Predictors of depressive symptoms in older adults living in care homes in Thailand

  • Author Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
    Suhathai Tosangwarn
    Correspondence
    Corresponding author at: School of Health Sciences, South Block, Queen's Medical Centre, Derby Road, Nottingham NG7 2HA, UK.
    Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
    Affiliations
    Department of Psychiatric Nursing, Boromarajonani College of Nursing, Nakhon Ratchasima, Nakhon Ratchasima province, Thailand

    School of Health Sciences, University of Nottingham, Queen's Medical Centre (QMC), Nottingham, UK
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  • Author Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
    Philip Clissett
    Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
    Affiliations
    School of Health Sciences, University of Nottingham, Queen's Medical Centre (QMC), Nottingham, UK
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  • Author Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
    Holly Blake
    Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
    Affiliations
    School of Health Sciences, University of Nottingham, Queen's Medical Centre (QMC), Nottingham, UK
    Search for articles by this author
  • Author Footnotes
    1 Present address: School of Health Sciences, University of Nottingham, Nottingham, UK.
Published:September 20, 2017DOI:https://doi.org/10.1016/j.apnu.2017.09.010

      HIGHLIGHTS

      • Internalised stigma of living in a care home was identified in the majority of care home residents
      • Internalised stigma of living in a care home is the strongest predictor of depressive symptoms among older adults living in care homes
      • There is a need for clinical interventions aimed at reducing internalised stigma of living in a care home

      ABSTRACT

      BACKGROUND

      Thai culture traditionally abhors elders living in care homes due to the belief that this represents a dereliction of filial piety by their children, thus care homes are stigmatized as the domain of poor older adults with no family. This may impact negatively on psychological wellbeing of residents, although little is known about the key factors influencing depressive symptoms. Therefore, this study explores factors associated with depressive symptoms, internalised stigma, self-esteem, social support and coping strategies among older adults residing in care homes in Thailand.

      METHOD/DESIGN

      A cross-sectional questionnaire study was conducted with 128 older residents recruited from two care homes in Northeast Thailand. Data were collected using the 15-Item Thai Geriatric Depression Scale, Internalised Stigma of Living in a Care Home Scale, Thai Version of Rosenberg Self-Esteem Scale, Thai Version of Multidimensional Scale of Perceived Social Support and the Coping Strategies Inventory Short-Form.

      RESULTS

      Depressive symptoms were significantly correlated with internalised stigma, self-esteem and social support (r = 0.563, −0.574 and −0.333) (p < 0.001), respectively. Perceived internalised stigma of living in a care home was the strongest predictor of care home residents reporting depressive symptoms (odds ratio = 9.165).

      DISCUSSION

      Older adults who perceived high internalised stigma of living in a care home were over nine times as likely to report experiencing depressive symptoms. Efforts to decrease or prevent perceived internalised stigma might help to reduce depressive symptoms. Interventions might include media collaboration, educational interventions in the care home setting and organising social activities for residents and their families.

      KEYWORDS

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