kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2016.16.2.127 kjhp-16-127 Original Article The Mediating Role of Optimism and Pessimism on the Relationship between Spirituality and Depression among Elderly Cancer Patients NamIlsung 1 YoonHyunsook 2 KimYojin 2 LimYeon-Ok 3 LeeHyunjoo 4 ChoiKyoungwon 5 Department of Social Welfare, Sungkonghoe University, Seoul, Korea Department of Social Welfare, Hallym University, Chuncheon, Korea Hallym University Institute of Aging, Hallym University, Chuncheon, Korea Department of Social Welfare, Hallym Polytechnic University, Chuncheon, Korea Department of Social Welfare, Graduate School of Hallym University, Chuncheon, Korea Corresponding author: Ilsung Nam, PhD Department of Social Welfare, Sungkonghoe University, 320 Yeondong-ro, Guro-gu, Seoul 08359, Korea Tel: +82-2-2610-4109, Fax: +82-2-2610-4373 E-mail: ilsungn@gmail.com 01 2016 20 01 2016 16 2 127 133 17012016 13062016 Copyright © 2016 The Korean Society of Health Promotion and Disease Prevention 2016 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. Background

Numerous studies have demonstrated that spirituality has protective effects on depression. However, there are only few studies on the theoretical mechanism showing how spirituality effects on depression. Thus, to find mediating variables explaining the relationship between the spirituality and depression may help to develop appropriate program for reducing depression in elderly cancer patients. In this study, we examined the effect of optimism and pessimism as their mediating effects on depression.

 Methods

This study is to verify the relationships between spirituality and depression along with the mediating effects of optimism and pessimism among 600 South Korean elderly cancer patients who participated in a community-based study about their mental health.

 Results

Optimism and pessimism are linked with spirituality and depression. Higher spirituality levels were associated with increased optimistic thinking, and then optimistic thinking is associated with low possibility of depression, whereas lower spirituality levels were associated with more pessimistic thinking, and in turn pessimistic thinking is associated with high depression scores.

 Conclusions

Understanding optimism and pessimism affecting depression level is critical for developing spirituality-based programs to reduce depression in elderly cancer patients.

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Regression results predicting depression of spirituality without controlling for optimism constructs

  B SE P value
Spirituality –0.258 0.064 <0.001
Age, y 0.007 0.034 0.302
Female –0.707 0.620 0.092
Employed –2.203 0.540 <0.001
Education, y –0.241 0.055 <0.001
Married –1.782 0.644 0.003

Abbreviations: SE, standard error.

Structural equation model with endogeneous variables (optimism and pessimism) predicting depression

  Predicting depression Predicting optimism Predicting pessimism
  B SE P value B SE P value B SE P value
Optimism –0.698 0.128 <0.001 – – – – – –
Pessimism 0.700 0.112 <0.001 – – – – – –
Spirituality –0.074 0.059 0.205 0.172 0.021 < 0.001 –0.091 0.022 <0.001
Age, y –0.003 0.033 0.702 –0.003 0.013 0.438 0.011 0.013 0.252
Female –0.289 0.568 0.480 0.381 0.211 0.074 –0.225 0.218 0.319
Employed –1.603 0.513 0.002 0.322 0.186 0.081 –0.285 0.198 0.124
Education, y –0.190 0.051 <0.001 0.021 0.019 0.521 –0.053 0.019 0.009
Married –1.521 0.605 0.023 0.430 0.224 0.091 0.053 0.226 0.718

Abbreviations: B, coefficient; SE, standard error.

Indirect effects of spirituality on depression through optimism and pessimism

  B SE 95% Confidence interval
  Lower Upper
Depression → Optimism → Spirituality –0.120 0.030 –0.178 –0.062
Depression → Pessimism → Spirituality –0.063 0.019 –0.100 –0.026

Abbreviations: B, coefficient; SE, standard error.