Korean J Adult Nurs.  2020 Feb;32(1):78-87. 10.7475/kjan.2020.32.1.78.

Factors Related to Suicide Ideation in Older Women Living Alone

• Ryu SI
• Park YH

• KMID: 2471031
• DOI: http://doi.org/10.7475/kjan.2020.32.1.78

Abstract

PURPOSE
This study aimed to investigate suicide ideation and attempts in older women living alone and to identify the factors affecting suicide ideation.
METHODS
This is a cross-sectional correlational study using secondary data analysis. Original data (n=1,023) were collected using face-to-face interviews from August to October 2018 in Siheung city to investigate the need for health care and daily life support services. Study participants were 297 older women (age=74.67±5.35), with inclusion criteria being women≥65 years old and living alone, those without cognitive impairment(Mini-Mental State Examination-2 Standard Version (MMSE-2 SV)≥24), and those who could evaluate instrumental activities of daily living. Data were analyzed using descriptive analysis, independent t-test, Pearson's correlation coefficient, and multiple linear regression analysis.
RESULTS
Data analysis showed 26.9% of participants reported suicide ideation with a frequency of 4.14 out of 10 points. Among study participants, 8.8% had attempted suicide with an average of 2.65 attempts. Participants who had children thought about suicide more than those who did not. Living children, personal income, participation in economic activity, social support, depression, chronic diseases, frailty, and suicide attempts were significantly correlated with suicide ideation. Therefore, depression, frailty and suicide attempts were factors affecting suicide ideation for older women living alone.
CONCLUSION
Our findings provide evidence that evaluating depression, frailty, and history of suicide attempts is important for suicide prevention in older women living alone.

MeSH Terms

Activities of Daily Living
Child
Chronic Disease
Delivery of Health Care
Depression
Female
Gyeonggi-do
Humans
Linear Models
Statistics as Topic
Suicidal Ideation
Suicide*
Suicide, Attempted

Reference

1. Korea Suicide Prevention Center. 2019 White book. Seoul: Korea Suicide Prevention Center;2019.

2. Korea Institute for Health and Social Affairs. 2017 survey of living conditions and welfare needs of Korean older persons [Internet]. Sejong: Ministry of Health Welfare;2018. cited 2019 December 4. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&page=1&CONT_SEQ=344953.

3. Lee H, Seol KH, Kim JW. Age and sex-related differences in risk factors for elderly suicide: differentiating between suicide ideation and attempts. International Journal of Geriatric Psychiatry. 2018; 33(2):e300–e306. DOI: 10.1002/gps.4794.

4. Turecki G, Brent DA. Suicide and suicidal behaviour. The Lancet. 2016; 387:1227–1239. DOI: 10.1016/s0140-6736(15)00234-2.

5. Baca-Garcia E, Perez-Rodriguez MM, Oquendo MA, Keyes KM, Hasin DS, Grant BF, et al. Estimating risk for suicide attempt: are we asking the right questions? Passive suicidal ideation as a marker for suicidal behavior. Journal of Affective Disorders. 2011; 134(1-3):327–332. DOI: 10.1016/j.jad.2011.06.026.

6. An S, Lee H. An exploratory study for developing a social stigma scale toward suicidal people. Health and Social Welfare Review. 2017; 37(2):325–357. DOI: 10.15709/hswr.2017.37.2.325.

7. Im JS, Park BCB, Ratcliff KS. Cultural stigma manifested in official suicide death in south Korea. Omega-Journal of Death and Dying. 2018; 77(4):386–403. DOI: 10.1177/0030222816675262.

8. Im MY, Kim YJ. A phenomenological study of suicide attempts in elders. Journal of Korean Academy of Nursing. 2011; 41(1):61–71. DOI: 10.4040/jkan.2011.41.1.61.

9. Choi I, Hwang HM. A study on ageism, hopelessness and suicidal ideation on elderly. Health Communication, the Official Journal of Korean Academy on Communication in Healthcare. 2015; 10(1):17–25. DOI: 10.15715/kjhcom.2015.10.1.17.

10. Ko H, Park YH, Cho B, Lim KC, Chang SJ, Yi YM, et al. Gender differences in health status, quality of life, anagd community service needs of older adults living alone. Archives of Gerontology and Geriatrics. 2019; 83:239–245. DOI: 10.1016/j.archger.2019.05.009.

11. Kim H, Lee A, Lee SI, Kim Y, Jung HY, Kim SG. Risk factors for suicidal ideation in the elderly. Journal of Korean Neuropsychiatric Association. 2015; 54(4):468–474. DOI: 10.4306/jknpa.2015.54.4.468.

12. Park JI, Yang JC, Han C, Park TW, Chung SK. Suicidal ideation among Korean elderly: risk factors and population attributable fractions. Psychiatry. 2016; 79(3):262–281. DOI: 10.1080/00332747.2016.1175837.

13. Choi M, Kim DH, Lee K, Yi JS. Physical, psychological, and social risk factors affecting suicidal ideation among the elderly. Journal of Korean Neuropsychiatric Association. 2015; 54(4):459–467. DOI: 10.4306/jknpa.2015.54.4.459.

14. Lee HS, Lee D. Structural equation modeling of suicide ideation and associated factors among elderly women in Korea. Korean Journal of Health Promotion. 2014; 14(4):162–171. DOI: 10.15384/kjhp.2014.14.4.162.

15. World Health Organization. Preventing suicide: a global imperative. Geneva: WHO Press;2014.

16. Kiriakidis S. Elderly suicide: risk factors and preventive strategies. Annals of Gerontology and Geriatric Research. 2015; 2(2):1–6.

17. Nam I. Path analysis of the relationship between living alone and suicide ideation in Korean older adults. Journal of Social Science. 2018; 29(2):211–226. DOI: 10.16881/jss.2018.04.29.2.211.

18. Fässberg MM, Cheung G, Canetto SS, Erlangsen A, Lapierre S, Lindner R, et al. A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging & Mental Health. 2016; 20(2):166–194. DOI: 10.1080/13607863.2015.1083945.

19. Morley JE, Vellas B, Abellan van, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. Journal of the American Medical Directors Association. 2013; 14(6):392–397. DOI: 10.1016/j.jamda.2013.03.022.

20. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. Journals of Gerontology. 2001; 56(3):M146–M156. DOI: 10.1093/gerona/56.3.m146.

21. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. TheScientificWorldJournal. 2001; 1:323–336. DOI: 10.1100/tsw.2001.58.

22. Balasubramaniam M. Rational suicide in elderly adults: a clinician's perspective. Journal of the American Geriatrics Society. 2018; 66(5):998–1001. DOI: 10.1111/jgs.15263.

23. Kim J, Lee YS, Lee J. Living arrangements and suicidal ideation among the Korean older adults. Aging & Mental Health. 2016; 20(12):1305–1313. DOI: 10.1080/13607863.2015.1078280.

24. Ministry of Health Welfare. 2017 Care service for older adults [Internet]. Sejong: Ministry of Health Welfare;2017. cited 2019 December 4. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=338646.

25. Mitchell PH, Powell L, Blumenthal J, Norten J, Ironson G, Pitula CR, et al. A short social support measure for patients recovering from myocardial infarction: the ENRICHD social support inventory. Journal of Cardiopulmonary Rehabilitation. 2003; 23(6):398–403. DOI: 10.1097/00008483-200311000-00001.

26. Jeon GS, Jang SN, Park S. Social support, social network, and frailty in Korean elderly. Journal of the Korean Geriatrics Society. 2012; 16(2):84–94. DOI: 10.4235/jkgs.2012.16.2.84.

27. Yesavage JA, Sheikh JI. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist. 1986; 5(1-2):165–173.

28. Kee BS. A Preliminary study for the standardization of geriatric depression scale short form-Korea version. Journal of Korean Neuropsychiatric Association. 1996; 35(2):298–307.

29. Korea Institute for Health and Social Affairs. Quastionnaires of 2017 survey of living conditions and welfare needs of Korean older persons [Internet]. Sejong: Ministry of Health Welfare;2017. cited 2019 December 31. Available from: https://data.kihasa.re.kr/micro/subject_view.jsp?WT.ac=new_data&project_seq=673.

30. Won CW, Yang KY, Rho YG, Kim SY, Lee E, Lull YJ, et al. The development of Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL) scale. Journal of the Korean Geriatrics Society. 2002; 6(2):107–120.

31. Hwang HS, Kwon IS, Park BJ, Cho B, Yoon JL, Won CW. The validity and reliability of Korean frailty index. Journal of the Korean Geriatrics Society. 2010; 14(4):191–202. DOI: 10.4235/jkgs.2010.14.4.191.

32. Substance Abuse and Mental Health Service Administratioin. 2018 National Survey of Drug Use and Health (NSDUH) releases [Internet]. Wasignton: U.S. Department of Health & Human Services;2018. cited 2019 December 4. Available from: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect8pe2018.htm.

33. Lee JH, Oh YE. Effect of social exclusion on depression and suicidal ideation among the elderly in Korea: focus on gender differences. The Korean Journal of Community Living Science. 2016; 27(4):831–850. DOI: 10.7856/kjcls.2016.27.4.831.

34. Almeida OP, McCaul K, Hankey GJ, Yeap BB, Golledge J, Flicker L. Suicide in older men: The Health In Men cohort Study (HIMS). Preventive Medicine. 2016; 93:33–38. DOI: 10.1016/j.ypmed.2016.09.022.

35. Kim HC. Depression as a mediator in the relation between the socioeconomic deprivation life satisfaction in older adults. Journal of the Korea Contents Association. 2019; 19(2):231–248. DOI: 10.5392/JKCA.2019.19.02.231.