Journal of Industrial Convergence (산업융합연구)

DAEHAN Society of Industrial Management (대한산업경영학회)
권호 표지
DOI QR코드

DOI QR Code

The Mediating Effects of Depression on Loneliness and Suicidal Ideation in Elderly Living Alone with Diabetes Mellitus: A Secondary Data Analysis

독거 당뇨병 노인의 외로움이 자살사고에 미치는 영향에 대한 우울의 매개효과 검증: 2차 자료 분석

  • Moonhee Gang (College of Nursing, Chungnam National University) ;
  • Yujin Ahn (College of Nursing, Chungnam National University)
  • Received : 2023.02.06
  • Accepted : 2023.05.20
  • Published : 2023.05.28
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study is to analyze suicidal ideation of elderly people with diabetes living alone and to investigate the relationship between suicidal ideation, loneliness, and depression. This study was conducted through secondary data analysis using total survey data for the elderly living alone in O province. The subjects of this study were 466 elderly people who were diagnosed with diabetes among the elderly living alone. The data of this study were analyzed using descriptive statistics, t-test, Pearson's correlation coefficients, multi-linear regression analysis, and the three-step mediating effect verification procedure of Baron & Kenny using the SPSS 26.0 program. The average loneliness score and average depression score of the subjects were 4.52±3.30 and 4.88±4.03, respectively, and 27.3% of the subjects said they had a suicidal ideation. The subject's loneliness (β=.20, p=.005) and depression (β=.30, p<.001) was found to be a significant factor in predicting suicide ideation. In addition, depression was found to be partially mediated in the relationship between loneliness and suicidal ideation. Through the results of this study, loneliness and depression were found to be important factors related to suicidal ideation in the elderly with diabetes living alone. In addition, in order to improve suicidal ideation in the elderly with diabetes living alone, intervention to lower the level of loneliness and depression is necessary.

본 연구는 독거 당뇨병 노인의 자살사고를 분석하고 자살사고와 외로움, 우울의 연관성을 규명하는 것이 목적이다. 본 연구는 O 지역의 독거노인을 대상으로 한 전수조사 자료를 활용하여 2차 자료 분석을 통해 수행되었다. 본 연구 대상자는 독거노인 중 당뇨병을 진단받은 466명이었다. 본 연구의 자료는 SPSS 26.0 프로그램을 이용하여 서술통계, t-test, Pearson's correlation coefficients, 다중선형회귀분석 및 Baron과 Kenny의 3단계 매개효과 검증 절차를 활용하여 분석하였다. 대상자의 평균 외로움 점수와 평균 우울 점수는 각각 4.52±3.30, 4.88±4.03으로 나타났으며, 자살사고가 있다고 응답한 대상자는 27.3%이었다. 대상자의 외로움(β=.20, p=.005)과 우울(β=.30, p<.001)은 자살사고를 예측하는 유의한 요인으로 나타났다. 또한 외로움과 자살사고의 관계에서 우울은 부분 매개하는 것으로 나타났다. 본 연구 결과를 통해 외로움과 우울은 독거 당뇨병 노인의 자살사고와 관련된 중요한 요인으로 나타났다. 또한 독거 당뇨병 노인의 자살사고를 개선하기 위해서는 외로움 및 우울의 수준을 낮추는 중재가 필요하다.

Keywords

References

  1. A. Izzo, E. Massimino, G. Riccardi & G. Della Pepa. (2021). A narrative review on sarcopenia in type 2 diabetes mellitus: prevalence and associated factors. Nutrients, 13(1), 183. DOI : 10.3390/nu13010183
  2. D. LeRoith et al. (2019). Treatment of diabetes in older adults: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 104(5), 1520-1574. DOI : 10.1210/jc.2019-00198
  3. G. Sesti et al. (2018). Management of diabetes in older adults. Nutrition, Metabolism and Cardiovascular Diseases, 28(3), 206-218. DOI : 10.1016/j.numecd.2017.11.007
  4. J. M. McCaffery et al. (2020). Loneliness relates to functional mobility in older adults with type 2 diabetes: the Look AHEAD Study. Journal of aging research, 2020, 8. DOI : 10.1155/2020/7543702
  5. KDCA. (2020). Korea National Health and Nutrition Examination Survey. Sejong: Korea Disease Control and Prevention Agency.
  6. R. M. AbdElmageed & S. M. M. Hussein. (2022). Risk of Depression and Suicide in Diabetic Patients. Cureus, 14(1). DOI : 10.7759/cureus.20860
  7. D. Corno & R. J. Burns. (2022). Loneliness and functional limitations among older adults with diabetes: Comparing directional models. Journal of Psychosomatic Research, 154, 110740. DOI : 10.1016/j.jpsychores.2022.110740
  8. K. D. Barnard-Kelly et al. (2020). An intolerable burden: suicide, intended self-injury and diabetes. Canadian journal of diabetes, 44(6), 541-544. DOI : 10.1016/j.jcjd.2020.01.008
  9. HH. J. Yoo, E. J. Choo & S. H. Lee. (2020). Study of hospitalization and mortality in Korean diabetic patients using the diabetes complications severity index. BMC Endocrine Disorders, 20(1), 1-10. DOI : 10.1186/s12902-020-00605-5
  10. W. M. Sweileh. (2018). Analysis of global research output on diabetes depression and suicide. Annals of general psychiatry, 17(1), 1-13. DOI : 10.1186/s12991-018-0214-2
  11. M. Markle-Reid et al. (2018). Community Program Improves Quality of Life and Self-Management in Older Adults with Diabetes Mellitus and Comorbidity. Journal of the American Geriatrics Society, 66(2), 263. DOI : 10.1111/jgs.15173
  12. Y. Ma, Q. Xiang, C. Yan, H. Liao & J. Wang. (2021). Relationship between chronic diseases and depression: the mediating effect of pain. BMC psychiatry, 21(1), 1-11. DOI : 10.1186/s12888-021-03428-3
  13. KFSP. (2021). Five-Year('13~'17) National Suicide Death Analysis Results Report. Seoul : KOREA FOUNDATION FOR SUICIDE PREVENTION.
  14. S. M. Kim & G. J. Lee. (2020). Risk Factors of Suicide Ideation in Younger-Old and Older-Old Persons: Using Data from the Korea Health Panel Survey. Journal of Korean Gerontological Nursing, 22(4), 281. DOI : 10.17079/jkgn.2020.22.4.281
  15. G. M. Lee & S. Y. Shin. (2020). Influence of Self-care Competency, Family Support, and Depression on Life Satisfaction in Older Patients with Diabetes Mellitus. Journal of Korean Gerontological Nursing, 22(4), 326. DOI : 10.17079/jkgn.2020.22.4.326
  16. L. Rodriguez-Manas et al. (2019). Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. Journal of Cachexia, Sarcopenia and Muscle, 10(4), 721-733. DOI : 10.1002/jcsm.12432
  17. J. Y. Jeong & S. I. Lee. (2017). Physical Health Related Factors on Suicidal Thought among Community-dwelling Elderly in Korea. Korean Public Health Res, 43(4), 59-72. DOI : 10.22900/KPHR.2017.43.4.005
  18. S. W. Lee et al. (2019). Risk Factors Associated with Loneliness in the Elderly Living Alone. Korean J Psychosomatic Med, 27(2), 173-180. DOI : 10.22722/KJPM.2019.27.2.173
  19. E. J. Bong. (2020). The Relationship between Sense of Loss and Suicidal Ideation among Rural Elders use Primary Health Care Post's Services: Mediating Effect of Depression. Journal of agricultural medicine and community health, 45(1), 1-12. DOI : 10.5393/JAMCH.2020.45.1.001
  20. E. Kobos, A. Szewczyk, J. Kokoszka-Paszkot & B. Dziedzic. (2021). Factors associated with loneliness in patients with diabetes mellitus. Nursing Open, 8(1), 517-524. DOI : 10.1002/nop2.655
  21. D. Corno & R. J. Burns. (2022). Loneliness and functional limitations among older adults with diabetes: Comparing directional models. Journal of Psychosomatic Research, 154, 110740.  DOI : 10.1016/j.jpsychores.2022.110740
  22. S. Gujral, M. A. Butters, A. Y. Dombrovski & K. Szanto. (2021). Late-Onset Suicide: A Dementia Prodrome?. American Journal of Geriatric Psychiatry, 29(7), 709. DOI : 10.1016/j.jagp.2020.12.004
  23. M. H. Gang & Y. J. Ahn. (2022). Related Factors of Suicide Ideation in Elderly People with Diabetes Mellitus Living Alone in Rural Area. Journal of Industrial Convergence, 20(10), 79-86.
  24. E. C. Huskisson. (1979). Measurement of pain. Lancet, 2(9), 1127-1131.
  25. B. S. Kee. (1996). A Preliminary Study for the Standardization of Geriatric Depression Scale Short Form-Korea Version. Journal of Korean Neuropsychiatric Association, 35(2), 298-307.
  26. Ministry of Health and Welfare. (2020). The Survey of Living Conditions and Welfare Needs of Older Korean Persons. Sejong : Ministry of Health and Welfare
  27. Ministry of Health and Welfare & KOREA INSTITUTE FOR HEALTH AND SOCIAL AFFAIRS. (2020). 2020 the Korean Elderly Survey. Sejong : KIHASA