Depression among Korean Americans (KAs) is higher than any other Asian or non-White ethnic group. Studies have shown a significant association between depression and limited health literacy in ethnicities with a limited English proficiency, and in older age. Older KAs may have such characteristics that affect their health literacy level, and possibly related to depression. Health literacy also shares common elements with depression literacy, and both may be closely related to depression. This is an exploratory cross-sectional study with survey consisting of 55 items translated (from English into Korean) and three qualitative questions were administered to 178 Korean Americans of age 60 and older. Depression was measured by PHQ-9. Chi-square, t-tests, ANOVA, and correlations were used, then a logistic regression analysis was performed for the final analysis to examine the relationship of background characteristics, health literacy, depression literacy, and depression. In addition, narrative responses for the definition of depression, and living arrangement and depression were obtained. About 22.5% of older KAs were depressed with PHQ-9 score ≥ 5. This study identified significant associations between health literacy and age (r = -0.20, p < 0.01), education (r = 0.565, p < 0.001), acculturation years (r = 0.397, p < 0.001), English proficiency (r = 0.636, p < 0.001), family support (r = 0.196, p < 0.01), and living with a spouse (F = 4.61, p = 0.01). No significant associations among the background characteristics and depression literacy, and no association between health literacy and depression literacy were found (r = 0.11, p = 0.89). The final model of logistic regression showed– sex, acculturation (length of stay in the U.S.), English proficiency, family support, and depression literacy –significant associations with depression. Health literacy was not significant on depression. Older KA men are less likely to have depression (OR = 0.29, p = 0.01). Older KAs with higher level of English proficiency, or more family support, are less likely to have depression (OR = 0.75, p = 0.002; OR = 0.91, p < 0.001 respectively), and length of stay in the U.S. was marginal (OR = 0.96, p = 0.05). Older KAs with depression are likely to have more knowledge about depression (OR = 1.15, p = 0.02) compared to their counterparts. Narrative responses in the survey showed only 35.5% of the participants believe that depression involves mental health. The findngs of this study showed an even higher prevalence for depression at 29.6% among the older KAs living with adult children and having household responsibilities. The findings suggest an explanatory framework to understand older KAs with depression, and improving their health literacy alone may not reduce the prevalence of depression. The result implies the education of family and members of the Korean community, especially among the identified higher risk group (older KAs with limited education, or limited English proficiency) to promote mental well-being in older Korean Americans.
|Advisor:||Oh, Kyeung Mi|
|Commitee:||Douglas, Charlene, Weinstein, Ali|
|School:||George Mason University|
|School Location:||United States -- Virginia|
|Source:||DAI-B 78/12(E), Dissertation Abstracts International|
|Subjects:||Mental health, Nursing|
|Keywords:||Depression, Depression literacy, Health literacy, Older korean americans|
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