Older adults with disabilities are a vulnerable group who experiences double difficulties as people with disabilities and older adults due to negative attitude given to them. This phenomenon may negatively impact on psychological health of them such as depression. The literature demonstrates that older adults with disabilities are vulnerable to depression compared to other groups (Cheruvu & Chiyaka, 2019; Haigh et al., 2018). Previous studies also found that psycho-social variables such as social support and self-esteem can reduce depression. However, little is known about the structural association among social support, self-esteem, and depression among older adults with disabilities. Thus, considering that depression tends to increase when self-esteem is low (Shahar & Davidson, 2003) and depression is lowered when self-esteem is high (Orth et al., 2009), this study examined the moderating effect of self-esteem on the relationship between perceived social support and depression of older adults with disabilities.
Methods: Data were obtained from secondary data of the 15th 2020 Korea Welfare Panel, collected by using a stratified sampling method with proportional allocation of region and type of disabilities. A nationally representative sample of the current study consisted of 657 older adults with disabilities above the 65 years old. As the dependent variable, perceived social support was measured by a 5-point Likert scale with 10 items of MSPSS (Multi-dimensional Scale of Perceived Social Support). As the independent variable, depression was measured by a 4-point Likert scale with 11 items of CESD (Center for Epidemiological Studies of Depression Scales). Covariates included demographic characteristics: Age, gender, education, level of disability, marital status, and income. Hierarchical multiple linear regression model was conducted to analyze the data.
Approximately 7.6% of the sample reported that they experienced depressive symptoms (CESD cutoff >=16). Results of a correlation analysis shows that marital status (married=1) and level of disability (severe=1) were positively correlated with depression. On the other hand, gender (male=1), educational (high school graduate and above=1), income, perceived social support, and self-esteem were negatively correlated with depression. Results of hierarchical multiple linear regression model demonstrate that overall significant model with the perceived social support (B=-.414, p<.01) and covariates explained 29.1% of variance in depression. Also, the moderating effect of self-esteem on the relationship between perceived social support and depression was found to be statistically significant (B=.014, p<0.5).
Conclusions and implications:
This study found that perceived social support was negatively associated with depression, and self-esteem moderated on the relationship between perceived social support and depression among older adults with disabilities. These findings suggest that increasing perceived social support might be a strategy to reduce depression of older adults with disabilities. Therefore, social workers should try to bridge older adults with disabilities to family, neighborhood and friends by implementing social relationship program and psychological program to increase their social support and self-esteem. In addition, Personal Assistance Service for people with disabilities should be extended to older adults with disabilities so that more socially included in their community.