellbeing and social support of middle-aged women for reducing their depressions.
Key Words: Spirituality; Social support; Depression; Women

Table 1.

General Characteristics of the Participants (N=216)

Characteristic	Characteristic	Categories	n (%)
Sociodemographic characteristics	Age (year)	40~49	95 (44.0)
		50~59	90 (41.7)
		60~64	31 (14.3)
	Marital status	Married	187 (86.5)
		Unmarried	9 (4.2)
		Divorced	11 (5.1)
		Bereaved	9 (4.2)
	Education	≤Middle school	34 (15.7)
		High school	94 (43.5)
		≥Undergraduate	88 (40.8)
	Occupation	Homemaker	68 (31.5)
		Specialized job	74 (34.3)
		Service & salaried worker	26 (12.0)
		Others	48 (22.2)
	Perceived economic status	Low	47 (21.8)
		Moderate	125 (57.9)
		High	44 (20.4)
	Perceived health condition	Health	74 (34.3)
		Moderate	118 (54.6)
		Unhealth	24 (11.1)
	Menopause	Yes	94 (43.5)
	Menopause	No	122 (56.5)
	Utilization of spare time	Takes care of the house	54 (25.0)
		Society activity participation	47 (21.8)
		Exercise	62 (28.7)
		Others	53 (24.5)
Religion related characteristics (N=171)	Religion	None	45 (20.8)
		Protestant or catholic	92 (42.6)
		Buddhism	67 (31.0)
		Others	12 (5.6)
	Attending religious event	≥2/week	57 (26.4)
		1/week	30 (13.9)
		1/month	27 (12.5)
		Others^†	57 (28.2)
	Beliefs of religion	Large	62 (28.7)
		Moderate	73 (33.8)
		Small or None	81 (37.5)

^†1~2 or 2~3/month, 3~4/year, special day etc.

Table 2.

Degree of Spiritual Wellbeing, Social Support, and Depression (N=216)

Variables	M±SD	Min	Max	Possible range	Item/M±SD or n (%)	Range
Spiritual wellbeing	58.02±10.26	34	80	20~80	2.90±0.51	1~4
Existential wellbeing	30.12±4.80	16	40	10~40	3.02±0.48	1~4
Religious wellbeing	27.80±6.77	13	40	10~40	2.78±0.67	1~4
Social support	89.72±15.46	27	123	25~125	3.58±0.61	1~5
Valuable support	22.52±3.91	7	30	6~30	3.75±0.65	1~5
Emotional support	25.42±4.50	8	35	7~35	3.63±0.64	1~5
Informational support	20.90±4.02	6	30	6~30	3.48±0.67	1~5
Material support	20.87±4.25	6	29	6~30	3.47±0.70	1~5
Depression	16.34±9.19	3	48	0~60	0.81±0.51	0~3
Low group (＜21)					154 (71.3)
High group (≥21)					62 (28.7)

Table 3.

Differences in Depression by General Characteristics (N=216)

Variables	Characteristics	Categories	M±SD	t or F (p)	Scheffé
Sociodemographic characteristics	Age (year)	40~49	15.91±9.18	0.21
		50~59	16.56±9.27	(.807)
		60~64	17.03±9.25
	Marital status	Married^a	15.90±8.99	3.10	a＜d
		Unmarried^b	16.55±7.81	(.028)
		Divorce^c	16.36±10.23
		Bereave^d	25.33±10.35
	Education	≤Middle school^a	20.73±9.04	7.01	a＞c
		High school^b	16.86±9.75	(.001)
		≥Undergraduate^c	14.10±7.96	(.001)
	Occupation	Homemaker	17.79±9.62	1.71
		Specialized job	15.39±9.04	(.167)
		Salaried worker	13.69±7.53
		Others	17.20±9.04
	Perceived economic status	High^a	14.27±8.78	9.33	a, b＜c
		Moderate^b	15.24±8.57	(＜.001)
		Low^c	21.23±9.65	(＜.001)
	Perceived health condition	Health^a	13.95±8.12	10.03	a, b＜c
		Moderate^b	16.44±8.84	(＜.001)
		Unhealth^c	23.25±10.74	(＜.001)
	Menopause	Yes	16.54±9.06	0.27
	Menopause	No	16.19±9.33	(.785)
	Utilization of spare time	Takes care of the house^a	21.03±10.58	8.63	a＞b, c
		Society activity participation^b	13.04±8.42	(＜.001)
		Exercise^c	14.29±7.11
		Others^d	16.90±8.69
Religion related characteristics (N=171)	Religion	None^a	17.46±9.90	3.01	-
		Protestant or catholic^b	14.44±8.42	(.031)
		Buddhism^c	18.52±9.90
		Others^d	14.58±4.16
	Attending religious event	≥2/week^a	13.40±9.40	2.91	a＜d
		1/week^b	16.43±6.81	(.036)
		1/month^c	16.59±6.82
		Others^d†	18.32±9.81
	Beliefs of religion	Large^a	13.41±7.61	7.06	a＜c
		Moderate^b	16.30±8.83	(.001)
		Small or none^c	18.62±10.05	(.001)

^†1~2 or 2~3/month, 3~4/year, special day etc.

Table 4.

Correlation between Spiritual Wellbeing, Social Support, and Depression (N=216)

Variables	Spiritual wellbeing	Existential wellbeing	Religious wellbeing	Social support	Emotional support	Material support	Valuable support	Informational support	Depression
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Spiritual wellbeing	1.00
Existential wellbeing	.84 (＜.001)	1.00
Religious wellbeing	.92 (＜.001)	.56 (＜.001)	1.00
Social support	.45 (＜.001)	.50 (＜.001)	.33 (＜.001)	1.00
Emotional support	.42 (＜.001)	.46 (＜.001)	.30 (＜.001)	.96 (＜.001)	1.00
Material support	.41 (＜.001)	.47 (＜.001)	.30 (＜.001)	.91 (＜.001)	.84 (＜.001)	1.00
Valuable support	.41 (＜.001)	.47 (＜.001)	.29 (＜.001)	.92 (＜.001)	.84 (＜.001)	.78 (＜.001)	1.00
Informational support	.53 (＜.001)	.46 (＜.001)	.34 (＜.001)	.91 (＜.001)	.84 (＜.001)	.75 (＜.001)	.78 (＜.001)	1.00
Depression	-.57 (＜.001)	-.69 (＜.001)	-.37 (＜.001)	-.49 (＜.001)	-.47 (＜.001)	-.44 (＜.001)	-.46 (＜.001)	-.44 (＜.001)	1.00

Table 5.

Factors Influencing Depression of the Participants (N=216)

Variables	Step 1					Step 2
Variables	B	SE	β	t	p	B	SE	β	t	p
Academic background^†	-4.14	1.63	-.18	-2.53	.012	-0.08	1.40	-.00	-0.06	.954
Perceived economic status^†	3.90	1.55	.18	2.52	.013	0.50	1.30	.02	0.39	.701
Utilization of spare time^†	-4.78	1.46	-.23	-3.27	.001	-3.77	1.20	-.18	-3.15	.002
Spiritual wellbeing						-0.56	0.07	-.63	-7.83	＜.001
Social support						-0.12	0.04	-.18	-2.70	.008
	R²=.21, Adjusted R²=.17, F=5.38, p＜.001					R²=.49, Adjusted R²=.46, F=15.67, p＜.001

^†Dummy variables: Utilization of spare time(Takes care of the house=0, Society activity participation, Exercise and Others=1), Academic background (≤Middle school=0, High school and≥Undergraduate=1), Perceived economic status (Low=0, High and Moderate=1).

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Influence of Spiritual Wellbeing and Social Support on Depression in Middle-aged Women

Korean J Adult Nurs. 2014;26(2):181-190. Published online April 30, 2014

DOI: https://doi.org/10.7475/kjan.2014.26.2.181

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Influence of Spiritual Wellbeing and Social Support on Depression in Middle-aged Women

Korean J Adult Nurs. 2014;26(2):181-190. Published online April 30, 2014

DOI: https://doi.org/10.7475/kjan.2014.26.2.181

Influence of Spiritual Wellbeing and Social Support on Depression in Middle-aged Women

Table 1.

General Characteristics of the Participants (N=216)

Characteristic	Characteristic	Categories	n (%)
Sociodemographic characteristics	Age (year)	40~49	95 (44.0)
		50~59	90 (41.7)
		60~64	31 (14.3)
	Marital status	Married	187 (86.5)
		Unmarried	9 (4.2)
		Divorced	11 (5.1)
		Bereaved	9 (4.2)
	Education	≤Middle school	34 (15.7)
		High school	94 (43.5)
		≥Undergraduate	88 (40.8)
	Occupation	Homemaker	68 (31.5)
		Specialized job	74 (34.3)
		Service & salaried worker	26 (12.0)
		Others	48 (22.2)
	Perceived economic status	Low	47 (21.8)
		Moderate	125 (57.9)
		High	44 (20.4)
	Perceived health condition	Health	74 (34.3)
		Moderate	118 (54.6)
		Unhealth	24 (11.1)
	Menopause	Yes	94 (43.5)
	Menopause	No	122 (56.5)
	Utilization of spare time	Takes care of the house	54 (25.0)
		Society activity participation	47 (21.8)
		Exercise	62 (28.7)
		Others	53 (24.5)
Religion related characteristics (N=171)	Religion	None	45 (20.8)
		Protestant or catholic	92 (42.6)
		Buddhism	67 (31.0)
		Others	12 (5.6)
	Attending religious event	≥2/week	57 (26.4)
		1/week	30 (13.9)
		1/month	27 (12.5)
		Others^†	57 (28.2)
	Beliefs of religion	Large	62 (28.7)
		Moderate	73 (33.8)
		Small or None	81 (37.5)

^†1~2 or 2~3/month, 3~4/year, special day etc.

Table 2.

Degree of Spiritual Wellbeing, Social Support, and Depression (N=216)

Variables	M±SD	Min	Max	Possible range	Item/M±SD or n (%)	Range
Spiritual wellbeing	58.02±10.26	34	80	20~80	2.90±0.51	1~4
Existential wellbeing	30.12±4.80	16	40	10~40	3.02±0.48	1~4
Religious wellbeing	27.80±6.77	13	40	10~40	2.78±0.67	1~4
Social support	89.72±15.46	27	123	25~125	3.58±0.61	1~5
Valuable support	22.52±3.91	7	30	6~30	3.75±0.65	1~5
Emotional support	25.42±4.50	8	35	7~35	3.63±0.64	1~5
Informational support	20.90±4.02	6	30	6~30	3.48±0.67	1~5
Material support	20.87±4.25	6	29	6~30	3.47±0.70	1~5
Depression	16.34±9.19	3	48	0~60	0.81±0.51	0~3
Low group (＜21)					154 (71.3)
High group (≥21)					62 (28.7)

Table 3.

Differences in Depression by General Characteristics (N=216)

Variables	Characteristics	Categories	M±SD	t or F (p)	Scheffé
Sociodemographic characteristics	Age (year)	40~49	15.91±9.18	0.21
		50~59	16.56±9.27	(.807)
		60~64	17.03±9.25
	Marital status	Married^a	15.90±8.99	3.10	a＜d
		Unmarried^b	16.55±7.81	(.028)
		Divorce^c	16.36±10.23
		Bereave^d	25.33±10.35
	Education	≤Middle school^a	20.73±9.04	7.01	a＞c
		High school^b	16.86±9.75	(.001)
		≥Undergraduate^c	14.10±7.96	(.001)
	Occupation	Homemaker	17.79±9.62	1.71
		Specialized job	15.39±9.04	(.167)
		Salaried worker	13.69±7.53
		Others	17.20±9.04
	Perceived economic status	High^a	14.27±8.78	9.33	a, b＜c
		Moderate^b	15.24±8.57	(＜.001)
		Low^c	21.23±9.65	(＜.001)
	Perceived health condition	Health^a	13.95±8.12	10.03	a, b＜c
		Moderate^b	16.44±8.84	(＜.001)
		Unhealth^c	23.25±10.74	(＜.001)
	Menopause	Yes	16.54±9.06	0.27
	Menopause	No	16.19±9.33	(.785)
	Utilization of spare time	Takes care of the house^a	21.03±10.58	8.63	a＞b, c
		Society activity participation^b	13.04±8.42	(＜.001)
		Exercise^c	14.29±7.11
		Others^d	16.90±8.69
Religion related characteristics (N=171)	Religion	None^a	17.46±9.90	3.01	-
		Protestant or catholic^b	14.44±8.42	(.031)
		Buddhism^c	18.52±9.90
		Others^d	14.58±4.16
	Attending religious event	≥2/week^a	13.40±9.40	2.91	a＜d
		1/week^b	16.43±6.81	(.036)
		1/month^c	16.59±6.82
		Others^d†	18.32±9.81
	Beliefs of religion	Large^a	13.41±7.61	7.06	a＜c
		Moderate^b	16.30±8.83	(.001)
		Small or none^c	18.62±10.05	(.001)

^†1~2 or 2~3/month, 3~4/year, special day etc.

Table 4.

Correlation between Spiritual Wellbeing, Social Support, and Depression (N=216)

Variables	Spiritual wellbeing	Existential wellbeing	Religious wellbeing	Social support	Emotional support	Material support	Valuable support	Informational support	Depression
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
Spiritual wellbeing	1.00
Existential wellbeing	.84 (＜.001)	1.00
Religious wellbeing	.92 (＜.001)	.56 (＜.001)	1.00
Social support	.45 (＜.001)	.50 (＜.001)	.33 (＜.001)	1.00
Emotional support	.42 (＜.001)	.46 (＜.001)	.30 (＜.001)	.96 (＜.001)	1.00
Material support	.41 (＜.001)	.47 (＜.001)	.30 (＜.001)	.91 (＜.001)	.84 (＜.001)	1.00
Valuable support	.41 (＜.001)	.47 (＜.001)	.29 (＜.001)	.92 (＜.001)	.84 (＜.001)	.78 (＜.001)	1.00
Informational support	.53 (＜.001)	.46 (＜.001)	.34 (＜.001)	.91 (＜.001)	.84 (＜.001)	.75 (＜.001)	.78 (＜.001)	1.00
Depression	-.57 (＜.001)	-.69 (＜.001)	-.37 (＜.001)	-.49 (＜.001)	-.47 (＜.001)	-.44 (＜.001)	-.46 (＜.001)	-.44 (＜.001)	1.00

Table 5.

Factors Influencing Depression of the Participants (N=216)

Variables	Step 1					Step 2
Variables	B	SE	β	t	p	B	SE	β	t	p
Academic background^†	-4.14	1.63	-.18	-2.53	.012	-0.08	1.40	-.00	-0.06	.954
Perceived economic status^†	3.90	1.55	.18	2.52	.013	0.50	1.30	.02	0.39	.701
Utilization of spare time^†	-4.78	1.46	-.23	-3.27	.001	-3.77	1.20	-.18	-3.15	.002
Spiritual wellbeing						-0.56	0.07	-.63	-7.83	＜.001
Social support						-0.12	0.04	-.18	-2.70	.008
	R²=.21, Adjusted R²=.17, F=5.38, p＜.001					R²=.49, Adjusted R²=.46, F=15.67, p＜.001

Table 1. General Characteristics of the Participants (N=216)

†

1~2 or 2~3/month, 3~4/year, special day etc.

Table 2. Degree of Spiritual Wellbeing, Social Support, and Depression (N=216)

Table 3. Differences in Depression by General Characteristics (N=216)

†

1~2 or 2~3/month, 3~4/year, special day etc.

Table 4. Correlation between Spiritual Wellbeing, Social Support, and Depression (N=216)

Table 5. Factors Influencing Depression of the Participants (N=216)

†

Dummy variables: Utilization of spare time(Takes care of the house=0, Society activity participation, Exercise and Others=1), Academic background (≤Middle school=0, High school and≥Undergraduate=1), Perceived economic status (Low=0, High and Moderate=1).

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Influence of Spiritual Wellbeing and Social Support on Depression in Middle-aged Women

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