Correlation of Depression and Quality of life among rural elderly

Manpreet Kaur¹, Sukhpreet Kaur², Rajwant Kaur³

¹Professor, SGRD College of Nursing, SGRDIMSR, Vallah, Amritsar, Punjab

²Lecturer, BMSM College of Nursing, Gurdaspur

³Assistant Professor, SGRD College of Nursing, SGRDIMSR, Vallah, Amritsar, Punjab

*Corresponding Author E-mail: manpreet_arora001@rediffmail.com

ABSTRACT:

Ageing is a life spanning process of growth and development from Birth to death. Old age is an integral part of the whole, bringing fulfilment and self actualization. Ageing, along with the functional decline, economic dependence, and social cut off, autonomy of young generation, adds to depression, which further compromises their quality of life. The study was undertaken to correlate the level of depression and quality of life among 95 elderly selected through systematic random sampling technique, in a rural community of Amritsar, Punjab. Tools used were Geriatric Depression Scale and WHO QOL-BREF scale. The obtained data was analysed and interpreted using descriptive and inferential statistics. The major findings of the study reveal that that 81(89.5%) of elderly had mild depression and only 4(4.2%) were severe depressed. Present study reveals that majority 92(96.8%) had good quality of life and only 3(3.2%) had average quality of life. In domain wise quality of life, in environment domain majority of elderly 87(91.6%) had good quality of life. Present study shows that the correlation between depression and quality of life depicts that there is correlation between depression and environment wellbeing domain with r value 0.297.

KEY WORDS: Depression, Quality of life, Rural, Elderly.

INTRODUCTION:

Ageing is a natural process always associated with physiological and biological decline. It is the outcome of certain structural and functional changes takes place in the major parts as the life years increases. In the words of Seneca “Old age is an incurable disease”. It affects every individual, family, community and society. It is a normal, progressive and irreversible process.¹ Ageing is the process of physical, psychological and social change.

Mental health has impact on physical health and vice-versa. For example older adults with physical health conditions such as heart disease have higher rates of depression than those who are medically fit. Depression is recognized as a serious public health concern in developing countries. The Global Burden of Disease study showed that depression will be the single leading cause of Disability Adjusted Life Years by 2020 in the developing world. Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and sense of well-being.²

Depression is a common illness and is affecting approximately 121 million people worldwide; in 2000, it was the leading cause of disability and the fourth leading contributor to the global burden of disease. There has been increasing evidence that depression is correlated to mortality and health service utilization among the elderly.³ The Local National Morbidity Survey of India showed that the prevalence of mental problems among the elderly was 26% reported that prevalence of depression among the elderly in rural areas was slightly higher (7.6%) compared to urban areas (6.3%).⁴ Quality of life is a surrogate indicator for general well-being.⁵ Quality of life in elderly patients was a significant independent predictor of functional status after discharge from the hospital. Depressive symptoms are also closely related to quality of life.⁶ Depressive symptoms in elderly with chronic illness were associated with a decline in self-rated quality of life. Moreover, depression also had a significant negative impact on quality of life and was associated with increased mortality due to either suicide or chronic illness.⁷

MATERIALS AND METHODS:

The present study was undertaken to find out the prevalence of depression and also to seek association of depression with demographic variables among rural elderly residing at village Chappa Ram Singh, Amritsar. A Descriptive Survey design was employed in the study, among 95 samples of elderly selected through Systematic random sampling. Informed consent was obtained from the study subjects. The final tool for data collection had three parts. Part A consists of socio demographic profile which includes twelve items relating to demographic data of the elderly such as age, gender, educational status, marital status, past occupational status, present work status, type of family, history of previous illness, family monthly income, personal income source, perception of economic dependency, house bound status. Part B consists of standardized Geriatric Depression Scale which includes 30 items (r = 0.92). For each correct response, one mark was given and for each incorrect response, zero mark was awarded. For measuring quality of life WHOQOL-BREF scale was used. It is a 26 item instrument that covers quality of life aspects related to spirituality, physical environment, leisure activities and personal beliefs. It is scored as physical score (7-35), Psychological score (6-30), social relationship score (3-15), environmental score(8-40). Reliability for Geriatric Depression Scale (Punjabi version) and WHOQOL-BREF scale (Punjabi version) was computed by test retest method and calculated by Karl Pearson’s coefficient correlation, r =0.97 and 0.98 respectively. The data was analyzed by descriptive and inferential statistics through SPSS 16 version.

RESULTS:

The findings of the study reveal that 81(85.3%) of elderly had mild depression and only 4(4.2%) were severely depressed whereas 10.5% were normal (Table 1). The average mean of level of depression among elderly was 13.17 and S.D was 3.42.

Table 1: Frequency and Percentage of level of depression among elderly N=95

Level of Depression	F	%	Mean	SD
Normal (0-9) Mild depressive (10-19) Severe depressive (20-30)	10 81 04	10.5 85.3 4.2	13.17	3.42

Table 2 reveals the overall quality of life of elderly. It shows that majority 92 (96.8%) had good quality of life and only 3 (3.2%) had average quality of life. The average mean for overall quality of life was 233.13 with S.D of 18.

Table 2: Frequency and Percentage of overall Quality of life among elderly N=95

Classification	f	%	Mean	SD
Excellent (400-301) Good (300-201) Average (200-101) Poor (100-0)	00 92 03 00	- 96.8 3.2 -	233.13	18.00

Table 3 shows the domains of quality of life. It shows that in physical domain, majority 91(95.8%) had good quality of life, 3(3.2%) had average and only 1(1.1%) had excellent quality of life with mean 62.78 and S.D 5.73. In psychological domain 77(81.1%) had good quality of life, 18(18.9%) had average quality of life. In Social domain, nearly half of elderly 51(53.7%) had average quality of life, 43(45.3%) had good quality of life and only 1(1.1%) had poor quality of life whereas in environment domain majority of elderly 87(91.6%) had good quality of life, 8(8.4%) had average quality of life. None of the elderly rated their quality of life as poor as excellent.

Table 3: Frequency and percentage of Quality of life (Domain wise) among elderly N=95

Domains	f	%	Mean	SD	Range
Physical health wellbeing (0-100)
Poor	0	0.0	62.78	5.73	31
Average	03	3.2
Good	91	95.8
Excellent	01	1.1
Psychological wellbeing (0-100)
Poor	00	0.0	57.98	6.68	25
Average	18	18.9
Good	77	81.1
Excellent	00	0.0
Social relationship wellbeing (0-100)
Poor	01	1.1	50.77	11.8	50
Average	51	53.7
Good	43	45.3
Excellent	00	0.0
Environment wellbeing (0-100)
Poor	00	0.0	61.60	6.13	31
Average	08	8.4
Good	87	91.6
Excellent	00	0.0

Fig. 1: Correlation of depression and quality of life

Table:4 Correlation between depression and quality of life among elderly N=95

Quality of life	Depression r value	P value
Overall QOL Physical health wellbeing Psychological wellbeing Social relationship wellbeing Environment wellbeing	0.19^NS 0.049^NS 0.006^NS 0.155^NS 0.297^*	0.066 0.636 0.951 0.135 0.003

* Significant at p <0.05level ; NS- Not significant

Table 4 and Fig 1 reveals the correlation between depression and quality of life. It depicts that overall quality of life and domains of quality of life showed no correlation between depression except for environment wellbeing

DISCUSSION AND CONCLUSION:

Percentage distribution of level of depression among elderly showed that 81(89.5%) of elderly were mild depressive whereas only 10 (10.5%) were normal and 4(4.2%) were severe depressive. While another study conducted by Shankar Radhakrishnan.et.al (2013) stated that percentage distribution of level of depression among elderly showed that out of the total population 41.2% were normal, 37.8% were having mild depression and 21% were severely depressed⁸. Another study by Kim Jeung Im.et al⁹ (2009) reported the prevalence of depression among the subjects was 63%, out of which 21% had severe depressive symptoms.

Overall quality of life of elderly shows that majority 92(96.8%) have good quality of life followed by 3(3.2%) have average quality of life. Whereas another study conducted by Syed Qadri (2013) revealed that more than half (68.2%) of elderly had good quality of life whereas only 0.9% had poor quality of life¹⁰. Another study conducted by Missiriya Sahbanathul (2014) reported that majority of elderly 8(13.3%) had more satisfied with the Quality of life 23(38.3%) had satisfied, and 29(48.3%) were unsatisfied¹¹.

Present study reveals that there is correlation between depression and environment wellbeing. Whereas another study conducted by Demura S. et al (2003) concluded that depression in the old-old elderly was more significantly related to many lifestyle items compared with the young-old elderly, and especially in the old-old elderly, the extent of social activities related to a decrease in depression¹².

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Received on 16.09.2016 Modified on 15.10.2016

Accepted on 27.10.2016 © A&V Publications all right reserved

Int. J. Adv. Nur. Management. 2016; 4(4): 323-326.

DOI: 10.5958/2454-2652.2016.00072.X