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J Korean Acad Nurs. 2018 Aug;48(4):475-484. English. Original Article.
Lee G , Ham OK , Lee BG , Kim AM .
Redcross College of Nursing, Chung-Ang University, Seoul, Korea.
Department of Nursing, Inha University, Incheon, Korea.
College of Nursing ยท The Research Institute of Nursing Science, Catholic University of Daegu, Daegu, Korea.


To examine the prevalence of depressive symptoms and differentiate factors associated with them in urban and rural areas by applying the Ecological Models of Health Behavior.


We employed a cross-sectional design and convenience sample of 460 female adolescents. The instruments included the Adolescent Mental-Health Problem-Behavior Questionnaire (AMPQ-II) and the Beck Depression Inventory (BDI).


Depressive symptoms were confirmed in 15.7% of urban adolescents and 22.9% of rural adolescents (p < .05). In the urban group, perception of health and stress associated with school performance were significantly associated with depressive symptoms. In the rural group, academic/internet related problems and rule violations were significantly associated with depressive symptoms (p < .05). General life happiness, worry/anxiety, and mood/suicidal ideation were common factors in both urban and rural areas (p < .05).


Multiple factors were associated with depressive symptoms, and those significant factors differed between urban and rural female youths. Accordingly, tailored approaches are required considering urban and rural differences. The approaches should include intrapersonal, interpersonal, and organizational levels of interventions.

Copyright © 2019. Korean Association of Medical Journal Editors.