STRESS

Original Articles

Quality of Life and Its Influencing Factors among Older Adults with Diabetes Mellitus in Korea: Mee Young Im; STRESS. 2025;33(4):226-235. Published online December 31, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.4.226

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Abstract PDF: Background
This study aimed to assess the quality of life (QoL) of older adults with diabetes in Korea and to identify the factors influencing their QoL.
Methods
A total of 1,887 individuals aged ≥65 years with diabetes (weighted n=8,305,093) from the 7th–8th (2018–2020) Korea National Health and Nutrition Examination Surveys were analyzed. Considering the complex sampling design, descriptive statistical analyses, independent t-tests, analysis of variance, and multiple regression analyses were performed.
Results
The mean EQ‑5D index score was 0.87 (±0.01). Among the five EQ‑5D dimensions, self-care had the highest proportion of participants reporting “no problems” (86.6%), whereas mobility had the lowest proportion (57.5%). Significant factors associated with QoL included economic activity (B=0.02, p＜.001), chewing difficulty (B=−0.04, p＜.001), activity limitations (B=−0.10, p＜.001), and aerobic physical activity (B=0.04, p＜.001). In particular, all mental health variables—including perceived health status (B=−0.08, p＜.001), perceived stress (B=−0.03, p＜.021), and depression (B=−0.13, p＜.001)—showed significant associations with QoL. The final regression model explained 40.7% of the variance in QoL (Adj. R²=40.7, p＜.001).
Conclusions
The QoL of older adults with diabetes may be influenced not only by physical health, but also by psychological well-being. Therefore, integrated nursing interventions that promote physical activity, maintain oral health, and enhance mental health are essential for improving the QoL in this population.

Effects of Loneliness on Stress in Middle-Aged and Older Adults: Sequential Dual Mediating Roles of Social Interaction Anxiety and Self-Control: Seung Chul Lee, Wonil Choi, SoYeong Yoon, Soo Rim Noh; STRESS. 2025;33(2):93-102. Published online June 30, 2025; DOI: https://doi.org/10.17547/kjsr.2025.33.2.93

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Background
The aim of this study is to identify the psychological pathways linking loneliness to stress among middle-aged and older adults, focusing on the mediating roles of social interaction anxiety and self-control.
Methods
A total of 580 adults aged 40∼71 years completed an online self-report questionnaire. Structural equation modeling was used to test a sequential mediation model, and covariates such as age, sex, depression, and extraversion were controlled for.
Results
Loneliness was positively associated with stress and social interaction anxiety, and negatively with self-control. Social interaction anxiety and self-control each mediated the relationship between loneliness and stress. Moreover, a significant sequential mediation pathway was observed: loneliness was associated with higher levels of social interaction anxiety, which in turn was negatively related to self-control, and lower self-control was linked to heightened stress. After controlling for covariates, only the indirect effect via social interaction anxiety remained significant. This suggests that anxiety in social contexts may serve as a robust emotional mechanism underlying the association between loneliness and perceived stress.
Conclusions
This study empirically supports the sequential mediation model in which loneliness increases social interaction anxiety, which in turn reduces self-control, ultimately elevating stress. These findings highlight the importance of considering both interpersonal and intrapersonal factors in mental health interventions for aging populations. Addressing loneliness, reducing social interaction anxiety, and strengthening self-control may be effective targets for psychological intervention and community-based programs tailored to the needs of middle-aged and older adults.

Citations

Citations to this article as recorded by

Loneliness and perceived stress in family caregivers of older adults with disabilities: the mediating role of psychological resilience
Yinghui Song, Ying Luo, Xiwen Zhang, Ying Zhou, Shudi Chen, Caiying Huang
BMC Geriatrics.2026;[Epub] CrossRef

Impact of Frailty, Depression, and Loneliness on Ego-Integrity in Community-Dwelling Elderly: Seon Ju Song, Sung Hee Ko, Ji Young Kim, Hyun Kyung Kim; STRESS. 2022;30(3):139-146. Published online September 30, 2022; DOI: https://doi.org/10.17547/kjsr.2022.30.3.139

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Abstract PDF: Background
This study examined how frailty, depression, and loneliness impact ego-integrity among the community-dwelling elderly
Methods
The study participants comprised 187 elderly people in J-province. Data collected in October 2018 via structured self-report questionnaires were used to assess the participants’ general characteristics, frailty, depression, loneliness, and ego-integrity. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple regression.
Results
Significantly positive correlations were found among frailty, depression, and loneliness. Ego-integrity showed significantly negative correlations with frailty, depression, and loneliness. Finally, loneliness was a significant factor, explaining about 28.7% of the variance on ego-identity.
Conclusions
The study’s findings suggest that an intervention focused on reducing loneliness would improve ego-integrity among the elderly.

The Moderating Role of Cultural and Leisure Activities in the Effects of Subjective Health Status on Life Satisfaction: Focus on Middle and Old-aged Single Households with Persons with Disabilities: Jongnam Lee; STRESS. 2020;28(4):230-236. Published online December 31, 2020; DOI: https://doi.org/10.17547/kjsr.2020.28.4.230

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Abstract PDF: Background
The purpose of this study is to verify how participation in cultural and leisure activities by middle- and old-aged households with people with disabilities affects subjective health status and life satisfaction.
Methods
Secondary analyses were conducted with 1,223 persons aged 50 years or over and living alone with disabilities, using the raw data from the 2017 National Survey on Persons with Disabilities.
Results
The results indicated that participation in cultural and leisure activities moderates the effects of subjective health status on life satisfaction.
Conclusions
This study revealed that policies and programs to encourage participation in cultural and leisure activities for persons with disabilities are needed for enhancing life satisfaction.

A Systematic Review of the Suicide Prevention Program for the Elderly: Taekyun Gwon, Heeseung Choi; STRESS. 2019;27(1):53-63. Published online March 31, 2019; DOI: https://doi.org/10.17547/kjsr.2019.27.1.53

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4 Citations

Abstract PDF

Background:

This study is a systematic review of literature to analyze the characteristics and effects of suicide prevention programs for the elderly.

Methods:

We systematically reviewed literature published from 2007 to 2018 in 8 domestic and foreign databases (KISS, NDSL, Koreamed, RISS, Pubmed, CINAHL, EMBASE, CENTRAL). The main search terms were ‘elderly’, ‘suicide’, ‘intervention program’, and included 8 articles matching the selection criteria in the final analysis. The program was divided into activities, counseling, and community support programs.

Results:

Most of the programs effectively reduced suicidal ideation and depression by reducing suicide risk factors and improving protective factors.

Conclusions:

As a result of the analysis, it was found that it is necessary to develop a specialized program for the prevention of suicide in the elderly considering social, environmental, personal and community characteristics.

Citations

Citations to this article as recorded by

Dual mediating effects of changes in daily life and anxiety on the relationship between occupation and depression in Korea during the COVID-19 pandemic
Soo-bi Lee, Ye-bin Jeon, Myeong-Sook Yoon
BMC Public Health.2022;[Epub] CrossRef
The Double Mediating Effect of Family Support and Family Relationship Satisfaction on Self-Compassion and Meaning in Life among Korean Baby Boomers
Yu-soo Jeong, Young-soon Lee
International Journal of Environmental Research and Public Health.2022; 19(16): 9806. CrossRef
An Exploratory Study on How and Why Young and Middle-aged Adults Disclose Depressive Feelings to Others: Focusing on the Influence of Perception of Social Norms
Soontae An, Hannah Lee
Journal of Korean Academy of Community Health Nursing.2021; 32(1): 12. CrossRef
Influence of socio-economic deprivation on the change patterns of depression in young adults: Focusing on seven areas of deprivation
Soo-Bi Lee, Yoonjoo Choi, Hyunok Lee
Korean Journal of Health Education and Promotion.2021; 38(5): 45. CrossRef

The Effect of Work-Family Conflict, Fatigue and Perceived Health on the Health Promoting Behavior of Married Working Women a Rural Population: HyeaKyung Lee, EunHee Shin; Korean J Str Res. 2016;24(3):167-176. Published online September 30, 2016; DOI: https://doi.org/10.17547/kjsr.2016.24.3.167

3,371 View
44 Download
4 Citations

Abstract PDF

This study aims to investigate the relationship of workplace to family conflict, fatigue, recognition of health status and health enhancement behaviors in the subjects of middle aged businesswomen, and to analyze the factors to affect their health enhancement behaviors. The subjects of this study were 152 middle aged businesswomen from 40 to 64 years old who lived in South and North Choongchung Provinces, and their data were collected using by the survey form. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple linear regression with stepwise method. The variables with the highest influence to the health promotion activity of middle-aged working women were fatigue 16.0% (β=−.319, p<.001), family type 2.2% (β=−.163, p=.031), and work-family conflict 1.8% (β=−.181, p=.033) and it was found that these three variables explained 20.9% of health promotion activity. There needs to be plans to lower the levels of fatigue and work-family conflict that is known as predictive factors of health promotion activity of middle-aged working women as well as further social support for subjects who do not live with their family. In addition, it is required to establish the simple exercise facilities in the workplace so as for the middle aged businesswomen who hardly spend the time to enhance their health so often. Moreover, the atmosphere of the workplace should be organized to increase the perception and the practices on the health enhancement by sports for all that can be simply practiced in the workplace without specific facilities.

Citations

Citations to this article as recorded by

Factors affecting physical and mental fatigue in adults from South Korea: A cross-sectional study
Kyeha Kim, Jihyun Oh
Medicine.2023; 102(50): e36549. CrossRef
The Relationship between Parenting Stress and Health Promotion Behavior of Working Women: Mediating Effect of Supporting Resources
Gwijin Lee, Jinhwa Lee, Bokim Lee
Journal of Korean Academy of Community Health Nursing.2021; 32(4): 529. CrossRef
A Study on Experiences of Health Problems and Coping in Middle-aged and Elderly Women in the Community: Focusing on Focus Group Interview Approach
Yeo Won Jeong, Kyung Im Kang, Byeong Ju Lee
Journal of Korean Academy of Community Health Nursing.2020; 31(2): 119. CrossRef
The Effects of Perceived Stress, Marital Intimacy and Mental Health on the Climacteric Adaptation in Middle-aged Women in Urban Areas
Hyun-Joo Park
The Korean Journal of Rehabilitation Nursing.2019; 22(1): 38. CrossRef

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