Journal List > J Korean Acad Nurs > v.48(4) > 1108859

Lee, Ham, Lee, and Kim: Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea

Abstract

Purpose

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.

Methods

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).

Results

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, aca-demic/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).

Conclusion

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.

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Figure 1.
Intrapersonal, interpersonal, organizational level of this study.
jkan-48-475f1.tif
Table 1.
Differences in Intrapersonal Level Characteristics between Urban and Rural Areas (N=460)
Variables Distribution Urban (n=255) Rural (n=205) χ2 p
n (%) n (%)
Grade 1st 65 (25.5) 60 (29.2) 17.09 <.001
2nd 101 (39.6) 45 (22.0)
3rd 89 (34.9) 100 (48.8)
Academic achievement Upper 60 (23.5) 30 (14.7) 5.73 .057
Middle 126 (49.4) 112 (54.6)
Lower 69 (27.1) 63 (30.7)
General life happiness Very happy 55 (21.6) 33 (16.1) 7.80 .099
Happy 104 (40.8) 72 (35.1)
Moderate 78 (30.6) 87 (42.4)
Unhappy 15 (5.9) 12 (5.9)
Very unhappy 3 (1.1) 1 (0.5)
Perception of health Very good 97 (38.0) 51 (24.9) 10.68 .030
Good 76 (29.8) 63 (30.7)
Fair 61 (23.9) 68 (33.2)
Poor 20 (7.9) 22 (10.7)
Very poor 1 (0.4) 1 (0.5)
Table 2.
Differences in Interpersonal and Organizational Level Characteristics between Urban and Rural Areas (N=460)
Variables Distribution Urban (n=255) Rural (n=205) χ2 p
n (%) n (%)
Family members living together Both parents 230 (90.2) 179 (87.3) 5.68 .224
Father 4 (1.6) 8 (3.9)
Mother 18 (7.0) 11 (5.3)
Grandparents 2 (0.8) 4 (2.0)
Other 1 (0.4) 3 (1.5)
Source of stress Conflict with family 30 (11.8) 18 (8.8) 3.36 .644
School performance 151 (59.2) 123 (60.0)
Friends 28 (11.0) 24 (11.7)
Health 5 (2.0) 5 (2.5)
Future uncertainty 31 (12.1) 21 (10.2)
Other 10 (3.9) 14 (6.8)
Satisfaction with school life Very satisfied 68 (26.7) 22 (10.7) 19.79 .001
Satisfied 88 (34.5) 77 (37.6)
Moderate 80 (31.4) 84 (41.0)
Unsatisfied 12 (4.7) 16 (7.8)
Very unsatisfied 7 (2.7) 6 (2.9)
Table 3.
Differences in Depressive Symptoms and Mental Health Problem Behaviors between Urban and Rural Areas (N=460)
Variables Distribution Urban (n=255) Rural (n=205) χ2 p
n (%) n (%)
BDI Minimal (0~9) 164 (64.3) 114 (55.6) 4.94 .176
Mild (10~15) 51 (20.0) 44 (21.5)
Moderate (16~23) 30 (11.8) 33 (16.1)
Severe (24~63) 10 (3.9) 14 (6.8)
M±SD M±SD t p
BDI 8.44±7.17 10.23±8.34 -2.48 .015
AMPQ-II Worry/anxiety 3.79±0.23 4.91±4.19 -3.07 .002
Mood/suicidal ideation 4.64±4.12 5.52±4.21 -2.25 <.001
Academic/internet related problems 2.55±2.21 3.55±2.19 -4.83 <.001
Peer problems 0.56±1.12 1.10±1.73 -4.05 <.001
Rule violations 0.15±0.90 0.29±0.80 -1.78 .075

BDI=Beck depression inventory; AMPQ-II=the adolescent mental-health problem-behavior questionnaire.

Table 4.
Differences in Factors Associated with Depressive Symptoms between Urban and Rural Groups (N=460)
Urban Rural
Variable Model 1 1 Model 2 Model 3 Model 1 Model 2 Model 3
B β VIF B β VIF B β VIF B β VIF B β VIF B β VIF
Grade
  1st -1.17 -.07 1.40 -1.38 -.08 1.46 - -1.36 -.08 1.45 -0.40 -.02 1.19 -0.43 -.02 1.21 -0.37 -.02 1.21
  2nd -0.30 -.02 1.35 -0.32 -.02 1.36 - -0.31 -.02 1.36 -0.55 -.03 1.23 -0.67 -.03 1.27 -1.11 -.06 1.29
Academic achievement
  Upper -1.24 -.07 1.78 -1.07 -.07 1.83 - -0.91 -.05 1.87 -1.40 -.06 1.63 -1.34 -.06 1.68 -0.94 -.04 1.70
  Middle -0.82 -.06 1.61 -0.81 -.06 1.63 - -0.70 -.05 1.65 -0.79 -.05 1.37 -0.97 -.06 1.44 -1.09 -.07 1.46
General life 1.94 .24** 1.52 1.86 .23** 1.59 1.62 . .20** 1.90 2.54 .26** 1.42 2.54 .26** 1.42 2.14 .22** 1.58
happiness
Perception of 0.85 .12* 1.30 0.90 .12* 1.32 0.81 .11* 1.42 0.73 .09 1.19 0.74 .09 1.21 0.71 .08 1.25
health
Worry/anxiety 0.42 .21** 1.92 0.44 .22** 2.06 0.45 . .23** 2.16 0.63 .32** 2.02 0.62 .31** 2.38 0.58 .29** 2.42
Mood/suicidal 0.79 .45** 2.34 0.77 .44** 2.50 0.79 . .45** 2.53 0.51 .26** 2.22 0.50 .25** 2.28 0.51 .26** 2.29
ideation
-0.10 Academic/internet -.03 1.58 -0.12 -.04 1.60 - -0.11 -.03 1.71 0.37 .10 1.80 0.24 .09 1.83 0.48 .13* 1.90
related problem ms
Family members living togethera
  Both parents -0.05 .00 1.07 .02 .00 1.08 0.73 .03 1.10 0.92 .04 1.11
Source of stressb
  School performance 1.57 .11 1.84 1.65 .11* 1.88 1.12 .07 1.80 1.11 .07 1.80
  Family/friends 1.76 .10* 2.12 1.72 .10 2.14 0.58 .03 1.93 0.25 .10 1.98
Peer problems -0.04 -.01 1.36 - -0.02 .00 1.40 0.20 .04 1.54 0.35 .07 1.66
Satisfaction with school life - -0.45 .06 1.66 -0.85 .09 1.36
Rule violations - -0.27 -.03 1.35 -1.46 -.14* 1.23
F 6 60.32** 42.50** 37.05** 3 33.62** 23.24** 21.90**
Adjusted R2 .68 .68 .68 .59 .59 .61
△R2 .01 .00 .01 .02
Durbin-Waston=1.87, Tolerance=0.61~0.96, Shapiro-Wilk=.132 Durbin-Waston=1.88, Tolerance=0.43~0.93, Shapiro-Wilk=.061

* p<.05, **p<.001. VIF=Variance inflation factor.

Reference group, others (father, mother, grandparents, and others);

†† Reference group, health/future uncertainty/other.

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