Employed women with depression in Korea

Factors affecting suicidal ideation among premenopausal and postmenopausal women

WHAT IS KNOWN ON THE SUBJECT?: Pre- and postmenopausal women (PPW) experience changes in physical, psychological and social health. South-East Asia's female suicide rate is the highest compared with other countries, and the suicide rate of PPW in these countries continues to increase. The most influential factor in Asian women's suicidal ideation is family conflict; specifically, if PPW in South Korea cannot express their anger, it results in a culture-bound syndrome called "Hwa-Byung." However, there is a lack of research on Asian PPW. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study found differences in individual- and community-level factors affecting suicidal ideation between pre- and postmenopausal women. Individual factors that commonly affected suicidal ideation were experiencing violence, stress and depression. Individual factors that affected the suicidal ideation of premenopausal women more than postmenopausal women were religious beliefs, alcohol use and chronic disease. Community level factors affecting suicidal ideation were locational depression and locational counselling for stress in premenopausal women and locational counselling for depression in postmenopausal women. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses could help prevent suicide by developing and applying community-based programmes for PPW, considering the specific socio-economic and cultural context and characteristics of Asian women. Mental health nurses could help PPW participate in programmes by preparing various interventions such as case management, personal counselling, physical activity, home-based mental health services, cognitive behavioural therapy and digital interventions for self-management. Mental health nurses need to prepare various methods such as online, offline, individual and group methods to work effectively in any social situation. ABSTRACT: Introduction Pre- and postmenopausal women (PPW) experience physical and psychological changes with hormonal changes. Among Asian middle-aged women, family and culture affect suicidal ideation, and the suicide rate among this population is increasing. There are few existing research on suicidal ideation among Asian PPW. Aim We examined individual- and community-level factors that predict suicidal ideation among PPW. Method Large-scale panel data from 5,154 South Korean PPW aged 35-64 years were used in a series of multilevel logistic regression analyses to examine factors associated with suicidal ideation at individual and community levels. Results Among premenopausal women, religious beliefs, alcohol use, chronic disease, experience of violence, stress and depression were individual-level factors. Locational depression and locational counselling for stress were community-level factors. Among postmenopausal women, experience of violence, stress, depression and perceived health status were individual level factors, and locational counselling for depression was a community level factor. Discussion Suicidal ideation among PPW is affected by both individual and community level factors. Nurses must comprehensively determine what risk factors affect suicidal ideation through various intervention methods-including online, offline, individual and group methods-while considering socio-economic situations. Implications for Practice Mental health nurses should provide targeted biopsychosocial interventions targeting psychosocial and physical problems and promoting the use of community resources to reduce PPW's suicidal ideation.

An Instrumental Variable Probit (IVP) analysis on depressed mood in Korea: the impact of gender differences and other socio-economic factors

BACKGROUND

Depression is a mental health state whose frequency has been increasing in modern societies. It imposes a great burden, because of the strong impact on people's quality of life and happiness. Depression can be reliably diagnosed and treated in primary care: if more people could get effective treatments earlier, the costs related to depression would be reversed. The aim of this study was to examine the influence of socio-economic factors and gender on depressed mood, focusing on Korea. In fact, in spite of the great amount of empirical studies carried out for other countries, few epidemiological studies have examined the socio-economic determinants of depression in Korea and they were either limited to samples of employed women or did not control for individual health status. Moreover, as the likely data endogeneity (i.e. the possibility of correlation between the dependent variable and the error term as a result of autocorrelation or simultaneity, such as, in this case, the depressed mood due to health factors that, in turn might be caused by depression), might bias the results, the present study proposes an empirical approach, based on instrumental variables, to deal with this problem.

METHODS

Data for the year 2008 from the Korea National Health and Nutrition Examination Survey (KNHANES) were employed. About seven thousands of people (N= 6,751, of which 43% were males and 57% females), aged from 19 to 75 years old, were included in the sample considered in the analysis. In order to take into account the possible endogeneity of some explanatory variables, two Instrumental Variables Probit (IVP) regressions were estimated; the variables for which instrumental equations were estimated were related to the participation of women to the workforce and to good health, as reported by people in the sample. Explanatory variables were related to age, gender, family factors (such as the number of family members and marital status) and socio-economic factors (such as education, residence in metropolitan areas, and so on). As the results of the Wald test carried out after the estimations did not allow to reject the null hypothesis of endogeneity, a probit model was run too.

RESULTS

Overall, women tend to develop depression more frequently than men. There is an inverse effect of education on depressed mood (probability of -24.6% to report a depressed mood due to high school education, as it emerges from the probit model marginal effects), while marital status and the number of family members may act as protective factors (probability to report a depressed mood of -1.0% for each family member). Depression is significantly associated with socio-economic conditions, such as work and income. Living in metropolitan areas is inversely correlated with depression (probability of -4.1% to report a depressed mood estimated through the probit model): this could be explained considering that, in rural areas, people rarely have immediate access to high-quality health services.

CONCLUSION

This study outlines the factors that are more likely to impact on depression, and applies an IVP model to take into account the potential endogeneity of some of the predictors of depressive mood, such as female participation to workforce and health status. A probit model has been estimated too. Depression is associated with a wide range of socio-economic factors, although the strength and direction of the association can differ by gender. Prevention approaches to contrast depressive symptoms might take into consideration the evidence offered by the present study.

Relationship between handling heavy items during pregnancy and spontaneous abortion: a cross-sectional survey of working women in South Korea

The researchers conducted a cross-sectional survey to determine the relationship between handling heavy items during pregnancy and spontaneous abortion among working women in South Korea. One thousand working women were selected from a database of those eligible for maternity benefits under the National Employment Insurance Plan. Study results showed that handling heavy items during pregnancy was associated with an increased risk of spontaneous abortion after adjusting for general characteristics of the participants and their work environment. A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant.

Relationship between handling heavy items during pregnancy and spontaneous abortion: a cross-sectional survey of working women in South Korea

The researchers conducted a cross-sectional survey to determine the relationship between handling heavy items during pregnancy and spontaneous abortion among working women in South Korea. One thousand working women were selected from a database of those eligible for maternity benefits under the National Employment Insurance Plan. Study results showed that handling heavy items during pregnancy was associated with an increased risk of spontaneous abortion after adjusting for general characteristics of the participants and their work environment. A collective effort is needed on the parts of employers, employees, occupational health nurses, and the government to protect working women from lifting heavy items while pregnant.

Burden of Chinese stroke family caregivers: the Hong Kong experience

OBJECTIVE

To ascertain the clinical and sociodemographic factors associated with family caregivers' burden in Chinese patients with stroke in Hong Kong.

DESIGN

Cross-sectional design.

SETTING

Stroke Clinic.

PARTICIPANTS

Patients (N=123) from a stroke clinic and their family caregivers.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Predictive factors of family caregivers' burden in Chinese stroke patients in Hong Kong. Caregivers' burden was assessed with the Caregiving Burden Scale (CBS). Patients' and caregivers' sociodemographic data and clinical characteristics were recorded. Physical and psychological conditions were measured and rated with the following instruments: Cumulative Illness Rating Scale, Geriatric Depression Scale (GDS), Barthel Index, Instrumental Activities of Daily Living, Mini-Mental State Examination, Lubben Social Network Scale, Modified Life Event Scale (MLES), Hospital Anxiety and Depression Scale (HADS), and a single question about fatigue.

RESULTS

In the univariate analysis, the CBS score had significant correlations with certain characteristics of caregivers (sex, GDS, HADS, depressive symptoms, fatigue, and MLES) and those of patients' (sex, age, education, GDS). Regression analysis revealed that caregivers' GDS and patients' education were the independent correlates of the CBS.

CONCLUSIONS

The severity of depressive symptoms in Chinese stroke caregivers and patients' education are independent factors associated with the caregivers' burden. Further studies evaluating interventions on caregivers' burden should include the assessment and management of mood disorders.