The Relationship between Grief level and Suicidal Ideation of Elderly Living Alone and the Moderation Effect of Social Support / 農村醫學 地域保健

OBJECTIVES: The purpose of this study is to examine the moderating effect of social supports on the relationship between grief level and suicidal ideation of the elderly living alone. METHODS: We analyzed data from a questionnaire administered to subjects aged 65 years or older living alone for a 2017 community mental health project in Gyeongnam S city. To investigate the moderating effects of variables, we conducted a hierarchial regression analysis and confirmed the change R2. RESULTS: When adjusted for education and economic level, grief level had not a direct impact on suicidal ideation. And it was found that interdependent social support was moderating variables in the relationship of grief level and suicidal ideation of the elderly living alone. CONCLUSIONS: There is a need for appropriate programs that reduce suicidal ideation and therefore suicidal action. Moreover, it is especially necessary to enhance interdependent social supports.

The Association between Hopelessness, Social Support and Community Integration and Depression among Elderly Living Alone / 農村醫學 地域保健

OBJECTIVES: This study was performed to investigate the association between hopelessness, social support and community integration, and depression. METHODS: We analyzed data from a questionnaire administered to subjects aged 65 years or older living alone for a 2015 community mental health project in Gyeongnam S city. We used a correlation analysis and a hierarchical regression analysis to identify factors that affect depression. RESULTS: When controlling for socio-demographic factors, hopelessness and community integration had significant effects on depression. That is, the higher the hopelessness (B=0.768, p<.001) and the lower the community integration (B=-0.163, p=.012), the higher the depression in elderly living alone . CONCLUSIONS: There is a need for approaches at both the individual and social levels that consider and improve measures to prevent and reduce depression. Moreover, it is especially necessary to enhance community integration.

The Association of Trust, Social Participation with Self-Rated Health Status: Mediating Effect of Depression / 農村醫學 地域保健

OBJECTIVES: This study was performed to investigate the relationship between individual-level social capital and depression. And, we assessed if depressive symptom mediates the relationship between social capital and self-rated health status. METHODS: Data from the 2011 Community Health Survey were analyzed for this study. We used chi-square tests and analyzed a four step approach in which several regression analyses were conducted and significance of the coefficients was examined at each step. RESULTS: In men, the results of controlling mediating factor (depression): social participation was not significantly associated with self-rated health status(p=0.082), the finding supports that social participation was fully mediated by depression. In women, the relationship between social capital(trust, social participation) and self-rated health status was partially mediated by depression. CONCLUSIONS: In order to increase self rated health status, not only improvement in trust and social participation are needed but effort to reduce depression must be combined.

The Strategies to Address Regional Health Inequalities in Gyeongsangnam-Do: Health Plus Happiness Plus Projects / 農村醫學 地域保健

OBJECTIVES: This study was conducted to implement Health Plus Happiness Plus projects in Gyeongsangnam-Do and assess the policy implications of initiatives to address regional health inequalities. METHODS: Health Plus Happiness Plus projects were started as strategies to address regional health inequalities in Gyeongsangnam-Do. The principles of these projects are taken from the Health Action Zones initiatives in England: participation, partnership, resource concentration in project areas. The time period for these projects is from 2010 to 2017, and the total budget is 5.6 billion won. In 2010, a 6.8 hundred million won total budget was invested in 17 project areas. Such investments fell into four broad categories: establishment of the means and local framework; survey development to analyze the health determinants; development of an education and training center; and establishment of a technical support center. RESULTS: Education and training programs for practitioners and coordinators were provided, and project teams and project promotion committees were established in project areas. Health survey result briefing meetings were held, and 17 health committees were established in project areas. CONCLUSIONS: Health Plus Happiness Plus projects have some problems in relation to participation and partnerships, however, if these principled projects are performed continuously, they will contribute to a reduction of standardized mortality rate and regional health inequalities in Gyeongsangnam-Do and the improvement of residents' well-being in project areas.

The Influence of Individual-Level Social Capital on Depression / 農村醫學 地域保健

OBJECTIVES: This study was performed to investigate the relationship between individual-level social capital and depression. METHODS: Data from the 2009 Community Health Survey were analyzed for this study. We used chi-square tests and hierarchical logistic regression analyses to determine the relationship between individual-level social capital and depression. The Korean version of the Center for Epidemiological Studies-Depression Scale was used to measure depression. RESULTS: After controlling for socio-demographic factors such as, health behavior and chronic illness morbidity, that are associated with individual-level social capital, trust and informal participation significantly affected depression. Respondents with "be trust"(0.536, 95% CI 0.419-0.685) and who participate in "informal groups"(0.657, 95% CI 0.516-0.836) had significantly lower odds ratios of depression. CONCLUSIONS: Considering and introducing measures to increase the social capital of residents, need reduce depression. It is especially necessary to enhance resident empowerment.

A Study on Effects of Coercion by Family and Experts on the Recovery Attitude of the Persons with Mental Illness / 신경정신의학

OBJECTIVES: Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. METHODS: The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, depending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. RESULTS: When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. CONCLUSION: The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.

A Study on Effects of Coercion by Family and Experts on the Recovery Attitude of the Persons with Mental Illness / 신경정신의학

OBJECTIVES: Based on the debate between paternalism and rights-driven view, to investigate the effects of coercion on the recovery attitudes of patients with mental illness. METHODS: The participants were 352 patients with schizophrenia (79.8%) and mood disorders (major depressive disorder 9.1%, bipolar 11.1%), who were in hospital or who were enrolled in a community mental health center or a social rehabilitation center. All were interviewed. Coercion was divided into family and experts, depending on coercer and was divided into positive and negative coercion such as persuasion, inducement, asked preference, threat, physical force and so on, depending on types of coercion. Recovery attitudes were subdivided into subjective clinical recovery attitudes and life recovery attitudes. RESULTS: When socio-demographic and disorder characteristics were controlled, positive coercion by family and experts had a significant effect on life recovery attitudes, and positive coercion by experts had a significant effect on subjective clinical recovery attitudes. The level of symptoms was found to be an important predictor of recovery attitudes. CONCLUSION: The findings of this study propose the important of the control of mental symptoms, more realistic training in family education, the secure of human rights protection guidelines applicable in the field and so on.

Associations between Self-Efficacy, Social Capital and Self-Rated Health Status in Healthy Individuals

BACKGROUND: Discrepancies exist in the existing researches regarding the association between social capital and self-efficacy, and most of these researches have been done in developed countries. The aims of this study were to assess the independent association between individual social capital and self-efficacy and to assess the associations between individual social capital, self-efficacy and self-rated health. METHODS: Data were obtained from the Gyeongnam health survey (6,500 persons) conducted in 2008. A self-administered questionnaire was additionally administered to gather information on demographic variables, health behaviors, chronic diseases, self-efficacy, social capital, and self-rated health status. Total study population was 3,843 as those with chronic diseases were excluded. RESULTS: In males, trust was positively associated with confidence and preference to task difficulty, and participation was negatively associated with confidence and positively associated with regulation and preference to task difficulty. In females, trust was positively associated with confidence and preference to task difficulty and negatively associated with regulation. Participation was positively associated with preference to task difficulty. In males, the odds for self-rated health status was better for persons with confidence (95% confidence interval, CI 1.088-1.705), trust (95% CI 1.172-1.821) and participation (95% CI 1.268-2.117). In females, the odds for self-rated health status was better for those with confidence (95% CI 1.250-1.803), preference of task difficulty (95% CI 1.019-1.683) and participation (95% CI 1.024-1.555). CONCLUSIONS: High social capital measured at an individual level may promote self-efficacy and health status.

Effects of Structural and Functional Characteristics of Social Network on Social Adjustment in People With Mental Illness / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate effects of structural and functional characteristics of social network on social adjustment in people with mental illness. METHODS: 236 members of the people with mental illness who were enrolled in day hospital, community mental health center and social rehabilitation center participated in the survey. RESULTS: Of structural and functional characteristics of social network, the influenced factors on social adjustment were network size of professional, social support (family, friend and professional) and conflict with professional. When controlling socio-demographic and disorder characteristics, this regression model affected significantly on social adjustment but the power of influence reduced slightly. CONCLUSION: In order to improve the social adjustment of people with mental illness, it is necessary for social network to provide them with more emotional and social resources. Especially, it is important for mental health professionals to build active partnership with the people with mental illness as consumer. For people with mental illness, the economic stability through guaranteed income such as disability benefits, and occupational rehabilitation is very important.