Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-25T05:07:13.422Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-care management and risk factors for depressive symptoms among elderly outpatients in Taiwan

Published online by Cambridge University Press:  01 September 2011

Yun-Fang Tsai ,
Li-Ling Liu ,
Hsiu-Hsin Tsai  and
Shih-Chi Chung
Yun-Fang Tsai*
Affiliation:
School of Nursing, Chang Gung University, Taiwan, Republic of China Department of Nursing, Chang Gung Memorial Hospital in Keelung, Taiwan, Republic of China
Li-Ling Liu
Affiliation:
Nursing Management Department, Administration Center, Chang Gung Memorial Hospital, Taiwan, Republic of China
Hsiu-Hsin Tsai
Affiliation:
School of Nursing, Chang Gung University, Taiwan, Republic of China
Shih-Chi Chung
Affiliation:
School of Nursing, Chang Gung University, Taiwan, Republic of China
*
Correspondence should be addressed to: Yun-Fang Tsai, RN, PhD, School of Nursing, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan 333, Republic of China. Phone: +1 886-3-2118800 ext. 3204, 5958; Fax: +1 886-3-2118868. Email: [email protected].
Get access

Abstract

Background: Early detection and appropriate treatment interventions for depressive symptoms in the elderly are important issues for healthcare systems. However, few studies to date have focused on understanding self-care strategies to manage depressive symptoms among elderly people worldwide. The purpose of this study was to explore self-care management strategies and risk factors for depressive symptoms among elderly outpatients in Taiwan.

Methods: A convenience sample of elderly persons (≥65 years old; N = 1054) was recruited from outpatient clinics of two hospitals in northern Taiwan.

Results: In our sample, the prevalence of depressive tendency was 16.3%. The majority of participants (70.1%) managed depressive symptoms with self-care strategies. The strategy most often used to relieve depressive symptoms was “take a walk.” The main information source for self-care strategies was self-learning. Depressive tendency in this sample was shown by logistic regression analysis to be significantly predicted by gender, marital status, perceived income adequacy, perceived health condition, stroke, and cancer.

Conclusion: Elderly people need to be made more aware of strategies to self-manage depressive symptoms. Healthcare providers can decrease/prevent the first risk factor for depressive symptoms (poor perceived health status) by improving elders’ perceived health and promoting their actual health. The second risk factor (poor perceived income adequacy) can be decreased/prevented by carefully assessing patients’ financial situation during clinic visits and providing suitable referral for further assistance.

Keywords

depressive symptomselderlycommunity-dwellingself-care
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 2 , February 2012 , pp. 278 - 287
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Borthwick, D., Knowles, G., McNamara, S., Dea, R.O. and Stroner, P. (2003). Assessing fatigue and self-care strategies in patients receiving radiotherapy for non-small cell lung cancer. European Journal of Oncology Nursing, 7, 231–241.CrossRefGoogle ScholarPubMed
Burke, W. J., Rocaforte, W. H. and Wengel, S. P. (1991). The short form of the Geriatric Depression Scale: a comparison with the 30-item form. Journal of Geriatric Psychiatry and Neurology, 4, 173–178.CrossRefGoogle Scholar
Conwell, Y. and Thompson, C. (2008). Suicidal behavior in elders. Psychiatric Clinics of North America, 31, 333–356.CrossRefGoogle ScholarPubMed
Department of Health, Executive Yuan. (2010). Health and Vital Statistics-Populations and Family in 2008. Available at: http://www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=74401; last accessed 20 August 2010.Google Scholar
Djernes, J. K. (2006). Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatrica Scandinavica, 113, 372–387.CrossRefGoogle ScholarPubMed
Eller, L. S. et al. (2005). Self-care strategies for depressive symptoms in people with HIV disease. Journal of Advanced Nursing, 51, 119–130.CrossRefGoogle ScholarPubMed
Farhall, J., Greenwood, K. M. and Jackson, H. J. (2007). Coping with hallucinated voices in schizophrenia: a review of self-initiated strategies and therapeutic interventions. Clinical Psychology Review, 27, 476–493.CrossRefGoogle ScholarPubMed
Fiske, A., Wetherell, J. L. and Gatz, M. (2009). Depression in older adults. Annual Review of Clinical Psychology, 5, 363–389.CrossRefGoogle ScholarPubMed
Fu, C. C., Lee, Y. M. and Chen, J. D. (2003). Association between depressive symptoms and twelve-year mortality among elderly in a rural community in Taiwan. Journal of the Formosan Medical Association, 102, 234–239.Google Scholar
Huang, C. Q., Dong, B. R., Lu, Z. C., Yue, J. R. and Liu, Q. X. (2010a). Chronic diseases and risk for depression in old age: a meta-analysis of published literature. Ageing Research Reviews, 9, 131–141.CrossRefGoogle ScholarPubMed
Huang, C. Q., Zhang, X. M., Dong, B. R., Lu, Z. C., Yue, J. R. and Liu, Q. X. (2010b). Health status and risk for depression among the elderly: a meta-analysis of published literature. Age and Ageing, 39, 23–30.Google Scholar
Lebowitz, B. D. et al. (1997). Diagnosis and treatment of depression in late life: consensus statement update. JAMA, 278, 1186–1190.CrossRefGoogle ScholarPubMed
Lee, H. N., Yang, S. Y. and Tsai, S. Y. (2004). Drug interactions with antidepressants in elderly. Formosa Journal of Medicine, 8, 562–572.Google Scholar
Liu, C. Y. et al. (1997). Depressive disorders among older residents in a Chinese rural community. Psychological Medicine, 27, 943–949.CrossRefGoogle Scholar
Lu, C., Liu, C. and Yu, S. (1998). Depressive disorders among the Chinese elderly in a suburban community. Public Health Nursing, 15, 196–200.CrossRefGoogle Scholar
Miles, M. B. and Huberman, A. M. (1994). Qualitative Data Analysis, 2nd edn. Thousand Oaks, CA: Sage Publication.Google Scholar
Miller, D. K., Malmstrom, T. K., Joshi, S., Andresen, E. M., Morley, J. E. and Wolinsky, F. D. (2004). Clinically relevant levels of depressive symptoms in community-dwelling middle-aged African Americans. Journal of the American Geriatrics Society, 52, 741–748.CrossRefGoogle ScholarPubMed
Orem, D. E. (1985). Nursing: Concept of Practice, 3rd edn. New York: McGraw-Hill.Google Scholar
Sumaya, I. C., Rienzi, B. M., Deegan, J. F. 2nd. and Moss, D. E. (2001). Bright light treatment decreases depression in institutionalized older adults: a placebo-controlled crossover study. Journal of Gerontology, 56A, M356–M360.Google Scholar
Tsai, Y. F. (2006). Self-care management and risk factors for depressive symptoms among elderly nursing home residents in Taiwan. Journal of Pain and Symptom Management, 32, 140–147.CrossRefGoogle ScholarPubMed
Tsai, Y. F. and Chen, C. Y. (2006). Self-care symptom management strategies for auditory hallucinations among patients with schizophrenia in Taiwan. Applied Nursing Research, 19, 191–196.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Hsiung, P. and Holzemer, L. W. (2002). Symptom management in Taiwanese patients with HIV/AIDS. Journal of Pain and Symptom Management, 23, 301–309.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Tsai, H. H., Lai, Y. H. and Chu, T. L. (2004a). Pain prevalence, experiences and management strategies among the elderly in Taiwanese nursing homes. Journal of Pain and Symptom Management, 28, 579–584.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Wong, T. K., Juang, Y. Y. and Tsai, H. H. (2004b). The effects of light therapy on depressed elders. International Journal of Geriatric Psychiatry, 19, 545–548.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Chung, J. W., Wong, T. K. and Huang, C. M. (2005a). Comparison of the prevalence and risk factors for depressive symptoms among elderly nursing home residents in Taiwan and Hong Kong. International Journal of Geriatric Psychiatry, 20, 315–321.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Yeh, S. H. and Tsai, H. H. (2005b). Prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan. International Journal of Geriatric Psychiatry, 20, 1097–1102.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Wong, T. K., Tsai, H. H. and Ku, Y. C. (2008). Self-worth therapy for depressive symptoms in older nursing home residents. Journal of Advanced Nursing, 64, 488–494.CrossRefGoogle ScholarPubMed
Tsai, Y. F., Liu, L. L. and Chung, S. C. (2010). Pain prevalence, experiences, and self-care management strategies among the community-dwelling elderly in Taiwan. Journal of Pain and Symptom Management, 40, 575–581.CrossRefGoogle ScholarPubMed
Weyerer, S. et al. (2008). Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older. Journal of Affective Disorders, 111, 153–163.CrossRefGoogle ScholarPubMed
Whyte, E. M., Mulsant, B. H., Vanderbilt, J., Dodge, H. H. and Ganguli, M. (2004). Depression after stroke: a prospective epidemiological study. Journal of the American Geriatrics Society, 52, 774–778.CrossRefGoogle ScholarPubMed