Structural Equation Modeling of Suicidal Ideation and Associated Factors among Elderly Women in Korea

ABSTRACT

BACKGROUND: Although the suicide rate in Korea is the highest in the world, only limited studies have been done on suicide and its associated factors. In this regard, we studied a conceptual model and the relationships and interactions of activity of daily living (ADL), social support, depression, and suicidal ideation among elderly women in Korea. METHODS: A cross-sectional descriptive study, subjects included 194 community-dwelling elderly women. Their ADL, multi-dimensional scale of perceived social support (MSPSS), depression, and suicidal ideation (SI) were examined. The t-test, ANOVA test, Pearson's correlation coefficient, multiple regression analysis, and structural equation modeling were utilized in data analysis. RESULTS: There were significant correlations between SI and economic status, social support, and depression. Depression was correlated with not only SI but also ADL (r=0.195, P=0.006) and social support (r=-0.337, P<0.001). Absolute fit indices demonstrated that the research model had a good model fit. There were significant factor loading values from depression to SI (standardized estimate=0.157, P=0.023) and from social support to SI (standardized estimate=-0.308, P<0.001). There were two indirect effects from social support to SI and from ADL to SI. The mediating factor of these two indirect effects was depression. CONCLUSIONS: Suicidal ideation in the elderly needs to be prevented; and more attention should be given to this end. Social support programs encouraging family participation are greatly effective in prevention of senior citizens' suicidal ideation.