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Nshimyumuremyi E, Muziki JD, Harerimana E, Uwera T, Nshimiyimana A, Sebatukura SG, Mutabaruka J. Prevalence and Family Determinants of Geriatric Depression Among Elderly People in Elderly Support Groups in Rwanda. Psychol Res Behav Manag 2023; 16:1445-1455. [PMID: 37131955 PMCID: PMC10149077 DOI: 10.2147/prbm.s406386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023] Open
Abstract
Background The 1994 Tutsi genocide in Rwanda significantly impacted family structure, with many people growing old alone and lacking social bonds and connections with family members. However, little is known about the contribution of the family environment to geriatric depression which was highlighted by WHO as a psychological problem with a 10% to 20% prevalence rate among the elderly worldwide. This study aims to investigate geriatric depression and associated family determinants among the elderly in Rwanda. Methods With a community-based cross-sectional study design, we assessed geriatric depression (GD), quality-of-life enjoyment and satisfaction (QLES), family support (FS), loneliness, neglect, and attitude toward grief in a convenience sample of 107 participants (M=72.32, SD=8.79) aged between 60 and 95 years who were recruited from three groups of elderly people supported by the NSINDAGIZA organization in Rwanda. SPSS (version 24) was used for statistical data analysis; differences across various sociodemographic variables were tested for significance by an independent t-test; the relationship between study variables was tested by Pearson correlation analysis; and multiple regression analysis was performed to model the contribution of independent variables to dependent variables. Results A total of 64.5% of the elderly scored above the threshold of the normal range of geriatric depression (SDS>49), with higher symptoms in women than in men. Multiple regression analysis indicated that family support and quality-of-life enjoyment and satisfaction were contributors to geriatric depression in the participants. Conclusion Geriatric depression was relatively common in our participants. It is associated with the quality of life and family support received. Hence, adequate family-based interventions are needed to improve the well-being of geriatric people in their respective families.
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Affiliation(s)
- Eric Nshimyumuremyi
- Department of Clinical Psychology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean d’Amour Muziki
- Department of Clinical Psychology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Tubarerere Mu Muryango (TMM), National Child Development Agency (NCD), Kigali, Rwanda
- Correspondence: Jean d’Amour Muziki, Department of Tubarerere Mu muryango (TMM), National Child Development Agency (NCD), A&P Building, 3rd Floor 18KG Ave Kigali, Kigali, Rwanda, Tel +250788887249, Email
| | - Eugene Harerimana
- Department of Clinical Psychology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Thaoussi Uwera
- Department of Health Informatics, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Augustin Nshimiyimana
- Department of Clinical Psychology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Siméon Gitimbwa Sebatukura
- Department of Clinical Psychology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jean Mutabaruka
- Department of Clinical Psychology, College of Medicine, and Health Sciences, University of Rwanda, Kigali, Rwanda
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Do TTH, Nguyen DTM, Nguyen LT. Depressive Symptoms and Their Correlates Among Older People in Rural Viet Nam: A Study Highlighting the Role of Family Factors. Health Serv Insights 2022; 15:11786329221125410. [PMID: 36171762 PMCID: PMC9511289 DOI: 10.1177/11786329221125410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
This study examined the prevalence of depressive symptoms among older people living in a rural district in Hanoi, Vietnam in 2021. A cross-sectional survey was conducted with a sample of 495 people aged 60 years or older, using a structured questionnaire. The prevalence of self-reported depression, based on the short-form Geriatric Depression Scale—15 items, was 28.7%. Results from multiple variable logistic regression analyses showed that there was a significant association between age, educational level, family support, domestic violence, and depression. The study findings emphasize the importance of screening for depression in older people living in rural areas and the need for interventions aimed to enhance family support and reduce family-related stressors.
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Abstract
OBJECTIVES The present article describes the development and psychometric evaluation of the Geriatric Feelings of Burdensomeness Scale using two samples of older adults collected through Amazon Mechanical Turk. The scale is a 25-item measure of general subjective feeling of being a burden on or problem for others. The goal of the measure is to capture a broad conceptualization of burdensomeness that is relevant to a variety of important psychological variables. METHOD Two studies are described, including item development and selection, and the examination of reliability and validity evidence in a sample of 192 older adults. RESULTS The estimates of reliability (coefficient alpha and average interitem correlations) were strong. Preliminary examination of convergent validity evidence found significant moderate correlations between the Geriatric Feelings of Burdensomeness Scale and measures of conceptually related constructs (hopelessness, suicidality, perceived burdensomeness, thwarted belongingness). Small, non-significant correlations were found between three indices of religiosity, providing preliminary discriminant validity evidence. CONCLUSIONS Our results provide initial psychometric support for a more general and inclusive assessment tool for measuring older adults' feelings of burdensomeness. CLINICAL IMPLICATIONS With further research on clinical significance of feelings of burdensomeness and predictive validity, this measure may be used to identify concerns and beliefs about burdensomeness among distressed older adults.
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Affiliation(s)
- Julie Lutz
- Center for the Study and Prevention of Suicide, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Emma Katz
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Jarred Gallegos
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Rachael Spalding
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Barry Edelstein
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
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Polacsek M, Goh A, Malta S, Hallam B, Gahan L, Cooper C, Low LF, Livingston G, Panayiotou A, Loi S, Omori M, Savvas S, Batchelor F, Ames D, Doyle C, Scherer S, Dow B. 'I know they are not trained in dementia': Addressing the need for specialist dementia training for home care workers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:475-484. [PMID: 31646701 DOI: 10.1111/hsc.12880] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/12/2019] [Accepted: 09/27/2019] [Indexed: 05/22/2023]
Abstract
Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well-being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community-based care for people with dementia can be challenging. Workers often lack training in dementia-specific care for clients with increasingly complex needs, and typically work without direct supervision. As the demand for person-centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in-depth interviews of a purposive sample, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers' understanding of dementia, person-centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers' lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care. The findings of this study will be used to inform the essential elements of a training program aimed at enabling and empowering a skilled, specialist home care workforce to support older people with dementia to live well at home for as long as possible.
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Affiliation(s)
- Meg Polacsek
- National Ageing Research Institute, Parkville, Vic., Australia
- Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
| | - Anita Goh
- National Ageing Research Institute, Parkville, Vic., Australia
- The University of Melbourne, Parkville, Vic., Australia
- NorthWestern Mental Health, Parkville, Vic., Australia
| | - Sue Malta
- The University of Melbourne, Melbourne, Vic., Australia
| | | | - Luke Gahan
- The Australian Red Cross Blood Service, Melbourne, Vic., Australia
- La Trobe University, Melbourne, Vic., Australia
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
| | - Lee-Fay Low
- Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | | | - Samantha Loi
- Department of Psychiatry, University of Melbourne and NorthWestern Mental Health, Parkville, Vic., Australia
| | - Maho Omori
- National Ageing Research Institute, Parkville, Vic., Australia
| | - Steven Savvas
- National Ageing Research Institute, Parkville, Vic., Australia
- Royal Freemasons, Melbourne, Vic., Australia
| | | | - David Ames
- National Ageing Research Institute, Parkville, Vic., Australia
- The University of Melbourne, Parkville, Vic., Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Vic., Australia
| | - Colleen Doyle
- National Ageing Research Institute, Parkville, Vic., Australia
| | - Sam Scherer
- Royal Freemasons, Melbourne, Vic., Australia
| | - Briony Dow
- National Ageing Research Institute, Parkville, Vic., Australia
- The University of Melbourne, Parkville, Vic., Australia
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Polacsek M, Boardman GH, McCann TV. Help-seeking experiences of older adults with a diagnosis of moderate depression. Int J Ment Health Nurs 2019; 28:278-287. [PMID: 30120874 PMCID: PMC8351636 DOI: 10.1111/inm.12531] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2018] [Indexed: 02/03/2023]
Abstract
Depression is the most prevalent mental illness among older adults. However, help-seeking by older adults is frequently delayed, resulting in longer duration of untreated symptoms, poorer health outcomes, and consequent higher healthcare use. Early help-seeking and access to appropriate support benefits individuals, while providing better outcomes from health systems constrained by limited resources. The aim of this study, which is abstracted from a larger study, was to identify the factors that inhibited and enabled formal help-seeking in older adults with a diagnosis of moderate depression. Corbin and Strauss' approach to grounded theory informed data collection and analysis. Two themes and related subthemes concerning help-seeking barriers and facilitators were abstracted from the data. Help-seeking barriers were attributable to stigma, self-motivation, accessing formal support, ageism, and difficulty obtaining an initial diagnosis. Help-seeking facilitators were accepting personal responsibility, mental health literacy, therapeutic alliances, and informal support. Findings have implications for the role of mental health nurses, who are well-placed to provide support to community-based older adults with depression. More broadly, mental health nurses and other clinicians should seek to reduce help-seeking barriers and implement ways to facilitate help-seeking in this cohort.
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Affiliation(s)
- Meg Polacsek
- Institute for Health and SportVictoria UniversityMelbourneVic.Australia
| | | | - Terence V. McCann
- Institute for Health and SportVictoria UniversityMelbourneVic.Australia
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Brändström L, Mazaz N, Berggren I. Nurse collaboration in community and psychiatric care: a Swedish study. Br J Community Nurs 2015; 20:297-303. [PMID: 26043016 DOI: 10.12968/bjcn.2015.20.6.297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Linnéa Brändström
- Specialist Nurse in Public Health 2014, Primary Health Care in Sollebrunn, Alingsås
| | - Nader Mazaz
- Specialist Nurse in Psychiatric Care and Specialist Nurse in Public Health 2014, The Psychiatric Clinic, Norra Älvsborg County Hospital, Trollhättan
| | - Ingela Berggren
- Associate Professor, Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
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Severinsson E, Holm AL. Chronic disease management: implementation and coordination of healthcare systems for depressed elderly persons. Issues Ment Health Nurs 2014; 35:934-9. [PMID: 25426749 DOI: 10.3109/01612840.2014.930215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to evaluate the implementation of the research-based Chronic Care Model (CCM), discuss methods and summarise research recommendations for improving the care of depressed elderly persons. Interviews were conducted and state-of-the-art reviews employed. Three important areas emerged: (1) barriers to and facilitating factors in the implementation of the CCM; (2) the challenges involved in re-designing the delivery system and interdisciplinary team collaboration; and (3) empirical evidence pertaining to self-management support and how older persons manage to live with depressive ill-health. In conclusion, implementation research requires evidence-based knowledge, staff involvement and familiarity with the context in which development occurs.
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Affiliation(s)
- Elisabeth Severinsson
- Centre for Women's, Family and Child Health, Buskerud and Vestfold University College , Kongsberg , Norway
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Holm AL, Lyberg A, Severinsson E. Living with stigma: depressed elderly persons' experiences of physical health problems. Nurs Res Pract 2014; 2014:527920. [PMID: 25013728 PMCID: PMC4074963 DOI: 10.1155/2014/527920] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 12/25/2022] Open
Abstract
The aim of this paper is to deepen the understanding of depressed elderly persons' lived experiences of physical health problems. Individual in-depth interviews were conducted with 15 depressed elderly persons who suffer from physical health problems. A hermeneutic analysis was performed, yielding one main theme, living with stigma, and three themes: longing to be taken seriously, being uncertain about whether the pain is physical or mental, and a sense of living in a war zone. The second theme comprised two subthemes, feeling like a stranger and feeling dizzy, while the third had one subtheme: afraid of being helpless and dependent on others. Stigma deprives individuals of their dignity and reinforces destructive patterns of isolation and hopelessness. Nurses should provide information in a sensitive way and try to avoid diagnostic overshadowing. Effective training programmes and procedures need to be developed with more focus on how to handle depressive ill health and physical problems in older people.
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Affiliation(s)
- Anne Lise Holm
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 235, 3603 Kongsberg, Norway
| | - Anne Lyberg
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 235, 3603 Kongsberg, Norway
| | - Elisabeth Severinsson
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 235, 3603 Kongsberg, Norway
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