آثار برنامه های ورزشی روی آمادگی جسمانی، افسردگی و خودکارایی زنان سالخورده کم درآمد در کره جنوبی Effects of Exercise Program on Physical Fitness, Depression, and Self-Efficacy of Low-Income Elderly Women in South Korea

Population aging has become a common concern the world over. In Korea, the population of elderly people is increasing at a faster rate than in many other countries (Korea Ministry of Health and Welfare, 2007). Adults over the age of 65 currently account for 8.7% of the population in Korea (Korea National Statistical Office [KNSO], 2001). With a higher average life span, women constitute nearly two thirds of the population aged over 65 in Korea (KNSO, 2001). At the same time, poverty among elderly people is a growing concern and has been considered as a major longterm social issue. Nearly 45% of the population aged over 65 lives in poverty, with an income of o300,000 won per month (US$214). A higher percentage of elderly women (11.3%) as compared with elderly men (6.3%) subsist on the National Basic Livelihood Security (KNSO, 2001). As a result, the number of poor elderly women at risk for chronic illnesses is increasing. According to a report issued by the Korean Ministry of Health and Welfare in 2007, 79.4% individuals aged over 65 were suffering from at least one disease. Of these, the majority were women (Korea Ministry of Health and Welfare, 2007). The combination of aging, reduced economic resources, and chronic illnesses may reduce the capabilities of elderly women to engage in health promotion activities. Previous investigations have reported that lack of exercise, smoking, alcohol intake, poor dietary habits, and reduced health examinations are the major factors that influence the health of elderly people (Centers for Disease Control and prevention [CDC], 2004; Cho, 1998; J. J. Park & Hong, 2000). In Korea, lack of exercise has been shown to be the most influential factor affecting the health of the elderly (Cho, 1998). Lack of exercise is most common among women who are older, less educated, and live on a reduced income (CDC, 2004; J. J. Park & Hong, 2000). Barriers to performing exercises include insufficient knowledge, prejudices, misunderstandings, chronic health conditions, and inadequate social recognition accorded to elderly people (Conn, Burks, Pomeroy, Ulbrinch, & Cochran, 2003). In elderly people, physical exercise has positively affected physical fitness; prevented or alleviated symptoms of chronic diseases (e.g., arthritis, hypertension, lumbago, sciatica, osteoporosis, diabetes); and improved mental health (e.g., depression) (Christmas & Andersen, 2000). The positive effects of physical exercise on the psychoemotional wellbeing and quality of life have been reported in several Korean studies (Jung, 2002; J. M. Park & Han, 2003). Specifically, depression and insomnia among elderly people has been shown to be decreased by the increase of social interactions through group exercise interventions (Jung, 2002; J. M. Park & Han, 2003). However, previous studies have not considered the socioeconomic status of subjects in terms of their accessibility to health promotion programs. Lowincome elderly women have not yet been included as a specific participant group in health promotion programs although their vulnerability to health problems is higher than that of any other group Self-efficacy or self-confidence in being able to successfully perform a specific activity or behavior is one of the factors that influence the ability of an individual to begin and sustain the performance of physical exercise (Oka, DeMarco, & Haskell, 2005). To sustain participation in exercise programs, strategies to enhance self-efficacy should be included in intervention. The self-efficacy theory is founded on selfefficacy expectations and outcome expectations (Bandura, 1997). Self-efficacy plays an important role in helping maintain a level of physical exercise or activity (Resnick, Luisi, & Vogel, 2008; Resnick, Vogel, & Luisi, 2006). The self-efficacy theory espouses the intent to help elderly people increase their selfefficacy and thereby increase overall physical fitness and decrease depression (Bandura, 1997; Resnick et al., 2008). This study aimed at examining the effects of exercise programs on physical fitness, depression, and self-efficacy in low-income elderly women in South Korea. Specifically, the following hypotheses were tested in the study: (1) participants in the exercise group will show a significantly greater improvement in their physical fitness than those in the control group after 8 weeks of intervention and (2) participants in the exercise group will show a significantly greater improvement in depression and self-efficacy than those in the control group after 8 Weeks of intervention,