The Mental Health Among the Elderly People: Depression - Essay Example

Depression: Nursing Articles Review Depression is one of the major disorders that affect the mental health of all people.However, the severity of the disorder has been overlooked especially in people whose high rate of prevalence presents a global health problem. Research on depression among old people remains scarce. Thus, amalgamating information from various articles that details the findings of research conducted on depression among the elderly presents one of the major ways of getting information about the disorder. Introduction Depression is a major disorder that affects all kinds of people in all walks of life, but with a bias towards the old people. Depression among the old people is a growing global health concern due to the increasing number of old people within the world populace. Despite the disorder being a major mental health problem, little has been done in terms of research studies to uncover the underlying causes, effects, and mental health requirements of the old. Depression among other people especially the young has been extensively studied and documented due its effects that cause major problems to the health wellbeing of people. Little literature from various research studies targeting depression among the old people is a source of valuable knowledge of the nature, causes, and the mental health effects it has on the old people. Systemic review of research articles on depression among the old provides a synthesis of information collected to give an in-depth view of the disorder. Background Depression is a state characterized by low moods and hate of activity, which interferes with an individual’s behaviors, feelings, sense of well-being, and general thought process. Depression is one of the major psychiatric disorders that have residual effects on the mental health wellbeing of individuals (Park & Jun, 2013). Depression is characterized by feelings of hate towards activities, loss of memory, cognitive abilities, and general concentration. These lingering symptoms have lasting adverse effects on the mental functionality of an individual. A major problem with the disorder remains the inability of the individuals suffering from the disorder and the people surrounding them to diagnose the disorder. The disorder is more pronounced among the elderly due to the isolation, dependency on others, and failure to diagnose and treat it. Coupled with this is the increased push by governments to cut healthcare costs in the midst of already constrained medical budgets. The elderly therefore face a problem in that healthcare is already unavailable due to financial constraints. The prevalence of the disorder remains undiscovered with few research studies targeting the problem being documented. Current research studies suggest that depression among the elderly is largely a social problem. Many old people rely on care provided by extended families to push through their old age. However, shifting social patterns, family relations, and structure due to globalization has affected the care of the old and increased prevalence of depression among the elderly. Purpose of the articles review Research studies have indicated that the number of old people is increasing both in developing and developed countries due to globalization and socio-economic developments. This has necessitated an increased need to address major health problems that affect the elderly. Among health problems are psychiatric disorders, where depression ranks as the third major disorder. However, despite depression being a major health problem, few research studies have documented the prevalence, causes, and effects of the disorder among the elderly. As a major global health concern, it is crucial to look at the similarities and differences in prevalence, causes and effects of depression among the elderly in different regions of the world. Further, it is also important to look at the studies conducted in terms of the design in order to decipher the findings as one way of looking at biases that might have affected the studies. The need to have vast knowledge on depression among the elderly is a major purpose of the article review. Methodology Depression has been extensively studied like many other psychiatric disorders, albeit most studies have studied it as a secondary psychiatric disorder. Thus, research articles that contain studies on depression as the major research subject are few. Of concern is the study of depression among the elderly remains. The success of the research review process relies on the methods applied to select the articles for review. The basic methodology applied in selecting the articles was sorting according to the several criteria established by the researcher. First, articles were selected based on their general coverage of depression as a secondary or primary research subject. The articles had to conform to four established criteria; authenticity, credibility, representativeness, and meaning. Articles’ authenticity was based on soundness and authorship. The articles were sound if they were complete and reliable. The articles were supposed to have all pages, no misprints or any other deformity that could undermine their credibility. Articles were also selected based on their authorship. Many articles are found to be attributed to other authors and not the original authors. To authenticate authorship, authors’ articles were searched online and in databases. Articles were also scrutinized for authenticity of information provided by the author(s). Articles were also supposed to be representative in the fact that they have survived in time and that they are available for use. Articles withheld from researchers may not be credible due to lack of criticisms. Lastly the articles were selected based on their meaning. Meaning refers to the researcher’s ability to understand the article. The articles were then exposed to more sorting based on their ability to address depression as a major research problem. This yielded fewer articles and eliminated articles that studied depression as a secondary research problem. The articles were finally exposed to more sorting in order to get a maximum of three articles for the review process. The last sorting was thorough and articles were selected based on; ability to address depression among the elderly as the research problem, ability to address depression among the elderly in a socio-economic context, and ability to show clear and systematic research process. Three articles were picked for research review. Results Research design: - The three articles used a cross-sectional and descriptive research designs. The articles sort to explain the prevalence of depression among the elderly in geriatric homes or geriatric-related scales of measurement. The prevalence was related to various social factors with the family institution playing a major role. Park & Jun (2013) used the Korean Geriatric Depression Scale (GDS-15) to assess the prevalence of depression among 60-64 years old inhabitants living in rural Korea. The authors correlated the prevalence of depression with family-related factors like marriage and dependability on children. Bhamani, Karim & Khan (2013) cross-sectional research also used the Geriatric Depression Scale (GDS) to research the prevalence of depression among the elderly exposed to different family-related situations in Karachi, Pakistan. The research by Choulagai, Sharma & Choulagai (2013) looked at the prevalence of depression among the elderly living in geriatric homes. The research was cross-sectional and descriptive in design. The three articles utilized questionnaires and in-depth interviews as methods of data collection, which yielded descriptive analysis of the state of depression among the elderly in the three regions. Sample: - The articles utilized the same sampling criteria to ensure representativeness and data credibility. Due to the use of Geriatric Depression Scale (GDS), the articles excluded the cognitively-impaired participants using the Mini Mental State Examination. The sample used for the research were pooled from the whole population, with exclusions of elderly people who had cognitive impairment, medical conditions, did not consent to participation in the research, or were unavailable for the entire research period. Choulagai, et.al (2013) sampled all the elderly people living in five purposely-selected geriatric homes. The study excluded respondents who could not have the GDS used on them due to cognitive impairment and other mental problems. A total of 78 respondents were assented to the research and were consequently included. The study by Park, et.al (2013) sampled all 60-64 years old people living in Dalseong County in Daegu, South Korea. Out of the 5,015 60-64 years old people living in the area identified through the registration department, 3,041 were included in the research. The rest were dismissed due to unavoidable reasons like failure to participate, quasi-residential status, inaccurate birth records, unknown addresses, and medical conditions. Bhamani, et.al (2013) population included all the people who were above 60 years of age living in Karachi. The multi-stage sampling technique initially excluded; those with mental retardation, cognitively-impaired people, those with serious and severe medical conditions, and those who did not give their consent. The study sample was then chosen using a multi-stage cluster sampling technique. The sampling relied on the national statistics information. Setting: - The research studies were conducted in a familial context or a social environment that gave the respondents an environment representative of their real feelings. This was crucial in identifying the extent to which family relations and social environment influence the prevalence of depression among the elderly. Further, it was crucial in indentifying the major causes of the high prevalence noted among the elderly population in relation to the social and family environment that the elderly are exposed to. Park, et.al (2013) research study was set in the rural village of Dalseong County in Daegu, South Korea, which depicts a rural setting influenced by town settings. This in turn affects the social and family structures in the society. Bhamani, et.al (2013) research study was carried out in the town of Karachi, Pakistan, which depicts a setting influenced by family structure, socio-economic factors, and education achievements. Choulagai, et.al (2013) study was carried out in geriatric homes located in Kathmandu Valley, India, which is affected by various family, educational, socio-economic, and social situations. Research tools: - The research studies utilized different research tools depending on the nature and applicability of the research tools to the research studies. All the research studies utilized questionnaires and in-depth interviews to collect data. The research tools were backed by different metrics that determined the type of research tools to be used. The research studies utilized the Geriatric Depression Scale (GDS) as a major metric in the studies. Research by Park, et.al (2013) and Bhamani, et.al (2013) utilized the Mini Mental State Examination (MMSE) metric to assess the cognitive impairment of the elderly and hence applied both questionnaires and in-depth interviews. Bhamani, et.al (2013) utilized the Federal Bureau of Statistics information to generate sampling frame and thus used detailed questionnaires for data collection. Choulagai, et.al (2013) utilized the information on geriatric homes in Kathmandu Valley and used in-depth interviews and semi-structured questionnaires. The research tools were crucial in determining the prevalence of depression among the elderly and its association with family, socio-economic, and education situations. Data collection process: - The research studies used questionnaires and in-depth interviews to collect data. Informed consent was obtained before the respondents could be interviewed. Further, the data collection process incorporated ethical concerns, privacy and confidentiality of information due to the nature and vulnerability of the respondents. Data collection process was done over a period of extended time to ensure that all the sampled respondents were interviewed. Interviewing and questionnaires were drafted in the local dialects and selected interviewers were supposed to have command over the local dialects. Choulagai, et.al (2013) study was conducted between July and December 2010 using semi-structured questionnaires and in-depth interviews. Bhamani, et.al (2013) research study was conducted between July – September 2008 using detailed questionnaires. Park, et.al (2013) research study utilized questionnaires and in-depth interviews. Data analysis: - Data collected was analyzed using statistical and theme analysis. Park, et.al (2013) research study statistical data analysis involved use of Pearson’s correlation coefficient to assess MMSE-K and GDS-15 scores correlation. Respondents’ characteristics were given in numbers and proportions, which enhanced the descriptive analysis of the prevalence of depression and its association with social factors. Choulagai, et.al (2013) used numbers, proportions and standard deviations to relate the prevalence of depression with social factors. Bhamani, et.al (2013) statistical analysis was done using SAS and Epi data version 3.1. Descriptive data analysis was done through descriptive statistics and univariate and multivariate analysis. Discussion Limitations and strengths of the articles The articles had several limitations. First, old age is characterized by failing mental ability, which naturally affects the concentration, memory, activity, and consequent withdrawal from active life. The articles failed to address the impacts of old age mental retardation, which affected prevalence of depression among the elderly. Secondly, the methods of data collection limited the studies’ observation exposure. Questionnaire filling and answering interview questions is bound to be influenced by the researcher and the condition of the respondent at that particular time. This has effects on the outcome of the research. The strength of the articles’ lay on the extent to which they addressed the issue of depression among the elderly. All the articles address the problem of depression among the elderly and relate the prevalence of the disorder to various family and socio-economic conditions, which the elderly people are exposed to by the society. Data collection is done over an extended period and using data collection methods that effectively suit the research problem. Statistical and theme analysis effectively brings out the prevalence of depression and its relation to family and socio-economic conditions of the respondents. Summary of findings Prevalence of depression among the elderly in the three studies is high as opposed to the negligence that has assumed the prevalence to be low. This indicates that there is a need to focus more on depression in old people. Cognitive impairment was more prevalent in people with repeated depressions. Most of the depressed old people are women. Family and socio-economic factors like dependence, widow or widower, and presence of children in a marriage influenced the prevalence of depression. People with no children, divorced, widowed or lacking family support showed were more exposed to depression. Education and employment reduced the likelihood of old people being depressed. Analysis of the data collected indicated that people in geriatric homes were more depressed than the people living out of the homes. Park, et.al (2013) indicates that people with depression should be evaluated for other mental conditions, as a result of depression effects. Bhamani, et.al (2013) states that the research findings are crucial to future research studies targeting various interventions in helping the old people. Nursing implications The findings from the three research studies indicate that more than 40% of the elderly in the population suffer from depression and that the prevalence of the disorder is related to various family and socio-economic factors. This can be used to develop various clinical interventions aimed at helping the old overcome depression. For example, nurses in geriatric homes can develop family-related intervention programs to deal with the issue of family dependence as a major cause of depression. The high prevalence also implies that more emphasis should be laid on diagnosing depression and dealing with it before it gets out of control. Further, medical aids and funding should be diverted to dealing with depression as a major cause of other mental problems, which affect people at old age. Depressed people must also be screened for other mental diseases and disorders. The findings from the articles are valuable in designing nursing strategies in geriatric homes as one way of reducing depression and its effects. The findings indicate that most of the mental problems in old age are attributable to depression. This informs the nursing practices used in dealing with the depression-associated mental disorders. References Park, B, Park, J. & Jun, J. (2013). Cognitive impairment, depression, comorbidity of the two and associated factors among the early sixties in a rural Korean community. PLoS ONE, 8(11). doi:10.1371/journal.pone.0079460. Choulagai, P. S., Sharma, C. K. & Choulagai, B. P. (2013). Prevalence and associated factors of depression among the elderly population living in geriatric homes in Kathmandu Valley. Journal of Institute of Medicine, 35(1): 39-44. Bhamani, M. A., Karim, M. S. & Khan, M. M. (2013). Depression in the elderly in Karachi, Pakistan: a cross-sectional study. BMC Psychiatry, 13(181): 1-8. Poster Read More