RAJIVGANDHIUNIVERSITY IF HEALTH SCIENCES,
KARNATAKA,BANGALORE
ANNEXURE-II
PROFORMA SYNOPSIS FOR REGISRATION OF SUBJECT FOR DISSERTATION
1 / Name of the candidate and Address(in block letters) / MR. RAMESH SUBBA I YEAR M. SC. NURSING DR. M. V. SHETTY INSTITUTE OF HEALTH SCIENCES, VIDYANAGAR,MANGLORE-575013.
2 / Name of the Institution / DR. M. V. SHETTY INSTITUTE OF HEALTH SCIENCES, VIDYANAGAR, MANGALORE-575 013.
3 / Course of study and subject / M.SC.NURSING PSYCHIATRIC NURSING
4 / Dateof Admission to Course / 14 / 6 / 2008
5 / Title of the Topic:
“A DESCRIPTIVE STUDY TO ASSESS THE LEVEL OF DEPRESSION AMONG ELDERLY IN SELECTED OLD AGE HOME AT MANGALORE, DK, WITH A VIEW TO DEVELOP HEALTH EDUCATION PAMPHLET”
6. / BRIEF RESUME OF THE INTENDED STUDY
6.1Need for the study
“You don’t heal old age; you protect it, promote it and extend it.”
– Sir James Sterling Ross
The oldest, theory of aging is wearing and tearing. Just like part of machine that deteriorates with each year of exposure to pollution, radiation, toxic foods, drugs, diseases, repeated movements, and various other stresses. Other popular theory is genetic clock. As the genetic clock gradually “switches off” the genes that promote growth; it might switch on genes that promote aging.1
According to census of India 2001, Indian population aged 60 years and older is about 7,66,22,231 which comprises 7.5% of total population. According to UN, urban population in India will increase from 30% in 2010 to more than 50% by 2045 with 35% in urban, only 32% in residing in rural community. In Mangalore Taluk, there are approximately 75,217 elderly, whereas females are 43,098 and males are 32,119.2
Ageing is a progressive state, beginning with conception and ending with death, which is associated with physical, social and psychological changes. There has been considerable increase in the absolute and relative numbers of elderly in the world population of both developed and developing countries in the 20th century. As a result of reduction in a both mortality and fertility, fewer children are born and more people reach old age (60 years and above) in the world. Around 335 million of these elderly live in developing countries. Nowadays the life expectancy in more than 20 developing countries is 72 years above. In developed countries, 20% of the population is elderly, and by 2050 that population will be 32%; and by 2050 that population will be “two for every child.”3
Developmental tasks in elderly are associated with varying degree of changes and losses such as health, significant others, sense of usefulness, socialisation, income, independent living and physical changes of aging. Psychosocial changes in elderly involve changes in roles and relationship which are retirement, social isolation, sexuality, housing and environment and death.4 In India, depression is found in 1-6% of the general population; among psychiatric outpatients it is 5-20% and among elderly 13-22% are found suffering from depression.5In USA, among the healthy, non-institutionalise elderly 1%, but also found that as many as 15% of elderly experiencing significant depression. In UK, 10-15% of elderly are living in community. 6 In the US, 6 million elderly are suffering from depression, but only 10% are receiving treatment. The elderly patients with significant symptoms of depression have roughly 50% higher costs than non-depressed elderly.7
The joint family of traditional Indian set up respected elderly while nuclear families do not include the elderly. The family integration has isolated the elderly or forced them to reside in old age home where standard of life is pathetically down.8 Rates of depression are high among the elderly, and suicide rates considerable higher than among younger adults.9
The growing population figure of elderly not only in India but also globally vastly increasing and that warrants more care and attention to be given to them. Depression also makes elderly cognitively disable which prevents to drain the invaluable experiences from them for the new generation. Hence the investigator was motivated to explore the level of depression in the institutionalised elderly and provide them psychological support with ways to reduce it by providing them more useful, more valuable & more practicable to daily life related information through a pamphlet.
6.2Review of Literature
A study on depression among geriatric population in Nepal was conducted at teaching hospital in Katmandu. The study aimed to find prevalence of depression using the Geriatric Depression Scale (GDS) and to find out association of GDS with ICD-10 Diagnostic Criteria for Research (ICD-10 DCR) among older adults in Nepalese population. The sample size was 100.Findings showed that majority (53.2%) were found to be experiencing depressive illness, among them 34.2% were mild and 19% were severe. 83.3%. of the patients diagnosed with probable depression GDS were also diagnose clinically with ICD-10 DCR (p<0.001). This study concludes that significant number of elderly patients attending OPD of tertiary care hospital suffers from depression .10
A comparative study was conducted by School of Social Work and Faculty of Social Welfare and Health Studies, University of Haifa on the levels of depression, hopelessness, suicidal ideation among elderly males and females, with reference to their living arrangement i.e., community versus nursing homes. Sample size was 227 (78 men and 149 women) in the community and 91 (33 men, 58 women) in the nursing home in both independent and frail functional status (ADL). Findings showed significantly more hopelessness, helplessness, and depression among nursing home residents compared to those in the community. The study concluded that there was need to pay interdisciplinary attention to the mental health of elderly residents of nursing home, particularly in the preliminary stages of placement and adjustment.11
A cross-sectional descriptive study was conducted on the prevalence of depressive symptoms among elderly Chinese private nursing home residents in Hong Kong. The aim was to determine the prevalence of significant depressive symptoms in a group of Cantonese-speaking Chinese private nursing home elderly living in Hong Kong, and to identify associated psychosocial health
factors.The data was collected from 245 elderly by using Chinese version of the Geriatric Depression Scale-Short Form (GDS-SF). The findings showed29% of elderly exhibited significant depressive symptoms. Depression was associated with features of self-perception of financial inadequacy, life dissatisfaction, poor self- perceived health, poor attitudes toward living arrangement and suicidal thoughts. Univaried analysis revealed associated socioeconomic risk factors including current non-Comprehensive Social Security Assistance (CSSA) recipients, education levels and low abilities for social activities. The conclusion of study was that the high prevalence of depressive symptoms in nursing home elderly requires the attention of Government authorities, health care and social service providers.12
A cross-sectional study was conducted on the prevalence of depression among elderly in an urban area of Selangar, Malaysia 2004. A total of 316 aged persons of age 60 years and above were selected as sample. Data was collected using a questionnaire-guided interview method. The structured questionnaire consisted of two parts: Part A with socio-demographic, socio-economic and clinical data, and Part B that consisted of the Geriatric Depression Scale (GDS-30). Out of 316 elderly subjects, 300 were interviewed giving a response rate of 94.9%. The results showed that the prevalence of depression among the elderly respondents were 6.3%. Gender (P=0.015), ethnicity (P=0.028), functional disability (P=0.00) and cognitive impairment (P=0.000) were found to be significantly associated with depression among the elderly respondents. Gender, ethnicity, presence of chronic illness, functional disability and cognitive impairment were identified as important factors to be emphasized on when assessing for depression in the elderly.13
A population-based prospective study on the natural history of depression in the oldest old was conducted in Netherlands to find the incidence, course, and predictors of depression in general population of oldest old in 500 subjects from age 85 through 89 years by using 15 item Geriatric Depression
Scale (GDS-15). The findings showed the annual risk for the emergence of depression was 6.8%, depression at base line was 14%.14
A descriptive study was conducted on the predictors of depression in aging South Asian Canadians. The aim of the study was to examine the prevalence and factors of depression among aging South Asians in Canada. Telephone surveys were conducted with a random sample of aging South Asians aged 55 and above. Hierarchical regression analysis was used to determine the factors of depression, which was measured by an adapted 15-item Geriatric Depression Scale. The findings showed that 21.4% were suffering from mild level of depression and the linkage between the relationships among socio-cultural factors and depression in older south Asians.15
6.3Statement of problem
“A DESCRIPTIVE STUDY TO ASSESS THE LEVEL OF DEPRESSION AMONG ELDERLY IN SELECTED OLD AGE HOME AT MANGALORE, DK, WITH A VIEW TO DEVELOP HEALTH EDUCATION PAMPHLET”
6.4Objectives of the study
The objectives of study are to:
- Assess the level of depression among elderly using a standard Geriatric Depression Scale.
- Find out association between level of depression and selected demographic variables.
- Prepare and distribute health education pamphlet to the elderly.
6.5Operational definition
- Depression: In this study, it refers to the state of mind that is scored & measured on the standard geriatric depression scale; and it is categorised as mild & severe levels of depression.
- Elderly: It refers to the people of aged 60 years and above.
- Old age home: It refers to the charitable institute where elderly are kept for food, shelter & care.
The study assumes that:
- elderly people suffer from significant depression.
- elderly will give true responses.
The study is limited to
- elderly who are residing in the selected old age home.
- elderly who are available during the time of data collection.
H1-There will be significant association between the levels of depression and selected demographic variables.
7. / MATERIALS AND METHODS
7.1Source of data
The data will be collected from a selected old age home, who will participate for fulfilling the inclusion criteria.
7.1.1Research design
A descriptive survey design will be selected for the study.
7.1.2Setting
The present study will be undertaken in a selected old age home at Mangalore.
7.1.3 Population
The population for the study will be elderly who are residing in a selected old age home.
7.2Method of data collection
7.2.1Sampling procedure
In a view of the nature of the problem and to accomplish the objectives of the study, 50 elderly will be selected using multistage sampling. In the first stage, among 9 old age homes, one will be selected using simple random technique. In the second stage, non probable purposive sampling technique will be used to select the samples.
7.2.2Sample size
The sample of the present study would consist of 50 elderly residing in the selected old age home.
7.2.3Inclusion criteria
Elderly who are
- residing in a selected old age home.
- willing to participate.
- available at the time of study.
- Elderly who are deaf & dump; and severely debilitated.
A demographic profile of the elderly and a Standard Geriatric Depression Scale will be used.
7.2.6Data collection method
After obtaining prior permission from the concerned authorities and also obtaining written consent from the sample, the data will be collected using the research instruments.
7.2.7Data analysis plan
Descriptive and inferential statistics will be used to analyse the data. Demographic data will be analysed using frequency, percentage. To find out the association chi-square test will be used.
7.3Does the study require any investigations or interventions to be conducted on patients, or other animals? If so please describe briefly.
Yes.
7.4Has ethical clearance been obtained from your institution in case of 7.3?
Yes.
8. / REFERENCES
- BergerKS. The developing person through the life span. 5th ed. Worth publishers.
- Mehta R. Helpage India NEPA, understanding. Elder abuse.
- Fathey T, Montgomery AA, Barnes J, Protheroe J. Quality of care elderly residents in nursing home and elderly people living at home, controlled observational study. BMJ 2003;326:580.
- Nambi S. Psychiatry for nurses. New Delhi: Jaypee Brothers Medical Publishers; 2005.
- Hotkas K. Depression in elderly. Psychiatric in Turkey (2006;8(1):30-7.
- Morgan CT, King RA, Weisz JR, Schopler J. Introduction to psychology. 7th ed. New Delhi: Tata McGraw Hill..
- Khatri JB, Nepal MK. Study of depression among geriatric population in Nepal. NepalMedicalCollege Journal 2006 Dec;13(4):220-3.
- Pnina R. Depression, homelessness and suicidal ideation among the elderly: A comparison between men and women living in nursing homes and in the community. School of Social Work and Faculty of Social Welfare and Health Studies, university of Haifa.
- Siu E, Chow L. The prevalence of depressive symptoms among elderly Chinese private nursing home residents in Hong Kong, International Journal of Geriatric Psychiatry 2006;19(8):739-40.
- Sherina M, Rampal LM, Aini M, Norludayati HM. The prevalence of depression among elderly in an urban area of Malaysia. The International Medical Journal 2005 Dec;4(2):57-63.
- Stek ML, Vinkers DJ, Gussekloo J, van der Mast RC, Beekman ATF, Westendrop RGJ. The natural history of depression in the oldest old. Br J Psychiatry 2008;31-8.
- Lai DWL, Surood S. Predictors of depression in ageing south Asian Canadians. Journal of Cross-cultural Gerontology 2008;23(1):57-75.
9. / Signature of a the candidate
10. / Remarks of the guide / RESEARCHABLE AND APPROPRIATE.
11. / Name of designation of (in block letter)
11.1 Guide / MR. RAJESH G. KONNURM. Phil (N), MBA,PGDGCASSISTANT PROFESSOR DEPARTMENT OF PSYCHIATRIC NURSING DR. M. V. SHETTY INSTITUTE OF NURSING SCIENCES, VIDYANAGAR, MANGALORE-575 013.
11.2 Signature
11.3 Co-guide(if any)
11.4 Signature
12 / 12.1Head of Department / MR. RAJESH G. KONNURM. Phil (N), MBA,PGDGCASSISTANT PROFESSOR DEPARTMENT OF PSYCHIATRIC NURSING DR. M. V. SHETTY INSTITUTE OF NURSING SCIENCES, VIDYANAGAR, MANGALORE-575 013.
12.2 Signature
13. / 13.1 Remarks of the chairman and Principal : RECOMMENDED
13.2 Signature
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