The article on Descriptive Epidemiology of Undetected Depression in Institutionalized Older People by Damian, Pastor-Barriouso, and Valderrama-Gamma (2010) is a cross-sectional study conducted in Madrid (Spain). The goal of the study was to determine the proportion of unidentified depression in older people who stay at aged care institutions.
The study design was cross-sectional. The researchers used the probability-sampling method to select the institutions that were included in the study. The private, as well as public nursing homes in Spain and their environs, were included in the study. A stratified cluster sampling method was used to select the participants. The sample consisted of old people who were more than sixty-five years. The ratio of women to men was 50:50. The exclusion criteria were older people who were more than sixty-five years but had not stayed in the nursing homes for more than sixty days, patients with severe cognitive abnormalities, and those who could not define the term depression. Therefore, the sample population was five hundred and seventy-nine old people.
The researchers collected data via interviews and review of health records. The health care professionals working in the nursing homes were interviewed to ascertain the diagnosis of depression as well as the prescriptions of the medications. The old people were interviewed using a depression scale. If the participant had a score of more than four, a diagnosis of depression, and a prescription, he was considered to be depressed. Stata Statistical Software analyzed the data. The estimation of occurrence of depression was via a confidence interval of ninety-five percent through the social, demographic, and health status of the participants.
The researchers found that one hundred and eight old people had depression yet they were undetected. The rate of health care professionals not detecting depression was low in patients who had not stayed for a longer period, private institutions, and big facilities. On the other hand, it was high in anxious patients, with Alzheimer’s disease and dysrhythmias. The cause of the high prevalence of undetected depression was the medications that the patient was taking and his health status.
The limitation of the study was that the researchers did not use DSM-IV criteria to diagnose depression but instead used a depression scale. This increased the probability of misclassification. Secondly, the researchers relied on the report of the patient to diagnose depression. Thirdly, old people with severe cognitive disorders were not included in the study yet their counterparts with mild impairment took part in the research. Lastly, the incidence of depression could have interfered with the results.
The article on Biopsychosocial factors related to depression in aged care residents by Davinson, McCabe, Knight, and Mellor (2012) is a cross-sectional study conducted in metropolitan Melbourne. The goal of the study was to explore the relationship that existed between depression in older people living in nursing homes and biopsychosocial factors.
The study design was cross-sectional research. The sample consisted of one hundred old people living in aged care institutions. Half of the participants had depression while the rest did not have. The ages of the sample population ranged from sixty-four to ninety-eight. The mean age was eighty-three years. Eighty women and twenty men were included in the study. The inclusion criteria were that the participant must have stayed in the nursing home for more than one week but less than ten years. The researchers used Mental Status Examination to determine the mental function of the participants.
The researchers collected the demographic data of the participants from their medical records. An interview using the DSM-IV axis was used to determine the presence of depression. The depressive scale was used to assess for the signs and symptoms of depression. Psychosocial factors were measured using a scale that contained the following factors: autonomy, environmental mastery, personal growth, positive relations, purpose in life, and self-acceptance. Religiosity was measured using a religious scale. Activities of daily living and physical health were assessed through the interview. T-test was used to analyze the data for the relationship that existed among them.
The researchers found that the predisposing factors to depression in older people were environmental mastery, purpose in life as well as autonomy. Environmental mastery is the ability of a person to interact with and control the environment. A person has a purpose in life is when he has a goal to achieve in his life. Autonomy is when a person is independent-minded. The researchers concluded by saying that psychological factors are imperative in comprehending depression among old people in nursing homes.
The limitation of the study was that it was cross-sectional research. Thus, the researchers couldn’t determine if the depressive state of the patient had an impact on the psychosocial factors. Secondly, the sample population was small; therefore, the findings could not be generalized. Finally, the study included a perceived health status from the participants instead of reviewing the medical records. The researchers recommended that other people should conduct longitudinal research with a bigger sample population.
The article on Spirituality, Depression, Living Alone, and Perceived Health among Korean Older Adults in the Community by You et al; (2009) is a descriptive, comparative as well as correlated research. The goal of the study was to explore the relationship between religion, depression, and the health of older people. The first hypothesis was that older people who stayed alone were more depressed and unhealthy than their counterparts who stayed with others. The second hypothesis was that older people who were religious would have lower rates of depression despite their residentials.
The study design was descriptive, comparative as well as correlated research. The study areas were Chonju city, Wanju, and Gangsoo Counties in Korea. Six community centers, two social services, two clinics, and two learning centers for the adults were included in the study. Stratified random sampling was used to select participants. Older people who were living alone knew Korean and were above the age of sixty-five years were included in the study. Older adults who qualified to be included in the study but the researchers were unable to interview them were excluded from the study. The study was done at the participant’s residential area or the nursing centers. The dependent variables were general health and depression. The independent variables were demographic attributes, religiosity, and spiritual factors.
The researchers collected data through a face-to-face interview. The general health was measured using an excellent-poor scale. Depression was measured through a self-reported questionnaire. Demographic and religiosity data were collected using questionnaires. The data were analyzed using SPSS (Statistical Package for the Social Sciences) programs. The analysis of descriptive data included calculation of mean, range, and standard deviation. Chi-square and T-tests were used to analyze the differences between older people who lived alone and those who lived with others. Pearson correlation was used to analyze the difference between dependent and independent variables.
The researchers found that eighty participants lived alone while seventy-two lived with their families. Sixty percent of the participants were women. Besides, ninety percent of the participants who were living alone were women. This was the reason why Korean women lived longer than men were. Most of the participants who were living alone belonged to a religious group. The researchers accepted the hypothesis that older people who stayed alone were more depressed and unhealthy than their counterparts who stay with others. Women were more depressed than men were. There was no relationship between going to church and the level of depression. A positive correlation existed between income and the level of depression.
The limitation of the study was that it was cross-sectional research. Thus, it could not be used to determine a cause-effect relationship. Self-reporting interfered with the validity of the results. The sample was selected from Koreans with low socioeconomic status yet older adults with high socioeconomic status could have a different opinion. The researchers recommended that people should be cautious before generalizing the findings of this study.
After the review of the three articles, the majority of the participants were women, thus, the study can be generalized to older women with depression. From the first article, health care professionals should be kin during the assessment of older people so that they do not miss the diagnosis of depression. From the second article, health care professionals should assess the psychosocial factors of older people because it predisposes them to depression. From the third article, health care professionals should be aware that religion and health play a significant role in the life of a depressed older person.
References
Damián, J., Pastor-Barriuso, R., & Valderrama-Gama, E. (2010). Descriptive Epidemiology of Undetected Depression in Institutionalized Older People.Journal of the American Medical Directors Association, 11(5), 312–319. Web.
Davison, T. E., McCabe, M. P., Knight, T., & Mellor, D. (2012). Biopsychosocial factors related to depression in aged care residents.Journal of Affective Disorders, 142(3), 290–296. Web.
You, K. S., Lee, H.-O., Fitzpatrick, J. J., Kim, S., Marui, E., Lee, J. S., & Cook, P. (2009). Spirituality, Depression, Living Alone, and Perceived Health Among Korean Older Adults in the Community.Archives of Psychiatric Nursing, 23(4), 309–322. Web.