Effects of a School-based Intervention Program for Middle School Adolescent Girls with Depression: As Part of the School Health Services

Kyung Mi Sung

doi:10.4040/jkan.2012.42.7.984

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Sung: Effects of a School-based Intervention Program for Middle School Adolescent Girls with Depression: As Part of the School Health Services

Original Article

J Korean Acad Nurs 2012;42(7):984-991.

Published online: 12 December 2012

DOI: https://doi.org/10.4040/jkan.2012.42.7.984

Effects of a School-based Intervention Program for Middle School Adolescent Girls with Depression: As Part of the School Health Services

Kyung Mi Sung

College of Nursing & Institute of Health Sciences, Gyeongsang National University, Jinju, Korea

Address reprint requests to : Sung, Kyung Mi College of Nursing, Gyeongsang National University, 816-15 Jinjudaero, Jinju 660-751, Korea Tel: +82-010-4234-0047 Fax: +82-55-772-8222 E-mail: sungkyungmi7@gmail.com

Received 9 June 2012 Revised 10 July 2012 Accepted 16 November 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression.

Methods

The study was a pretest–posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n= 30) and the comparison group (n= 28). The research instrument was Reynolds Adolescent Depression Scale.

Results

The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks.

Conclusion

The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curriculums by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.

Keywords: Adolescent, Female, Depression, School health services

References

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Figure 1.

Participant flow chart.

Figure 2.

Changes in intervention and comparison groups of depressive symptoms.

Table 1.

The Contents of School-based Intervention Program for a Middle School Girls with Depression

Session	Contents	Teaching methods
1	Study instruction
	1. Greeting	− Explain the program
	2. Provide guidelines for study participation
2	Basic understanding about adolescent depression
	1. Nature of adolescent depression	− Lecture using PPT
	2. Cause of adolescent depression	− Self-exam about the experience of depression
	3. Early signs and symptoms of adolescent depression
	4. Diagnosis and treatments of depression
3-4	Self-evaluation
	1. Explore one’s life experience	− Self-reflection
	2. Obtain insight	− Group counseling
5-6	Management strategy for depressed mood
	1. How to handle depressed mood	− Lecture using PPT
	- Get regular exercise, sleep pattern & eating habit	− Case method
	- Get sunlight for at least 30 min. everyday	− Small group discussion
	- Discuss your problems with others(friends, family, etc.)
	2. How to ask for help from others
	- When experiencing sleep disturbance, loss of appetite, difficulty in school life & peer relationship, loneliness, etc. for at least 2 weeks
7-8	Prevention of depression and suicide
	1. Self-help behaviors for prevention of depression	− Lecture using PPT
	2. Meaning of adolescent suicidal behavior	− A short video
	3. Helping friends who are depressed or contemplating suicide	− Activity, Q & A
9-10	Practical coping strategies for depression
	1. Build a new daily schedule to overcome depression	− Chart for a daily schedule
	2. Keep a diary as a routine work	− A short video
	3. Find individual strength and connect it with a special activity	− Activity, Q & A
11-13	Support system
	1. Individual online counseling for follow-up	− Provide information for email counseling after the
	2. Construct support system on an individual basis	meeting

Table 2.

Homogeneity Test for Demographic Characteristics of the Participants (N=58)

Characteristics	Categories	Total	Intervention group (n=30)	Comparison group (n=28)	χ² or t (p)
Characteristics	Categories	n (%)	n (%)	n (%)	χ² or t (p)
Birth order	First	27 (46.6)	13 (48.1)	14 (51.9)	0.26 (.793)
	Not first	31 (53.4)	17 (54.8)	14 (45.2)
Marital status of parents	Married	43 (74.1)	22 (51.2)	21 (48.8)	0.02 (.999)
	Divorce/separate	15 (25.9)	8 (53.3)	7 (46.7)
School satisfaction	Yes	29 (50.0)	16 (55.2)	13 (44.8)	0.73 (.694)
	No	26 (44.8)	12 (46.2)	14 (53.8)
	No response	3 (5.2)	2 (66.7)	1 (33.3)
Economic status	High	6 (10.3)	2 (33.3)	4 (66.7)	1.44 (.486)
	Moderate	41 (70.7)	21 (51.2)	20 (48.8)
	Low	11 (19.0)	7 (63.6)	4 (36.4)
Income resources	Both parents	18 (31.0)	12 (66.7)	6 (33.3)	3.46 (.326)
	Father	21 (36.2)	8 (38.1)	13 (61.9)
	Mother	16 (27.6)	8 (50.0)	8 (50.0)
	Others	3 (5.2)	2 (66.7)	1 (33.3)
Middle school grades	High	8 (13.8)	4 (50.0)	4 (50.0)	0.07 (.964)
	Moderate	22 (37.9)	11 (50.0)	11 (50.0)
	Low	28 (48.3)	15 (53.6)	13 (46.4)
Physical problems	Yes	23 (39.7)	14 (60.9)	9 (39.1)	1.28 (.294)
	No	35 (60.3)	17 (45.7)	19 (54.3)
Depressed mood	Frequently	18 (34.0)	10 (55.6)	8 (44.4)	1.93 (.381)
	Sometimes	23 (43.4)	13 (56.5)	10 (43.5)
	Rarely	12 (22.6)	4 (33.3)	8 (66.7)
Hobby	Yes	20 (34.5)	13 (65.0)	7 (35.0)	2.16 (.174)
	No	38 (65.5)	17 (44.7)	21 (55.3)
Negative life events	Many	18 (31.0)	10 (55.6)	8 (44.4)	1.73 (.409)
	Moderate	25 (43.1)	13 (52.0)	12 (48.0)
	No	15 (25.9)	6 (40.0)	9 (60.0)

Table 3.

Comparison of Depressive Symptoms between Intervention and Comparison Groups (N=58)

Variables	Test point	Intervention group (n=30)	Comparison group (n=28)	t (p)	Factor	F (p)
Variables	Test point	M±SD	M±SD	t (p)	Factor	F (p)
Depression	Pre	85.47±7.97	83.68±5.87	0.97 (.338)	Time	19.29 (<.001)
	Post	77.00±11.75	83.18±10.31	−2.47 (.017)	Group	5.56 (.022)
	F/u	74.23±10.82	84.86±10.51	−3.79 (<.001)	Time×Group	29.39 (<.001)
Dysphoric	Pre	24.47±3.22	24.68±2.75	−0.27 (.789)	Time	11.37 (<.001)
	Post	21.03±4.69	23.93±3.86	−2.56 (.013)	Group	7.77 (.007)
	F/u	20.60±4.25	24.18±3.63	−3.44 (.001)	Time×Group	5.90 (.004)
Anhedonia/ negative affect	Pre	16.57±3.34	16.29±2.97	0.34 (.737)	Time	2.04 (.135)
	Post	16.40±3.77	17.46±3.02	−1.19 (.240)	Group	1.57 (.215)
	F/u	16.00±3.53	18.18±3.42	−2.38 (.021)	Time×Group	6.43 (.002)
Negative	Pre	23.17±2.88	22.07±3.45	1.32 (.194)	Time	18.74 (<.001)
self-evaluation	Post	19.67±3.85	21.46±3.35	−1.19 (.240)	Group	1.81 (.183)
	F/u	19.37±3.68	21.82±3.52	−2.38 (.021)	Time×Group	14.40 (<.001)
Somatic	Pre	21.27±3.26	20.64±2.23	0.85 (.402)	Time	17.33 (<.001)
	Post	19.13±3.84	20.32±3.30	−1.26 (.213)	Group	1.56 (.216)
	F/u	18.30±3.50	20.61±3.14	−2.64 (.011)	Time×Group	16.51 (<.001)

Pre=Pretest before intervention; Post=Posttest after 10th intervention; F/u=Follow-up test after third follow-up counseling.

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