DOI QR코드

DOI QR Code

ICF 모델에 기반한 독거노인과 동거 노인의 자살 생각 관련 요인에 대한 비교분석: 2023년 지역사회건강조사 자료 활용

Comparative Analysis of Factors Related to Suicidal Ideation between Elderly Living Alone and Living with Families Based on the ICF Model: Using Data from the 2023 Community Health Survey

  • 심유화 (초당대학교 간호학과)
  • Yu-Hwa Shim (Dept. of Nursing, Chodang University)
  • 투고 : 2024.05.21
  • 심사 : 2024.06.18
  • 발행 : 2024.06.30

초록

This study utilized the raw data from the Community Health Survey (2023) to compare differences in body function, activity, participation, environment, personal factors, and suicidal ideations between elderly individuals aged 65 and older living alone and those living with families in Korea. The study subjects consisted of 80,618 elderly individuals aged 65 and older. Cross-tabulation analysis χ2-test), independent sample t-test, and logistic regression analysis were conducted. The results indicated that for both elderly individuals living alone and those living with families, age(p<.001), smoking(p<.001), stress(p<.001), depression experience(p<.001), and falls experiences(p<.001) were risk factors that increased suicidal ideations. Conversely, educational level(p<.05), income level(p<.001), subjective health status(p<.001), social participation(p<.001), economic activity(p<.001), community environment(p<.001), and social relationships were protective factors that reduced suicidal ideations. These findings demonstrate that demographic characteristics and individual health status significantly influence suicidal ideation in the elderly, while social factors contribute to a decrease in suicidal ideation. Furthermore, considering the differences found between elderly individuals living alone and those living with families regarding hypertension and gender, differentiated interventions for suicide prevention are necessary.

키워드

과제정보

본 연구는 초당대학교 2024학년도 교내연구과제연구 보조비를 지원받아 수행된 연구입니다.

참고문헌

  1. Carbonaro, G., Leanza, E., McCann, P., & Medda, F, "Demographic decline, population aging, and modern financial approaches to urban policy", International Regional Science Review, vol.41, no.2, pp.210-232, (2018).
  2. WHO, Ageing and health, World Health Organization, (2021).
  3. Statistics Korea, 2021 Statistics for the Elderly, Department of Social Statistics Planning, (2021).
  4. WHO, Mental health and substance use: Suicide data, World Health Organization, https://www.who.int/teams/mental-health-and-subs tance-use/suicide-data, (2019).
  5. Statistics Korea, Cause-of-death statistics in 2022 in the Republic of Korea. Department of Social Statistics Planning, (2023).
  6. Makara-Studzinska, M., Somasundaram, S. G., Halicka, J., Madej, A., Leszek, J., Rehan, M., ... & Aliev, G, "Suicide and suicide attempts in elderly patients: an epidemiological analysis of risk factors and prevention", Current pharmaceutical design, vol.27, no.19, pp.2231-2236, (2021).
  7. Mattson, M. P., & Arumugam, T. V, "Hal l marks of brain aging: adaptive and pathological modification by metabolic states", Cell metabolism, vol.27, no.6, pp.1176-1199, (2018).
  8. Kuzuya, M, "Era of geriatric medical challenges: Multimorbidity among older patients", Geriatrics & gerontology international, vol.19, no.8, pp.699-704, (2019).
  9. Hale, M., Shah, S., & Clegg, A, "Frailty, inequality and resilience", Clinical Medicine, vol.19, no.3, pp.219-223, (2019).
  10. Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K., & Allebeck, P, Burden of illness and suicide in elderly people: case-control study. BMJ, vol.318, no.7179, pp.1515-1519, (2018).
  11. Chang, C. K., Hayes, R. D., Broadbent, M. T. M., Hotopf, M., Davies, E., Mutsatsa, S., ... & Stewart, R, A cohort study on mental disorders, stage of cancer at diagnosis and subsequent survival. BMJ Open, vol.10 no.4, pp.e032850,
  12. Lee C, Park YH, Cho B, "Leveraging network analysis to determine sex differences in factors associated with frailty among older adults living alone", BMC Geriatrics, vol.23, no.1, pp.38, (2023).
  13. Kim, S. A., Kwon, M., & Seo, K, "Factors influencing depression: comparison between elders living alone and elders not living alone", Journal of Korean Gerontological Nursing, vol.21, no.2, pp.51-60, (2019).
  14. Teguo, M. T., Simo-Tabue, N., Stoykova, R., Meillon, C., Cogne, M., Amieva, H., & Dartigues, J.-F, "Feelings of loneliness and living alone as predictors of mortality in the elderly: the PAQUID study", Psychosomatic medicine, vol.78, no.8, pp.904-909, (2016).
  15. Joiner, T, Why People Die by Suicide. Cambridge, Harvard University Press, (2005).
  16. Okura, M., Ogita, M., Yamamoto, M., Nakai, T., Numata, T., & Arai, H, "The relationship of community activities with cognitive impairment and depressive mood independent of mobility disorder in Japanese older adults", Archives of gerontology and geriatrics, vol.70, pp.54-61, (2017).
  17. Hulur, G., Drewelies, J., Eibich, P., Duzel, S., Demuth, I., Ghisletta, P., Steinhagen-Thiessen, E., Wagner, G. G., Lindenberger, U., & Gerstorf, D, "Cohort differences in psychosocial function over 20 years: Current older adults feel less lonely and less dependent on external circumstances", Gerontology, vol.62, no.3, pp.354-361, (2016).
  18. Gleeson, H., Roesch, C., Hafford-Letchfield, T., & Ellmers, T, "Assessing suicide ideation among older adults: a systematic review of screening and measurement tools", International Psychogeriatrics, vol.34, no.5, pp.439-452, (2022).
  19. Hou, B., & Zhang, H, "Latent profil e anal ysis of depression among older adults living alone in China", Journal of Affective Disorders, vol.325, pp.378-385, (2023).
  20. Courtin, E., & Knapp, M, Social isol ation, loneliness and health in old age: a scoping review. Health & Social Care in the Community, vol.25, no.3, pp.799-812, (2017).
  21. Liu, H., Guo, L., & Feng, Z, Social participation, attitudes towards ageing and depressive symptoms among Chinese older adults. Ageing & Society, vol.44, no.2, pp.269-281, (2024).
  22. Taylor, H. O, "Social isolation's influence on loneliness among older adults", Clinical Social Work Journal, vol.48, no.1, pp.140-151, (2022).
  23. Hong, J., & Lee, K, "The aging work force in Korea", International archives of occupational and environmental health, vol.85, no.3, pp.253-260, (2012).
  24. Lin, Y., Lin, R., Liu, W., & Wu, W, "Effectiveness of horticultural therapy on physical functioning and psychological health outcomes for older adults: A systematic review and meta-analysis", Journal of clinical nursing, vol.31, no.15-16, pp.2087-2099, (2022).
  25. Kim, D., Arai, H., & Kim, S, "Social activities are associated with cognitive decline in older Koreans", Geriatrics & gerontology international, vol.17, no.8, pp.1191-1196, (2017).
  26. WHO. International classification of functioning, disability and health, Genenva, WHO, (2001).
  27. Stallinga, H. A., Snyman, S., Heidi Anttila, H., de Camargo, O. A. K., van der Veen, S., Paltamaa, J.,Maribo, T., Valerius, J. D., Sykes, C. R., Leonardi, M., Weckstrom, P., & Van Greunen, D, "The ICanFunction mHealth Solution (mICF): A project bringing equity to health and social care within a person-centered approach", Journal of Interprofessional Workforce Research and Development, vol.2, no.1, pp.1-17, (2019).
  28. Moran, M., Bickford, J., Barradell, S., & Scholten, I, "Embedding the international classification of functioning, disability and health in health professions curricula to enable interprofessional education and collaborative practice", Journal of Medical Education and Curricular Development, vol.7,
  29. Abdi, S., Spann, A., Borilovic, J., de Witte, L., & Hawley, M, "Understanding the care and support needs of older people: a scoping review and categorisation using the WHO international classification of functioning, disabil ity and heal th framework (ICF)", BMC geriatrics, vol.19, no.1, pp,1-15, (2019).
  30. Yi, Y., & Park, Y. H, "Structural equation model of the relationship between functional ability, mental health, and quality of life in older adults living alone", Plos one, vol.17, no.8, pp.e0269003, (2022).
  31. Fairhall, N., Sherrington, C., Kurrle, S. E., Lord, S., & Cameron, I. "ICF participation restriction is common in frail, community-dwelling older people: an observational cross-sectional study", Physiotherapy, vol.97, no.1, pp.26-32, (2011).
  32. Oh JY, Yang YJ, Kim BS, Kang JH, "Validity and reliability of Korean version of international physical activity questionnaire (IPAQ) short form", Journal of the Korean Academy of Family Medicine, vol.28, no.7, pp.532-541, (2007).
  33. Yang, J., Kim, H., & Choi, E. A, "Comparison study of the effect of ageism and social support on suicidal ideation among elderly in UK and S. Korea", International Journal of Korean Humanities and Social Sciences, vol.11, pp.745-760,
  34. Cukrowicz, K. C., Cheavens, J. S., Van Orden, K. A., Ragain, R. M., & Cook, R. L, "Perceived burdensomeness and suicide ideation in older adults", Psychology and aging, vol.26, no.2, pp.331, (2011).
  35. Bickford, D., Morin, R. T., Woodworth, C., Verduzco, E., Khan, M., Burns, E., ... & Mackin, R. S, "The relationship of frailty and disability with suicidal ideation in late life depression", Aging & mental health, vol.25, no.3, pp.439-444, (2021).
  36. Ko, Y., Han, S. Y., & Jang, H. Y, "Factors influencing suicidal ideation and attempts among older Korean adults: focusing on age discrimination and neglect", International journal of environmental research and public health, vol.18, no,4, pp.1852, (2021).
  37. Poorolajal, J., & Darvishi, N, "Smoking and suicide: a meta-analysis", PloS one, vol.11, no.7, pp.e0156348, (2016).
  38. Sohn, S. Y, "A study on factors affecting the elderly suicidal ideation in Korea", The Korean journal of health service management, vol.8, no.2, pp.149-160, (2014).
  39. Hautekiet, P., Saenen, N. D., Martens, D. S., Debay, M., Van der Heyden, J., Nawrot, T. S., & De Clercq, E. M, "A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing", BMC medicine, vol.20, no.1, pp.328, (2022).
  40. Lu, L., Xu, L., Luan, X., Sun, L., Li, J., Qin, W., ... & Jiao, A. A, "Gender difference in suicidal ideation and related factors among rural elderly: a cross-sectional study in Shandong, China", Annals of general psychiatry, vol.19, pp.1-9,
  41. Obuobi-Donkor, G., Nkire, N., & Agyapong, V. I, "Prevalence of major depressive disorder and correlates of thoughts of death, suicidal behaviour, and death by suicide in the geriatric population-A general review of literature", Behavioral Sciences, vol.11, no.11, pp.142, (2021).
  42. Bickford, D., Morin, R. T., Nelson, J. C., & Mackin, R. S, "Determinants of suicide-related ideation in late life depression: Associations with perceived stress", Clinical gerontologist, vol.43, no.1, pp.37-45,
  43. Park, J. I., Yang, J. C., Han, C., Park, T. W., & Chung, S. K, "Suicidal ideation among Korean elderly: risk factors and population attributable fractions", Psychiatry, vol,79. no,3, pp.262-281, (2016).
  44. Beghi, M., Butera, E., Cerri, C. G., Cornaggia, C. M., Febbo, F., Mollica, A., ... & Lozupone, M, "Suicidal behaviour in older age: A systematic review of risk factors associated to suicide attempts and completed suicides", Neuroscience & Biobehavioral Reviews, vol,127, pp.193-211, (2021).
  45. Shoib, S., Islam, S. M. S., Arafat, S. Y., & Hakak, S. A, "Depression and suicidal ideation among the geriatric population of Kashmir, India", International journal of social psychiatry, vol.67, no.6, pp.651-655, (2021).
  46. Kim, M. Y., & Kim, Y, "Comparison of factors influencing fall recurrence in the young-old and old-old: a cross-sectional nationwide study in South Korea", BMC geriatrics, vol.22, no.1, pp.520, (2022).
  47. Park, Y., Paik, N. J., Kim, K. W., Jang, H. C., & Lim, J. Y, "Depressive Symptoms, Fal l s, and Fear of Falling in Old Korean Adults: The Korean Longitudinal Study on Health and Aging (KLoSHA)", The Journal of frailty & aging, vol.6, no.3, pp.144-147, (2017).
  48. Heo, Y. J., Lee, J, M., Kwon, H. J., Yoon, Y., "The Association between Subjective Health and Depressive Symptoms among Poor and Non-poor Elderly in Seoul: The Moderating Effect of an Age-friendly Walking Environment", Korean Journal of Gerontological Social Welfare, vol.77, no.4, pp.301-327, (2022)
  49. Lutzman, M., Sommerfel d, E., & Ben-David, S, "Loneliness and social integration as mediators between physical pain and suicidal ideation among elderly men", International Psychogeriatrics, vol.33, no.5, pp.453-459, (2021).
  50. Kim, G. Y., "The relationship between the mental health and falling experience an elderly", Maser's thesis, School of Chosun University, Jeonnam, Korea.
  51. Kim, J. W., Jung, H. Y., Won, D. Y., Shin, Y. S., Noh, J. H., & Kang, T. I, "Landscape of elderly suicide in South Korea: Its trend according to age, gender, and educational attainment", OMEGA-Journal of death and dying, vol.82, no.2, pp.214-229,
  52. Lee, S. H., Oh, J. S., Lee, D. H., Choi, Y. H., & Lim, J. Y, "Correlation between income changes in the elderly receiving the basic old-age pension and suicide rates", Signa Vitae, vol.19, no.3, pp.44-49, (2013).
  53. Jang, H., Lee, W., Kim, Y. O., & Kim, H, "Suicide rate and social environment characteristics in South Korea: the roles of socioeconomic, demographic, urbanicity, general health behaviors, and other environmental factors on suicide rate", BMC Public Health, vol.22, no.1, pp.410, (2022).
  54. Hautekiet, P., Saenen, N. D., Martens, D. S., Debay, M., Van der Heyden, J., Nawrot, T. S., & De Clercq, E. M, "A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing", BMC medicine, vol.20, no.1, pp.328, (2022).
  55. Lera-Lopez, F., Ollo-Lopez, A., & Sanchez-Santos, J. M, "How does physical activity make you feel better? The mediational rol e of perceived health", Applied Research in Quality of Life, vol.12, pp.511-531, (2017).
  56. Arenson, M., Bernat, E., De Los Reyes, A., Neylan, T. C., & Cohen, B. E, "Social support, social network size, and suicidal ideation: A nine-year longitudinal analysis from the Mind Your Heart Study", Journal of psychiatric research, vol.135, pp.318-324, (2021).
  57. Chen, X., Giles, J., Yao, Y., Yip, W., Meng, Q., Berkman, L., ... & Zhao, Y, "The path to healthy ageing in China: a Peking University-Lancet Commission", The Lancet, vol .400, no.10367, pp.1967-2006, (2022).
  58. de Mendonca Lima, C. A., De Leo, D., Ivbijaro, G., & Svab, I, "Suicide prevention in older adults", Asia-Pacific Psychiatry, vol.1, no.3, pp.e12473, (2021).
  59. Cui, R., Gujral, S., Galfalvy, H., & Szanto, K, "The role of perceived and objective social connectedness on risk for suicidal thoughts and behavior in late-life and their moderating effect on cognitive deficits", The American Journal of Geriatric Psychiatry, vol.30, no.4, pp.527-532, (2022).
  60. Turana, Y., Tengkawan, J., Chia, Y. C., Shin, J., Chen, C. H., Park, S., ... & Kario, K, "Mental health problems and hypertension in the elderly: review from the HOPE Asia Network", The Journal of Clinical Hypertension, vol.23, no.3, pp.504-512, (2021).
  61. Zhang, X. N., Qiu, C., Zheng, Y. Z., Zang, X. Y., & Zhao, Y, "Self-management among elderly patients with hypertension and its association with individual and social environmental factors in China", Journal of Cardiovascular Nursing, vol.35, no.1, pp.45-53,
  62. Lee, M. A., "A Longitudinal Data Analysis on Depressive Symptoms of Korean Older Adults: Examining the Differential Effects of Spousal Loss and Marital Satisfaction across Men and Women", The Population Association of Korea, vol.37, no.1, pp.109-130, (2014).
  63. Hu, C., Zhao, D., Gong, F., Zhao, Y., Li, J., & Sun, Y, "Risk factors for suicidal ideation among the older people living alone in rural region of China: A path analysis", Medicine, vol.99, no.29, pp.e21330, (2020).