The older adult population in South Korea is growing at an unprecedented rate, faster than any other advanced country (National Statistic Organization Office, 2016). This growth has caused changes in the status and role of older adults in South Korean society, which have occurred amid changes in the economic and social structure following modernization, urbanization, and industrialization, thereby resulting in serious social issues (Kim, Kim, & Chung, 2014).
The aging society has led to an increasing social interest in older adults, who, in turn, must take more proactive and positive attitudes toward life. As overall living and economic standards improve, there has been growing concern about pursuing meaning during old age. Despite this concern, researchers have had difficulties solving problems facing this population of older adults (Kim et al., 2014). It is necessary to take measures regarding the loss of status, loneliness, or alienation that older adults experience, along with their physical, psychological, and social issues. Loss of status damages social and mental self-esteem and aggravates health status and psychological loneliness. A healthy life after retirement is essential for offering older adults a new outlook on life (Lee & Hong, 2012). Accordingly, seeking healthy and meaningful work can be considered leisure activities for older adults.
Leisure of older adults is different from leisure in general. This difference is due to the fact that leisure time has become abundant among older adults due to lengthened average life of the aged population (Cho, 2010; Lee, 2008). Using their free time has become a challenge for older adults. Older adults' participation in leisure activities promotes physical and mental well-being, improves their health, and helps increase their satisfaction in life and their morale (Lee & Hong, 2012; Lee, 2008). It also affects their pursuit of a pleasant, independent, and self-reliant life (Lee, 2008). Older adults' participation in leisure activities is related to their quality of life (Kim & Lee, 2010; Lee & Hong, 2012). Lack of participation in leisure or social activities causes them to become isolated, thereby resulting in various psychological problems, such as boredom, depression, or loneliness (Kim & Kim, 2011; Lee & Hong, 2012).
A literature review of studies conducted in South Korea and abroad has shown that leisure activities, or older adults' social activities, are correlated with perceived health status, psychological well-being, levels of depression, levels of loneliness, and successful aging (Ihle et al., 2017; Kim & Lee, 2010; Kim, 2009; Lee & Hong, 2012; Song & Um, 2008). Few studies have been conducted on these variables, as well as on male and female older adults' participation in leisure activities. Therefore, studies on older adults' participation level in leisure activities are necessary, as well as comparisons of the effects of leisure activities by gender. The current study aimed to examine and compare the effect of male and female older adults' participation level in leisure activities on their perceived health status, psychological well-being, levels of depression, levels of loneliness, and successful aging.
Design and Sample
A cross-sectional descriptive study design was used. The sample comprised 197 adults (women: n = 108, men: n = 89) ages 65 and older who were living in Gyeonggi Province, South Korea. Participants were recruited through convenience sampling. Inclusion criteria were individuals who were 65 or older, understood the purpose of the study, consented to participate in the study, had no cognitive impairment (as defined by scores ≥24 points on the Korean version of the Mini-Mental State Examination), and had complete ability to verbally communicate in Korean.
Sample size adequacy (n = 64 in both male and female groups) using t test G*power 3.1 analysis software was estimated based on alpha = 0.05, medium effect size = 0.5, and power = 0.8 (Faul, Erdfelder, Lang, & Buchner, 2007). Therefore, the sample size in the current study was adequate.
The data collection period for the current study was from May to November 2015. To recruit study participants, a researcher (M.K.G.) contacted prospective older adult participants living in Gyeonggi Province, South Korea by going door to door and explaining the purpose and objective of the research as well as participation details and instruments that were to be used in the study. Participants were selected after receiving written consent from volunteers. The questionnaire was given only to older adults who agreed to participate in the study, after which the completed questionnaires were collected. The questionnaires were self-reported and administered by the researcher. Each participant took approximately 25 to 30 minutes to complete the survey.
The questionnaire was designed to measure general characteristics of study participants, leisure activity participation, perceived health status, psychological well-being, levels of depression, levels of loneliness, and successful aging. General characteristics included participants' gender, age, educational level, marital status, religion, employment status, economic status, family members they lived with, and monthly income. The questionnaire comprised 9 items.
The leisure activity participation scale was designed by Havighurst (1973). Havighurst (1973) proposes a diverse range of activities to foster comfortable household environments, such as family life, religious affiliations, social and political agendas, social clubs, friendships, hobbies, and entertainment. These activities were revised by Cho (2005) to make them suitable to Korean individuals, with activities such as growing household plants, gardening, growing orchids, and raising fish. The activities included in family life were also changed to make them easier to understand based on sentiments of Korean individuals, such as having conversations with family members, going to family outings, or dining out. In addition, activities that correspond to Korean older adults' hobbies or forms of entertainment were revised to calligraphy and drawing the Four Gracious Plants. The scale by Cho (2005) was used to measure the participation level of study participants in leisure activities. It comprises a total of 20 questions using a 5-point Likert scale. The possible score range was 20 to 100, with higher scores indicating higher levels of participation in leisure activities. The reliability of this instrument was Cronbach's alpha = 0.88.
Speake, Cowart, and Pellet's (1989) perceived health status scale was redeveloped by Cho (2010). Speake et al. (1989) argued that management of nutrition, exercise, stress, self-realization, cognitive health, and social relationships was a key factor in health of older adults, as healthy behavior among older adults could delay physical degeneration and promote health in general. Cho (2010) redeveloped these cognitive health items based on the study by Speake et al. (1989). The scale by Cho (2010) was used to measure the perceived health status of study participants. It comprised three questions using a 5-point Likert scale. The possible score range was 3 to 15, with higher scores indicating greater perceived health status. The reliability of this instrument was Cronbach's alpha = 0.92.
The psychological well-being scale created by Ryff (1989) was modified by Cho (2005). Cho (2005) translated the scale into Korean and adapted it to suit Korean individuals. The scale by Cho (2005) was used to measure the level of psychological well-being of study participants. It comprised a total of 18 questions using a 5-point Likert scale. The possible score range was 18 to 90, with higher scores indicating greater psychological well-being. The reliability of this instrument was Cronbach's alpha = 0.86.
The depression scale designed by Yesavage et al. (1983) was recreated as the Geriatric Depression Scale Short Form–Korean by Kee (1996). This scale was used to measure the level of depression of study participants. It comprised a total of 15 questions using a 5-point Likert scale. The possible score range was 15 to 75, with higher scores indicating higher levels of depression. The reliability of this instrument was Cronbach's alpha = 0.86.
The UCLA Loneliness Scale created by Russell, Peplau, and Cutrona (1980) based on a 4-point Likert scale was modified by Nam (2012). Nam (2012) translated the scale into Korean and adapted it to suit Korean individuals. The scale by Nam (2012) was used to measure levels of loneliness of study participants. It comprised 26 questions using a 5-point Likert scale. The possible score range was 26 to 130, with higher scores indicating higher levels of loneliness. The reliability of this instrument was Cronbach's alpha = 0.93.
The successful aging scale, created by Rowe and Kahn (1997), was revised by Park (2011). The criteria of successful aging, as created by Rowe and Kahn (1997), comprise three parts: staying competent despite illness, maintaining physical functions, and proactively participating in social activities. Park (2011) revised the three parts to seven sub-factors: self-reliant life (independence and responsibility for one's own life); aiming toward self-realization (continuous activities and learning and realizing plans for self-realization); proactive participation in life (active social participation, such as leisure and social activities); satisfaction with children (good relationship with children and feeling proud of them); self-acceptance (acceptance of one's value and one's situation); acceptance of others (acceptance of others' situations and non-intervention); and companionship (happy married life, mutual understanding, and sharing of chores). The scale by Park (2011) was used to measure the level of successful aging of study participants. It comprised a total of 25 questions using a 5-point Likert scale. The possible score range was 25 to 125, with higher scores indicating more successful aging. The reliability of this instrument was Cronbach's alpha = 0.91.
Data were analyzed using SPSS version 21.0. Descriptive statistics, chi-square test, independent t test, and Fisher's exact test were used to analyze demographic characteristics of study participants. Correlations among study variables between genders were analyzed using Pearson's correlation coefficient. To examine the effect of male and female older adults' participation level in leisure activities on study variables, researchers divided participants into groups with higher and lower levels of participation in leisure activities according to average value, analyzing them accordingly. To compare between genders, the independent t test and analysis of covariance (ANCOVA) were used. Level of statistical significance was set at 0.05.
The study was approved by the Institutional Review Board of the respective university in Seoul, South Korea. Participants were informed that they could voluntarily take part in the study and that they could also withdraw from participating at any time if they wished. Moreover, they were informed about the anonymity and confidentiality of the data they would provide. Researchers obtained completed written consent forms from eligible participants prior to their participation.
General Characteristics of Study Participants
Average age of study participants was 76.95 (men: 76.37 years, women: 77.56 years). For male older adults, the percentage of those who received elementary education (47.2%) and those who received middle or high school education (44.9%) was similar, whereas for female older adults, the percentage of those who received elementary education or below (64.8%) was higher. In addition, the percentage of older adults with a religious affiliation was higher in women (53.7%) than in men (37.1%). The percentage of female older adults (87%) without a job was higher than that of male older adults (73%). However, there was no statistically significant difference between male and female older adults in terms of age, marital status, economic status, family members they lived with, and monthly income (Table 1).
General Characteristics of Study Participants (N = 197)
Correlations Among Study Variables Between Genders
In male older adults, the level of participation in leisure activities was positively related to perceived health status (r = 0.24, p < 0.05), and negatively related to depression (r = −0.24, p < 0.05). Thus, the higher the level of participation in leisure activities of male older adults, the better their perceived health status and lower their depression level. In female older adults, level of participation in leisure activities was positively related to psychological well-being (r = 0.33, p < 0.05) and successful aging (r = 0.23, p < 0.05). In other words, the higher the level of participation in leisure activities in female older adults, the better their psychological well-being and more successful their aging (Table 2).
Correlations among Study Variables between Genders (N = 197)
Influence of Leisure Activity Participation Between Genders
In male older adults, perceived health status, successful aging, psychological well-being, levels of depression, and levels of loneliness did not show a significant difference within the significance level p < 0.05 based on level of participation in leisure activities. However, within the significance level p < 0.08, there was a significant difference in perceived health status (t = −1.92, p = 0.058) and levels of loneliness (t = 1.83, p = 0.071). In female older adults, level of participation in leisure activities made a significant difference in their psychological well-being (t = 2.28, p = 0.025) and successful aging (t = 2.56, p = 0.012) (Table 3).
Influence of Leisure Activity Participation between Genders among Korean Older Adults (N=197)
Analysis of correlations between participation in leisure activities and related factors showed that in male older adults, the level of participation in leisure activities correlated with better perceived health status and lower levels of depression, whereas in female older adults, it correlated with better psychological well-being and more successful aging. These results demonstrated that there was a difference between male and female older adults in correlations between participation in leisure activities and research variables. Furthermore, such results support those of previous studies that indicated older adults' participation in leisure activities had a positive correlation with perceived health status, psychological well-being, life satisfaction, and successful aging (Cha, 2010; Chung & Song, 2011; Kim & Kim, 2011; Kim, 2009; Paggi, Jopp, & Hertzog, 2016), and a negative correlation with depression and loneliness (Fastame, Hitchcott, & Penna, 2018; Kim & Kim, 2011; Song & Um, 2008).
Analysis results regarding the difference in research variables between male and female older adults' participation in leisure activities showed that within the significance level p < 0.08, male older adults' participation in leisure activities resulted in a significant difference in perceived health status and loneliness. Female older adults' participation in leisure activities resulted in a significant difference in psychological well-being and successful aging, indicating that female older adults with higher levels of participation in leisure activities had better psychological well-being and more successful aging. These results support those of previous studies, which reported that older adults' participation in leisure activities had a positive effect on perceived health status, thereby encouraging life satisfaction and successful aging (Ihle et al., 2017; Kim & Lee, 2010). Moreover, older adults' proactive participation in leisure activities helped ensure life satisfaction and psychological well-being (Pack, Kim, & Kim, 2010), as well as lower levels of loneliness and depression. In addition, it helped them maintain their self-esteem, identity, and satisfaction with life (Song & Um, 2008). In particular, the current results demonstrated that participation in leisure activities had a more positive effect on psychological well-being and successful aging among female, rather than male, older adults. In consideration of the rising number of female older adults who live alone (Lee, Kim, & Sok, 2016; Sok, 2016), the current study results imply that more participation in leisure activities among female older adults who live alone would help lead to psychological well-being and successful aging.
Recent structural changes in the labor market and society have attracted interest in the use of older adult labor, and senior medical and social welfare services (Ihle et al., 2017; Kim, 2009; Song & Um, 2008). Accordingly, older adults' use of their leisure time, which has become longer than that of other age groups, is important. Older adults' need for leisure activities is not only about resting, but also about recovering balance in their lives (Havighurst, 1973), as leisure activities offer new experiences, challenges, and pleasure. Older adults' leisure activities are decisive factors in helping them enjoy their late life successfully, because they offer an opportunity to find self-balance and self-fulfillment (Ihle et al., 2017; Kim & Lee, 2010), as well as encourage older adults to reinvent themselves, acquire personal achievements, and relax, thus laying the foundation for a wholesome and healthy life (Lin, Jeng, & Yeh, 2018; Pack et al., 2010).
The current study has limitations in the sample's degree of representation and generalizability. Participants were recruited only from Gyeonggi Province, South Korea, which limited the characteristics of the data. However, the essential aim of this study was not to make generalizable results, but rather to provide information on which to build future research.
The current study determined that older adults' participation in leisure activities served as an attempt to recover their balance of life and rest, and promoted various positive effects (e.g., self-fulfillment, refreshment, personal achievement, vigor in life, increase in morale, life satisfaction). Therefore, it is necessary to develop more diverse and effective leisure programs that can improve older adults' perceived health status, psychological well-being, and successful aging, as well as reduce levels of depression and loneliness. Furthermore, the variables on which participation in leisure activities have a significant effect differ by gender. Thus, it is important to implement different leisure programs according to gender. Results of the current study can be used to establish leisure programs for male and female older adults.
Nursing strategies and interventions for increasing leisure activities in older adults are needed. For example, governments or communities can compensate older adults who participate in leisure activities. Active public awareness of leisure activities for older adults is also needed. Furthermore, it is necessary to conduct qualitative research that aims to understand and analyze the significance of leisure activities from the perspectives of male and female older adults.
Level of participation in leisure activities was positively correlated with perceived health status and negatively correlated with depression in male older adults. Meanwhile, it had a positive correlation with psychological well-being and successful aging in female older adults. Male older adults' participation in leisure activities had a statistically significant, albeit small, effect on their perceived health status and loneliness, whereas female older adults' participation in leisure activities had a significant effect on their psychological well-being and successful aging. The researchers hope that these results will help encourage older adults to participate more actively and positively in leisure activities so that they can live a physically, mentally, and psychologically healthier life.
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General Characteristics of Study Participants (N = 197)
|Variable||n (%)||t/χ2||p Value|
|Male (n = 89)||Female (n = 108)|
|Age (years) (mean [SD])||76.37 (4.32)||77.56 (4.83)||3.14||0.576|
| Completed elementary school or below||42 (47.2)||70 (64.8)|
| Completed middle or high school||40 (44.9)||31 (28.7)|
| Completed bachelor's degree or above||7 (7.9)||7 (6.5)|
| Married||47 (52.8)||54 (50)|
| Bereaved||30 (33.7)||42 (38.9)|
| Divorced||11 (12.4)||9 (8.3)|
| Single||1 (1.1)||3 (2.8)|
| No||56 (62.9)||50 (46.3)|
| Yes||33 (37.1)||58 (53.7)|
| No||65 (73)||94 (87)|
| Yes||24 (27)||14 (13)|
| High||13 (14.6)||14 (13)|
| Middle||55 (61.8)||62 (57.4)|
| Low||21 (23.6)||32 (29.6)|
|Family members living with participant||2.17||0.538|
| Spouse only||40 (44.9)||44 (40.7)|
| Children||32 (35.9)||33 (30.6)|
| Lives alone||17 (19.1)||31 (28.7)|
|Monthly income (10,000 Korean won)||7.26||0.123|
| <200||14 (15.7)||22 (20.4)|
| 200 to <300||50 (56.2)||47 (43.5)|
| 300 to <400||10 (11.2)||16 (14.8)|
| ≥400||15 (16.9)||23 (21.3)|
Correlations among Study Variables between Genders (N = 197)
|Study Variable||Leisure Activity Participation||Perceived Health Status||Psychological Well-Being||Depression||Loneliness||Successful Aging|
|Leisure activity participation|
|Perceived health status|
|Level of depression|
|Level of loneliness|
Influence of Leisure Activity Participation between Genders among Korean Older Adults (N=197)
|Variable||Mean (SD)||t Test||p Value|
|Low Levels of Leisure Activity Participationa||High Levels of Leisure Activity Participationb|
|Perceived health status|
| Men||2.83 (0.98)||3.22 (0.90)||−1.92||0.058**|
| Women||2.84 (1.05)||3.13 (1.15)||1.37||0.175|
| Men||3.09 (0.34)||3.16 (0.37)||−1.01||0.317|
| Women||3.03 (0.32)||3.19 (0.41)||2.28||0.025*|
|Level of depression|
| Men||2.97 (0.59)||3.16 (0.51)||−1.66||0.100|
| Women||3.06 (0.59)||3.04 (0.57)||−0.15||0.883|
|Level of loneliness|
| Men||3.33 (0.65)||3.09 (0.59)||1.83||0.071**|
| Women||3.30 (0.67)||3.23 (0.58)||−0.60||0.548|
| Men||3.08 (0.35)||3.22 (0.47)||−1.50||0.137|
| Women||3.07 (0.37)||3.27 (0.45)||2.56||0.012*|