농촌의학ㆍ지역보건 (Journal of agricultural medicine and community health)

한국농촌의학지역보건학회 (Korean Society for Rural Medicine and Community Health)
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생태학적 체계이론에 기반한 남자독거노인의 자살생각 예측모형

Prediction Model of Suicidal Ideation in Elderly Men Living Alone Based on Ecological System Theory

  • 투고 : 2017.03.07
  • 심사 : 2017.06.01
  • 발행 : 2017.06.30
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초록

본 연구는 남자독거노인의 자살생각을 설명하는 가설적 모형을 구축하여 실제 자료간의 적합도를 검증함으로써, 남자독거노인의 자살생각을 감소시켜주는 노인자살예방프로그램을 개발하기 위한 기초자료를 제공하고자 시도되었다. 가설적 모형의 적합도를 검증한 결과 ${\chi}^2/df$, RMR, GFI, AGFI CFI, IFI, RMSEA 기준을 만족하여 가설적 모형을 수정없이 최종모형으로 확정하였다. 남자독거노인의 자살생각에 영향을 미치는 가장 큰 요인은 자아존중감이였으며, 요인에 대한 설명력이 55%였다. 결론적으로 본 연구에서 남자독거노인의 자살생각의 최종 결과변인으로 검정된 우울, 사회적 고립감을 감소시키고 자아존중감, 가족결속력, 사회활동 참여, 스트레스 대처, 사회적 지지를 향상시킬 수 있는 효율적인 맞춤형 노인 자살예방 프로그램을 개발하여 적용한다면 남자독거노인의 자살생각을 예방하는데 도움이 될 것이라고 본다. 마지막으로 본 연구의 제한점을 토대로 몇 가지 제언을 하고자 한다. 우선, 본 연구는 가정, 경로당, 종합복지회관을 이용하는 남자독거노인을 대상으로 자료수집을 하였기 때문에 연구결과의 일반화에 한계가 있으므로 다양한 장소에서 남자독거노인을 대상으로 한 확대 연구를 제언한다. 또한 설문의 내용이 민감하여 제대로 답변을 못하는 경우도 있어 심도있게 향후 질적연구를 제언하며, 본 연구에서 규명된 남자독거노인의 자살생각 영향변인들을 근거로 남자독거노인의 자살생각을 예방하기 위한 맞춤형 노인자살예방 프로그램을 개발하고 그 효과를 평가하는 연구가 필요하다.

Objectives: This study was performed to build the predictive model of suicidal ideation of elderly men living alone. Methods: As for the subject, 251 subjects suitable for the selection criteria were selected among elderly men living alone above 65 years old in one region in Gyeongnam and three regions in Gyeongbuk. The data were collected via questionnaires and analyzed using SPSS version 20.0 and Amos version 18.0. Results: The goodness-of-fit test result of hypothetical model were suitable for recommended level: ${\chi}^2/df=1.47$, RMR=.04, GFI=.92, AGFI=.90, CFI=.95, IFI=.95, RMSEA=.04. Self-esteem, individual coping, family cohesion, social support, social activity, and depression explained 55% of the model of suicidal ideation. The most influential direct factor of suicidal ideation was self-esteem, and social isolation was the most influential indirect influence on suicidal ideation. Conclusion: To sum up the above results, if we promote the researched variables of self-esteem, family cohesion, social activity, individual coping and social support in addition to developing and utilizing an efficient customized suicidal prevention nursing intervention program thereby reducing depression and social isolation, suicidal ideation of elderly men living alone would be prevented.

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참고문헌

  1. Statistics Korea. [Internet]. Estimated future furniture 2013. [cited 2014 May 30]. Available from:http://meta.narastat.kr/metasvc/index.do?confmNo=10162&input.
  2. Harwood D, Jacoby R. Suicidal behavior among the elderly. In The international handbook of suicide and attempted suicide. New York, Wiley & Sons, 2000. pp.275-288
  3. Statistics Korea. [Internet] Cause of death statistics. 2008. [cited 2014 May 13]. Available from:http://meta.narastat.kr/metasvc/ index.do?confmNo=10154&input
  4. Seo GH, Kim YS. Investigation of social support and mental health among the elderly people living alone. Journal of Welfare for the Aged 2003;21: 7-26 (Korean)
  5. Almeida OP, Draper B, Snowdon J, Lautenchlager NT, Pirkis J, Byrne G, et al. Factors associated with suicidal thoughts in a large community study of older adults. Br J Psychiatry 2012;20(1): 466-472
  6. Kim YJ. Comparison of health habits, perceived stress, depression, and suicidal thinking by gender between elders living alone and those living with others. J Korean Acad Fundam Nurs 2009;16(3):333-344 (Korean)
  7. Sohn JN. A Study on Factors Influencing the Suicidal Ideation in Elderly People who Live Alone or Live with Family. J Korean Acad Psychiatr Ment Health Nurs 2012;21(2): 118-126 (Korean) https://doi.org/10.12934/jkpmhn.2012.21.2.118
  8. Yang YS. A Study on Time Use and Roles of the Older Adults in Aging Society. Korean Journal of Social Welfare Research 2007;16: 1-26 (Korean)
  9. Hur SY. Study on the Lived Experience of Elderly Men Living Alone in a Single Room Occupancy (Chokbang). Journal of the Korean Gerontological Society 2010;30(1): 241-260 (Korean)
  10. Hwang MG, Kim EJ. The Effect of Subjective Quality of Life and Self-esteem on Suicide Ideation among the Older Adults: Focused on the Mediating Effect of Depression. Journal of the Korean Gerontological Society. 2008;28(4): 865-885 (Korean)
  11. Kang WS. The Effect of Variables on Depression and Suicidal Instinct of the Elderly [dissertation]. Daejeon, Hansei University, 2012 (Korean)
  12. Lee MY, Nam KM.(2007). The Relationship between the Elderly's Stress and Their Depression and Suicidal Ideation-Focusing on Coping Strategy of Stress as Mediator. Korean Journal of Social Welfare Studies 2007;34: 307-325 (Korean)
  13. Cho EH, Lee GY.(2013). A Study on the Effect of Main Variables to the Suicidal Ideation among the Elderly Living Alone: Focused on the Direct and Indirect Effects of Social Support. Health and Social Welfare Review 2013;33(1),162-189 (Korean) https://doi.org/10.15709/hswr.2013.33.1.162
  14. Bae JY. Structural Equational Modeling for Elderly Suicidal Thoughts. Social Science Review 2005;25(3):59-73 (Korean)
  15. Shin HG. Effects of the elderly's ageism experience on suicidal thought and mediating effect of hopelessness and depression. Journal of Welfare for the Aged 2012; 56:191-216 (Korean)
  16. Lee HS. Understanding and preventing suicide. Seoul, Hakjisa,2008, pp.97-98
  17. Harlow LL, Newcomb MD, Bentler PM. Depression, self-derogation, substance use, and suicide ideation: Lack of purpose in life as a meditational factor. J Clin Psychol 1986;42(1):5-21 https://doi.org/10.1002/1097-4679(198601)42:1<5::AID-JCLP2270420102>3.0.CO;2-9
  18. Kim HS.(2002). A Study on Epistemology of Korean Elder's Suicidal Thought. Journal fo the Korea Gerontological Society 2002;22(1):159-172 (Korean)
  19. Kwon JH. A study on the factors influencing on the suicidal thoughts of the aged persons living alone [master's thesis]. Daejeon, Mokwon University, 2009 (Korean)
  20. Beck A, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974; 42(6):861-865 https://doi.org/10.1037/h0037562
  21. Rosenberg M, Simons RG. Black and white self-esteem, the urban school child. Washington D. C, Ros-Monograhp Seties, 1965, pp.553-556
  22. Jon BJ. Self-esteem: A test of its measurability. Yonsei Journal 1974;11(1): 107-130 (Korean)
  23. OH HS. The impact of the individual and environmental factors on the life-satisfaction of the elderly. Journal of Social Welfare Development 2003;9(3):323-352 (Korean)
  24. Youn HH. The stress, coping behavior and well-being of older adults. Journal of the Korea Gerontological Society 1994;14(1):17-31 (Korean)
  25. Lawton M, Moss M, Fulcomer M, Kleban MH. A Research and service oriented multilevel assessment instrument. J Gerontol 1982;37(1):91-99 https://doi.org/10.1093/geronj/37.1.91
  26. Leem MY. Determinants of health promoting behavior of college students in korea. [dissertation]. Seoul, Yonsei University, 1998 (Korean)
  27. Lee YH. The impact of elder abuse risk factors and characteristics on the effects of elder abuse. Journal of the Korea Gerontological Society 2003;23(2):105-123 (Korean)
  28. Zimet GD, Dahlem NW, Zimet SG., Farley GK. The multi dimensional scale of perceived social support. J Pers Assess 1988;52(1):30-41 https://doi.org/10.1207/s15327752jpa5201_2
  29. Jang GS, Rim CS, Jeong MS.. A Study on Influential Factors for the Suicide Ideation of the Elderly Living Alone. Journal of Social Science Research 2013;22:193-224 (Korean)
  30. Weiss RS. Loneliness: The experience of emotional and social isolation. Massachusetts, MIT Press, 1975, pp.236
  31. Kim YA. Factor affecting the suicidal ideation of elderly [master's thesis]. Seoul, Chongshin University, 2008 (Korean)