Marital experiences and depressive symptoms among older adults in rural South Africa

Development and Empirical Test of the Research-Informed South African Relationship Functioning Assessment (SARFA)

Intimate partners play an important role in chronic diseases. Despite the chronic disease burden increase in sub-Saharan Africa, very few culturally-relevant quantitative measures of intimate relationship functioning are available. We conducted an empirical investigation evaluating the psychometric properties of the South African Relationship Functioning Assessment (SARFA) assessing healthy relationship functioning in N = 150 community members (50% women; M age = 27.2 years) living in the Vulindlela area of KwaZulu-Natal, South Africa. Item development was based on prior qualitative research from two South African communities. All assessments were conducted in isiZulu, participants' primary language. An exploratory factor analysis was conducted on the initial 39-item measure. The best-fitting model consisted of one factor with 22 items. The SARFA's internal consistency was α = .94. Convergent validity was observed via significant positive associations (all rs ≥ .38, p < .001) between the SARFA's total score and measures of trust, emotional intimacy, constructive communication, sexual satisfaction, and relationship control (women only). Divergent validity was observed for women only. Encouraging initial psychometric properties of a culturally-relevant measure of relationship functioning in KwaZulu-Natal may have relevance to other communities and potential to be used in research involving couples and health in chronic disease-burdened communities.

Depressive symptoms and receipt of pensions: a cross-sectional analysis of the ELSI-Brazil study

OBJECTIVE

To investigate association between depressive symptoms and receipt of retirement pensions or other pensions in the Brazilian population aged 50 years or older.

METHOD

This was a cross-sectional study with participants from the baseline (2015-2016) of the Longitudinal Study of the Health of Elderly Brazilians. Depressive symptoms were measured by the eight-item Center for Epidemiologic Studies Depression Scale. Prevalence ratios (PR) were obtained by Poisson regression.

RESULTS

Among the total 8,469 participants, 33.9% (95%CI 32.8;34.9) reported depressive symptoms and 52.8% (95%CI 51.8;53.9) of the participants received a retirement or other pension. Prevalence of depressive symptoms was lower among participants receiving a retirement or other pension (PR = 0.79; 95%CI 0.73;0.86). Association remained significant after adjustments for sociodemographic and health indicators (PR = 0.84; 95%CI 0.76;0.92).

CONCLUSION

Participants who receive retirement or other pensions are less likely to report depressive symptoms.

MAIN RESULTS

Prevalence of depressive symptoms was 33.9% in the population studied and, after adjusted analysis, it remained statistically lower among participants who received retirement or other pensions.

IMPLICATIONS FOR SERVICES

Prevalence of depressive symptoms was higher in individuals who do not receive retirement or other pensions, which demands attention from health services in caring for this public in vulnerable situations regarding social security.

PERSPECTIVES

Carrying out longitudinal studies capable of assessing the temporality of association between receiving retirement or other pensions and the mental health of the elderly, thus contributing to better knowledge about the social determinants of mental health.