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Original Article

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

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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

© 2014 Korean Society of Adult Nursing

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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  • 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)
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 Marrieda 15.90±8.99 3.10 a＜d
Unmarriedb 16.55±7.81 (.028)
Divorcec 16.36±10.23
Bereaved 25.33±10.35
Education ≤Middle schoola 20.73±9.04 7.01 a＞c
High schoolb 16.86±9.75 (.001)
≥Undergraduatec 14.10±7.96
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 Higha 14.27±8.78 9.33 a, b＜c
Moderateb 15.24±8.57 (＜.001)
Lowc 21.23±9.65
Perceived health condition Healtha 13.95±8.12 10.03 a, b＜c
Moderateb 16.44±8.84 (＜.001)
Unhealthc 23.25±10.74
Menopause Yes 16.54±9.06 0.27
No 16.19±9.33 (.785)
Utilization of spare time Takes care of the housea 21.03±10.58 8.63 a＞b, c
Society activity participationb 13.04±8.42 (＜.001)
Exercisec 14.29±7.11
Othersd 16.90±8.69
Religion related characteristics (N=171) Religion Nonea 17.46±9.90 3.01 -
Protestant or catholicb 14.44±8.42 (.031)
Buddhismc 18.52±9.90
Othersd 14.58±4.16
Attending religious event ≥2/weeka 13.40±9.40 2.91 a＜d
1/weekb 16.43±6.81 (.036)
1/monthc 16.59±6.82
Othersd† 18.32±9.81
Beliefs of religion Largea 13.41±7.61 7.06 a＜c
Moderateb 16.30±8.83 (.001)
Small or nonec 18.62±10.05

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

    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)
    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.

    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)  

    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 Marrieda 15.90±8.99 3.10 a＜d
    Unmarriedb 16.55±7.81 (.028)
    Divorcec 16.36±10.23
    Bereaved 25.33±10.35
    Education ≤Middle schoola 20.73±9.04 7.01 a＞c
    High schoolb 16.86±9.75 (.001)
    ≥Undergraduatec 14.10±7.96
    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 Higha 14.27±8.78 9.33 a, b＜c
    Moderateb 15.24±8.57 (＜.001)
    Lowc 21.23±9.65
    Perceived health condition Healtha 13.95±8.12 10.03 a, b＜c
    Moderateb 16.44±8.84 (＜.001)
    Unhealthc 23.25±10.74
    Menopause Yes 16.54±9.06 0.27
    No 16.19±9.33 (.785)
    Utilization of spare time Takes care of the housea 21.03±10.58 8.63 a＞b, c
    Society activity participationb 13.04±8.42 (＜.001)
    Exercisec 14.29±7.11
    Othersd 16.90±8.69
    Religion related characteristics (N=171) Religion Nonea 17.46±9.90 3.01 -
    Protestant or catholicb 14.44±8.42 (.031)
    Buddhismc 18.52±9.90
    Othersd 14.58±4.16
    Attending religious event ≥2/weeka 13.40±9.40 2.91 a＜d
    1/weekb 16.43±6.81 (.036)
    1/monthc 16.59±6.82
    Othersd† 18.32±9.81
    Beliefs of religion Largea 13.41±7.61 7.06 a＜c
    Moderateb 16.30±8.83 (.001)
    Small or nonec 18.62±10.05

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

    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
    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

    Factors Influencing Depression of the Participants (N=216)

    Variables Step 1 Step 2
    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).
    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).

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

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