Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea

Gyuyoung Lee; Ok Kyung Ham; Bo Gyeong Lee; Abuan Micah Kim

doi:10.4040/jkan.2018.48.4.475

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

Original Article

J Korean Acad Nurs 2018;48(4):475-484.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.4.475

Differences in Factors Associated with Depressive Symptoms between Urban and Rural Female Adolescents in Korea

Gyuyoung Lee¹, Ok Kyung Ham², Bo Gyeong Lee^3,, Abuan Micah Kim²

¹Redcross College of Nursing, Chung-Ang University, Seoul

²Department of Nursing, Inha University, Incheon

³College of Nursing · The Research Institute of Nursing Science, Catholic University of Daegu, Daegu, Korea

Address reprint requests to : Lee, Bo Gyeong College of Nursing · The Research Institute of Nursing Science, Catholic University of Daegu, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea Tel: +82-53-650-3621 Fax: +82-53-650-4392 E-mail: leebbo03@gmail.com

Received 19 March 2018 Revised 18 August 2018 Accepted 19 August 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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.

Keywords: Female Adolescents, Depression, Behavioral Problem

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Figure 1.

Intrapersonal, interpersonal, organizational level of this study.

Table 1.

Differences in Intrapersonal Level Characteristics between Urban and Rural Areas (N=460)

Variables	Distribution	Urban (n=255)	Rural (n=205)	χ²	p
Variables	Distribution	n (%)	n (%)	χ²	p
Grade	1^st	65 (25.5)	60 (29.2)	17.09	<.001
	2^nd	101 (39.6)	45 (22.0)
	3^rd	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
Variables	Distribution	n (%)	n (%)	χ²	p
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
Variables	Distribution	n (%)	n (%)	χ²	p
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
1^st	-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
2^nd	-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 together^a
Both parents				-0.05	.00	1.07	.02	.00	1.08				0.73	.03	1.10	0.92	.04	1.11
Source of stress^b
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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