Journal List > J Korean Acad Community Health Nurs > v.26(3) > 1058384

TOOLS
Lim, Lee, Kim, and Go: The Effects of a Positive Psychology Improvement Program on Elders' Depression and Death Anxiety
Original Article

Journal of Korean Academy of Community Health Nursing 2015; 26(3): 238-247.

Published online: 30 September 2015

DOI: https://doi.org/10.12799/jkachn.2015.26.3.238

The Effects of a Positive Psychology Improvement Program on Elders' Depression and Death Anxiety

Seung Joo Lim1, Hung Sa Lee2, Chunmi Kim2, Young Go3

1Department of Nursing, Hoseo University, Research Institute for Basic Science, Asan, Korea.

2Department of Nursing Science, Sunmoon University, Asan, Korea.

3Department of Nursing, Gachon University, Incheon, Korea.

Corresponding author: Lee, Hung Sa. Department of Nursing Science, Sunmoon University, 70 Sunmoon-ro, 221 beon-gil, Tangjeong-myeon, Asan 336-708, Korea. Tel: +82-41-530-2742, Fax: +82-41-530-2725, leehj57@hanmail.net

Received 18 July 2015       Revised 14 September 2015       Accepted 21 September 2015

© 2015 Korean Academy of Community Health Nursing

(open-access):

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

This study was conducted to investigate the effects of a positive psychology improvement program on elders' depression and death anxiety.

Methods

This was conducted as a quasi-experimental study with non-equivalent control group pretest-posttest design. The participants were community elders aged over 65 recruited by convenient sampling. A total of 94 elders (32 in the individual experimental group, 32 in the collective experimental group, and 30 in the control group) participated. Data were collected between April and September, 2012 and analyzed by using SPSS/WIN 21.

Results

The individual and group approach experimental groups had significantly lower scores of depression than the control group after the treatment (F=7.50, p=.001). For death anxiety, however, only the individual experimental group had a significantly lower score compared to the control group (F=4.56, p=.013).

Conclusion

These results indicate that the positive psychology improvement program was effective in decreasing depression and death anxiety in the elderly. Therefore, the program needs to be applied in a customized way fittingly to the characteristics of the elderly in community, and individually and/or collectively according to its purposes.

Keywords: Elderly, Depression, Death, Anxiety, Psychology

Figures and Tables

Figure 1

Change in depression before and after referring the interaction of economic status.

jkachn-26-238-g001
Table 1

The Contents of Positive Psychology Improvement Program for the Subjects

jkachn-26-238-i001
Week Subject Contents Methods
Exp. I Exp. II
1st Introduction 1. Introduce program goal and contents. Group approach Individual approach
2. Talking about processing of the program, and a rule.
3. Sign the contract of attending program.
2nd Find the personal strengths 1. Talking about last week daily life. Writing & speaking Writing & talking
2. Finding the personal strengths.
3. Planning the one day schedule in which they use their strengths.
3rd To thank for their family 1. Introduce the last week life using positive thinking. Walking · Writing & speaking Walking · Writing & talking
2. Thinking about thankful things during walking.
3. To write a thanks letter for family.
4th Recall happy experiences 1 1. Remembering the sad experience, and expressing that feeling to positively. Writing & speaking Writing & speech
2. To know the effects of the positive thinking to express good feeling.
5th Recall happy experiences 2 1. See the photos or objects, and talking about good memory with that. Writing & speaking Writing & talking
2. Writing that good feeling and happy experience.
6th Recall happy experiences 3 1. Speaking about the happy time when they felt happiness with their family. Writing & speaking Writing & talking
2. Writing their emotional change.
7th To improve positive thinking 1. To think about the negative experiences of the past time. Speaking & singing Talking & singing
2. Think back to past negative emotions into positive, & Sing together.
8th To do friendly things for family 1. Establish plan to help family members. Writing & speaking Talking
2. Writing their planning helping them.
3. Learning about volunteering.
9th Making bucket list 1. Thinking about 10 things to do that they want (Bucket List). Speaking Talking
2. Speaking feel if they realize the bucket list.
10th Final ceremony 1. Speaking about the personal feeling after finishing the program. Certificate ceremony Certificate ceremony
2. To promise trying to keep the positive thinking and happy mind.
3. Give a certificate.

Exp.=experimental group.

Table 2

Homogeneity of General Characteristics before Intervention (N=94)

jkachn-26-238-i002
Characteristics Categories Exp. I Exp. II Cont. x2 or t p
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Age (year) 75.8±6.01 74.5±4.84 75.3±7.20 0.56 .568
Literacy Able 28 (87.5) 27 (84.4) 23 (76.7) 1.35 .508
Unable 4 (12.5) 5 (15.6) 7 (23.3)
Living with family Yes 10 (31.3) 12 (37.5) 15 (50.0) 2.35 .309
No 22 (68.8) 20 (62.5) 15 (50.0)
Economic status Not poor 10 (31.3) 14 (43.8) 19 (63.3) 6.50 .039
Poor 22 (68.8) 18 (56.3) 11 (36.7)
Number of disease 3.0±1.60 2.8±1.51 2.0±0.83 5.31 .007
Disease Hypertension 31 (96.9) 28 (87.5) 21 (70.0)
Diabetes mellitus 15 (46.9) 14 (43.8) 6 (20.0)
Arthritis 29 (90.6) 23 (71.9) 18 (60.0)
CAD 3 (9.4) 2 (6.3) 6 (2.0)
Others 11 (34.4) 12 (37.5) 8 (26.7)
Total 32 (100.0) 32 (100.0) 30 (100.0)

Exp.=experimental group; Cont.=control group; CAD=coronary artery disease.

Table 3

Homogeneity of Depression and Death Anxiety before Intervention (N=94)

jkachn-26-238-i003
Variables Exp. I Exp. II Cont. F p
M±SD M±SD M±SD
Depression 7.6±1.73 7.6±1.94 8.1±2.51 0.40 .670
Death anxiety 39.2±5.53 37.7±6.24 40.3±5.12 1.67 .193

Exp.=experimental group; Cont.=control group; CAD=coronary artery disease.

Table 4

Differences of Depression and Death Anxiety before and after Intervention

jkachn-26-238-i004
Variables Categories Before After Difference before and after ANOVA F (p) F (p) for PE†
M±SD M±SD M±SD 95% CI p
Depression Exp. Ia 7.6±1.73 6.0±2.55 -1.6±0.25 -2.19~-1.18 <.001 5.94 (.004)
a, b>c		 7.50 (.001)
a, b>c
Exp. IIb 7.6±1.84 6.4±2.61 -1.2±0.27 -1.82~-0.74 <.001
Cont.c 8.1±2.51 8.1±2.56 0.0±0.20 -0.38~0.44 .869
Death anxiety Exp. Ia 39.2±5.53 37.5±3.59 -1.7±0.91 -3.51~0.20 .079 7.17
(.001)
a, b<c		 4.56 (.013)
b<c
Exp. IIb 37.7±6.24 37.0±5.37 -0.7±1.33 -3.41~2.03 .610
Cont.c 40.3±5.12 41.4±5.63 1.1±6.62 -1.41~3.53 .385

Exp.=experimental group; Cont.=control group; †The absolute program effect among experimental group I, experimental group II, and control group with economic status (ANCOVA: The baseline value and the number of disease were used as covariables and economic status as fixed factors).

References

1. Bae JY, Kim WH, Yoon KA. Depression, suicidal thoughts and the buffering effect of social support among the elderly. J Korean Gerontol Soc. 2005; 25(3):59–73.
2. Chung SD, Koo MJ. Factors influencing depression: A comparison among babyboomers, the pre-elderly, and the elderly. J Welf Aged. 2011; 52:305–324.
3. Kim HS. A study on epistemology of Korean elder's suicidal thought. J Korea Gerontol Soc. 2002; 22(1):159–172.
4. Moon NS, Nam KM. The relationship between the death preparation of the aged and successful aging-focusing on depression and death anxiety as mediators. J Korean Gerontol Soc. 2008; 28(4):1227–1248.
5. Nam KM, Jung EK. The influence of social activity and social support perceived by elderly women living alone on their quality of life: Focusing on the mediating effect of depression and death-anxiety. J Welf Aged. 2011; 52:325–348.
6. Kim YS, Kim JM. The relationship between sociodemographic variables and death anxiety among the elderly. J Korean Gerontol Soc. 2009; 29(1):275–289.
7. Song YM, Yoo K. A study on effects of death education on death anxiety and life satisfaction. psychological well-being in older adults. J Welf Aged. 2011; 54:111–134.
8. Yoon HS, Koo BM, Lee K, Lee JY. The effectiveness of problem-solving treatment on geriatric depression. J Korean Gerontol Soc. 2010; 30(3):871–894.
9. Chang WS. The effects of the group forgiveness program on anger, anxiety and depression for female elders. J Korean Gerontol Soc. 2010; 30(1):109–126.
10. Oh CT, Kim CG. Effects of death education on attitude toward death and depression in older adults. J Korean Gerontol Soc. 2009; 29(1):51–69.
11. Chang WS, Lee JM. The effect of group reminiscence therapy on depression, quality of life and social behavior of patient with dementia. J Welf Aged. 2006; 34:239–270.
12. Han YR, Song MS, Lim JY. The effects of a cognitive enhancement group training program for community-dwelling elders. J Korean Acad Nurs. 2010; 40(5):724–735. DOI: 10.4040/jkan.2010.40.5.724.
crossref
13. Lee HS, Lee DH. Effects of a cognition activation program for the institutionalized old-old in Korea. J Korean Acad Community Health Nurs. 2013; 24(4):427–437. DOI: 10.12799/jkachn.2013.24.4.427.
crossref
14. Choi YH, Jeon EY. Effects of art therapy on cognition, depression, and quality of life in elderly. J Korean Acad Community Health Nurs. 2013; 24(3):323–331. DOI: 10.12799/jkachn.2013.24.3.323.
crossref
15. Lee KY. The effect of rhythmic activity program on IADL, depression and sleep of the elderly. J Korean Acad Soc Nurs Educ. 2006; 12(1):28–35.
16. Park SM. Meta-analysis of the interventions for caring depression of the elderly in the four countries: A comparison of the total effectiveness, short-term effectiveness, and long-term effectiveness. J Korean Gerontol Soc. 2011; 31(3):553–571.
17. Seligman MEP, Steen TA, Park N, Peterson C. Positive psychology progress: Empirical validation of interventions. Am Psychol. 2005; 60(5):410–421. DOI: 10.1037/0003-066x.60.5.410.
crossref
18. Peseschkian N, Tritt K. Positive psychotherapy effectiveness study and quality assurance. Eur J Psychother Counsell Health. 1998; 1(1):93–104.
crossref
19. Ramírez E, Ortega AR, Chamorro A, Colmenero JM. A program of positive intervention in the elderly: Memories, gratitude and forgiveness. Aging Ment Health. 2014; 18(4):463–470. DOI: 10.1080/13607863.2013.856858.
crossref
20. Tomasulo DJ. Positive group psychotherapy modified for adults with intellectual disabilities. J Intellect Disabil. 2014; 18(4):337–350. DOI: 10.1177/1744629514552153.
crossref
21. Lee JA. The effect of group positive psychotherapy program on depressed older adults. [Dissertation]. [Seoul]: Korea University;2011. 120.
22. Lee HJ, Um MY. Developing, and testing the effects of a group program for the low income depressed elderly women living alone, which integrated positive psychology and solution-focused therapy. Korean J Soc Welf. 2014; 66(3):101–131.
23. Han SM, Lee BK. Effectiveness of a character strengths-based positive psychotherapy on depression, life satisfaction, and quality of life among the depressed elderly. Korean J Clin Psychol. 2012; 31(4):971–992. DOI: 10.15842/kjcp.2012.31.4.006.
24. Park SH, Kim JY. The present and future of positive counseling and psychotherapy. J Korean Assoc Psychother. 2012; 4(1):61–77.
25. Jeong JH, Son CN. Effects of positive psychotherapy on depression, self-esteem, and optimism of adolescents with school maladjustments. Korean J Health Psychol. 2014; 19(1):99–117.
26. Go HJ, Choi JO, Lee HP. The reliability and factor structure of K-Trempler Death Anxiety Scale. Korean J Health Psychol. 2006; 11(2):315–328.
27. Sheikh JI, Yesavage JA. 9/Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. Clin Gerontol. 1986; 5(2):165–173. DOI: 10.1300/j018v05n01_09.
28. Jang Y, Kim G, Chiriboga D. Acculturation and manifestation of depressive symptoms among Korean-American older adults. Aging Ment Health. 2005; 9(6):500–507.
crossref
29. Lee EJ. Relationship of leisure sports activities, social support, depression and death anxiety among the elderly. J Leis Recreation Stud. 2014; 38(4):51–63.
TOOLS
Similar articles