Article Data

  • Views 532
  • Dowloads 115

Original Research

Open Access

Effects of depression, self-efficacy, and sexual function on quality of life in middle-aged Korean men

  • Seung Jo Ryu1
  • Myoungjin Kwon2,*,†,
  • Sun Ae Kim3,*,†,

1Eulji Medical Center, 35233 Daejeon, Republic of Korea

2Department of Nursing, Daejeon University, 34520 Daejeon, Republic of Korea

3Department of Nursing, Korea National University of Transportation, 27909 Chungbuk, Republic of Korea

DOI: 10.31083/j.jomh1805108 Vol.18,Issue 5,May 2022 pp.1-9

Submitted: 25 October 2021 Accepted: 24 December 2021

Published: 31 May 2022

*Corresponding Author(s): Myoungjin Kwon E-mail:
*Corresponding Author(s): Sun Ae Kim E-mail:

† These authors contributed equally.


Background: This study aimed to examine the relationship between depression, self-efficacy, sexual function, and quality of life in middle-aged Korean men, and to identify which of these factors affect their quality of life. Methods: Participants were 216 middle-aged Korean men, aged 41–64 years. Data were collected from October 23, 2020, to November 15, 2020, from three small and medium-sized enterprises, four government offices, university alumni associations, and meetings. Study variables were depression, self-efficacy, sexual function, and quality of life of middle-aged men. Results: There was a negative correlation between quality of life and depression (r = –0.51, p < 0.001), while self-efficacy (r = 0.52, p < 0.001) and sexual function (r = 0.35, p < 0.001) showed a positive correlation. Depression had a significant negative correlation with self-efficacy (r = –0.31, p < 0.001) and sexual function (r = –0.30, p < 0.001). Self-efficacy was positively correlated with sexual function (r = 0.27, p < 0.001). Model 1 included general characteristics that affected the quality of life, two of which were found to have significant effect: monthly household income and subjective health status. The explanatory power was 21.6% (F = 10.86, p < 0.001). Model 2 added depression, self-efficacy, and sexual function, and showed that subjective health status, depression, and self-efficacy had a significant effect on quality of life. The explanatory power increased to 43.6% (F = 19.49, p < 0.001). Conclusions: Depression, self-efficacy, and sexual function affect the quality of life of middle-aged Korean men. Therefore, these variables should be considered when establishing an intervention strategy to improve the quality of life for this group.


middle age; men; depression; self-efficacy; sexual function; quality of life

Cite and Share

Seung Jo Ryu,Myoungjin Kwon,Sun Ae Kim. Effects of depression, self-efficacy, and sexual function on quality of life in middle-aged Korean men. Journal of Men's Health. 2022. 18(5);1-9.


[1] Basta M, Vgontzas A, Kastanaki A, Michalodimitrakis M, Kanaki K, Koutra K, et al. ‘Suicide rates in Crete, Greece during the economic crisis: the effect of age, gender, unemployment and mental health service provision’. BMC Psychiatry. 2018; 18: 356.

[2] Kim BR, Sung KM. Andropause symptoms, stress, self-esteem and quality of life among middle-aged men. Journal of Digital Convergence. 2018; 16: 467–475.

[3] Marshall AJ, Harper-Jaques S. Depression and family relation-ships: ideas for healing. Journal of Family Nursing. 2008; 14: 56–73.

[4] Kim HJ, Choi GS, Park JS, Park SY, Yang CS, Lee HJ. The impact of robotic surgery on quality of life, urinary and sexual function following total mesorectal excision for rectal cancer: a propensity score-matched analysis with laparoscopic surgery. Colorectal Disease. 2018; 20: O103–O113.

[5] Lovegrove CE, Ficarra V, Montorsi F, N’Dow J, Salonia A, Minhas S. Sexual function outcomes following interventions for prostate cancer: are contemporary reports on functional outcomes misleading? International Journal of Impotence Re-search. 2020; 32: 495–502.

[6] Haider KS, Haider A, Doros G, Traish A. Long-Term Testos-terone Therapy Improves Urinary and Sexual Function, and Quality of Life in Men with Hypogonadism: Results from a Propensity Matched Subgroup of a Controlled Registry Study. The Journal of Urology. 2018; 199: 257–265.

[7] Vitale SG, Caruso S, Rapisarda AMC, Cianci S, Cianci A. Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parame-ters in menopausal women: result from a prospective, random-ized, placebo-controlled, parallel-group study. Menopause Re-view. 2018; 17: 32–38.

[8] Klemp JR, Myers JS, Fabian CJ, Kimler BF, Khan QJ, Sereika SM, et al. Cognitive functioning and quality of life following chemotherapy in pre- and peri-menopausal women with breast cancer. Supportive Care in Cancer. 2018; 26: 575–583.

[9] Kang H, Jang S. Effect of mindfulness yoga on depression sever-ity, self-esteem, and quality of life in middle-aged men. Iranian Journal of Public Health. 2021; 50: 1334–1342.

[10] Heckman JE, Chamie K, Maliski SL, Fink A, Kwan L, Connor SE, et al. The role of self-efficacy in quality of life for disadvan-taged men with prostate cancer. The Journal of Urology. 2011; 186: 1855–1861.

[11] Rosen RC, Seidman SN, Menza MA, Shabsigh R, Roose SP, Tseng LJ, et al. Quality of life, mood, and sexual function: a path analytic model of treatment effects in men with erectile dysfunction and depressive symptoms. International Journal of Impotence Research. 2004; 16: 334–340.

[12] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edn. APA: Washington, DC, USA. 2012.

[13] Blanchflower DG, Oswald AJ. Adolescents and age (Report No. 5785). The Institute for the Study of Labor: Bonn. 2011.[14] Health Insurance Review & Assessment Service. Dis-ease information through statistics 2015. Available at: gmid=HIRAA030502000000&sortSno=179 (Accessed: 12 October 2021).

[15] Möller-Leimkühler AM. The gender gap in suicide and prema-ture death or: why are men so vulnerable? European Archives of Psychiatry and Clinical Neuroscience. 2003; 253: 1–8.

[16] Kollia N, Panagiotakos D, Georgousopoulou E, Chrysohoou C, Yannakoulia M, Stefanadis C, et al. Exploring the path be-tween depression, anxiety and 10-year cardiovascular disease incidence, among apparently healthy Greek middle-aged adults: the ATTICA study. Maturitas. 2017; 106: 73–79.

[17] Hoy S. Beyond Men Behaving Badly: a Meta-Ethnography of Men’s Perspectives on Psychological Distress and Help Seeking. International Journal of Men’s Health. 2012; 11: 202–226.

[18] Rose AJ, Schwartz-Mette RA, Smith RL, Asher SR, Swenson LP, Carlson W, et al. How girls and boys expect that disclosure about problems will make them feel: Implications for friend-ships. Child Development. 2012; 83: 844–863.

[19] Gonzalez JM, Alegria M, Prihoda TJ. How do attitudes toward mental health treatment vary by age, gender, and ethnicity/race in young adults? Journal of Community Psychology. 2005; 33: 611–629.

[20] Smith K. Mental health: a world of depression. Nature. 2014; 515: 181.

[21] Schipper H, Clinch JJ, Olweny CLM. Quality of life studies: Definitions and conceptual issues. In Spilker B (ed.) Quality of life and pharmacoeconomics in clinical trials (pp. 11–23). Lippencott-Raven: Philadelphia. 1996.

[22] Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, et al. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy and Childbirth. 2018; 18: 455.

[23] Adam SS, Flahiff CM, Kamble S, Telen MJ, Reed SD, De Castro LM. Depression, quality of life, and medical resource utilization in sickle cell disease. Blood Advances. 2017; 1: 1983–1992.

[24] Sohn S. Factors related to health related quality of life in rural el-derly women. Journal of Korean Gerontological Nursing. 2012; 14: 91–98.

[25] Lazarus RS, Folkman S. Stress, appraisal, and coping. Springer: New York. 1984.

[26] Alessandri G, Perinelli E, De Longis E, Schaufeli WB, Theodorou A, Borgogni L, et al. Job burnout: The contribution of emotional stability and emotional self-efficacy beliefs. Jour-nal of Occupational and Organizational Psychology. 2018; 91: 823–851.

[27] Bandura A. Self-efficacy: The exercise of control. Freeman: New York. 1997.

[28] Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997; 49: 822–830.

[29] Travison TG, Araujo AB, O’Donnell AB, Kupelian V, McKin-lay JB. A population-level decline in serum testosterone levels in American men. The Journal of Clinical Endocrinology and Metabolism. 2007; 92: 196–202.

[30] Schubert M, Jockenhövel F. Late-onset hypogonadism in the ag-ing male (LOH): definition, diagnostic and clinical aspects. Jour-nal of Endocrinological Investigation. 2005; 28: 23–27.

[31] Corona G, Lee DM, Forti G, O’Connor DB, Maggi M, O’Neill TW, et al. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). The Journal of Sexual Medicine. 2010; 7: 1362–1380.

[32] Araujo AB, Esche GR, Kupelian V, O’Donnell AB, Travison TG, Williams RE, et al. Prevalence of symptomatic androgen deficiency in men. The Journal of Clinical Endocrinology and Metabolism. 2007; 92: 4241–4247.

[33] Steptoe A, Jackson SE, Wardle J. Sexual activity and concerns in people with coronary heart disease from a population-based study. Heart. 2016; 102: 1095–1099.

[34] Bispo GS, de Lima Lopes J, de Barros ALBL. Cardiovascular changes resulting from sexual activity and sexual dysfunction after myocardial infarction: integrative review. Journal of Clin-ical Nursing. 2013; 22: 3522–3531.

[35] World Health Organization Western Pacific Region. The Asia-pacific perspective: Redefining obesity and its treatment. (Re-port No.: 0-9577082-1-12000). Australia. 2000.

[36] Beck AT. Cognitive therapy and the emotional disorders. Inter-national University Press: New York. 1976.

[37] Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The Self-Efficacy Scale: Construction and Vali-dation. Psychological Reports. 1982; 51: 663–671.

[38] Zimmerman FJ, Katon W. Socioeconomic status, depression disparities, and financial strain: what lies behind the income-depression relationship? Health Economics. 2005; 14: 1197–1215.

[39] Jeong BG, Veenstra G. The intergenerational production of de-pression in South Korea: results from a cross-sectional study. International Journal for Equity in Health. 2017; 16: 13.

[40] Noh JW, Kwon YD, Lee LJ, Oh IH, Kim JS. Gender differences in the impact of retirement on depressive symptoms among middle-aged and older adults: A propensity score matching ap-proach. PLoS ONE. 2019; 14: e0212607.

[41] Niti M, Ng T, Kua EH, Ho RCM, Tan CH. Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. International Journal of Geriatric Psychiatry. 2007; 22: 1087–1094.

[42] Ma BO, Shim SG, Yang HJ. Association of erectile dysfunction with depression in patients with chronic viral hepatitis. World Journal of Gastroenterology. 2015; 21: 5641–5646.

[43] Demirtaş T, Temircan Z. Health-related quality of life, depres-sion, anxiety and sexual dysfunction in patients with testicular cancer. Journal of Men’s Health. 2021; 17: 135–140.

[44] Addis IB, Van Den Eeden SK, Wassel-Fyr CL, Vittinghoff E, Brown JS, Thom DH. Sexual activity and function in middle-aged and older women. Obstetrics and Gynecology. 2006; 107: 755–764.

[45] Cormie P, Newton RU, Taaffe DR, Spry N, Joseph D, Akhlil Hamid M, et al. Exercise maintains sexual activity in men under-going androgen suppression for prostate cancer: a randomized controlled trial. Prostate Cancer and Prostatic Diseases. 2013; 16: 170–175.

[46] McVary KT, Carrier S, Wessells H. Smoking and erectile dys-function: evidence based analysis. The Journal of Urology. 2001; 166: 1624–1632.

[47] Riise T, Moen BE, Nortvedt MW. Occupation, Lifestyle Factors and Health-Related Quality of Life: the Hordaland Health Study. Journal of Occupational and Environmental Medicine. 2003; 45: 324–332.

[48] Donovan D, Mattson ME, Cisler RA, Longabaugh R, Zweben A. Quality of life as an outcome measure in alcoholism treatment research. Journal of Studies on Alcohol. Supplement. 2005; 119–139.

[49] Im PK, Millwood IY, Chen Y, Guo Y, Du H, Kartsonaki C, et al. Problem drinking, wellbeing and mortality risk in Chinese men: findings from the China Kadoorie Biobank. Addiction. 2020; 115: 850–862.

[50] Lee H, Cho SH, Kim JH, Kim YK, Choo HI. Influence of Self Efficacy, Social Support and Sense of Community on Health-related Quality of Life for Middle-aged and Elderly Residents Living in a Rural Community. Journal of Korean Academy of Nursing. 2014; 44: 608.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.7 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (

Submission Turnaround Time