Tosangwarn Suhathai, Clissett Philip, Blake Holly
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.
School of Health Sciences, University of Nottingham, Queen's Medical Centre (QMC), Nottingham, UK.
Arch Psychiatr Nurs. 2018 Feb;32(1):51-56. doi: 10.1016/j.apnu.2017.09.010. Epub 2017 Sep 21.
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.
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).
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.
泰国文化传统上厌恶老年人住在养老院，因为人们认为这意味着子女未尽孝道，因此养老院被视为无家可归的贫困老年人的住所。这可能会对居民的心理健康产生负面影响，尽管对于影响抑郁症状的关键因素知之甚少。因此，本研究探讨了泰国养老院老年人抑郁症状、内化耻辱感、自尊、社会支持和应对策略之间的相关因素。
方法/设计：对从泰国东北部两家养老院招募的128名老年居民进行了横断面问卷调查。使用15项泰国老年抑郁量表、养老院生活内化耻辱感量表、泰国版罗森伯格自尊量表、泰国版多维感知社会支持量表和应对策略量表简表收集数据。
抑郁症状分别与内化耻辱感、自尊和社会支持显著相关（r=0.563、-0.574和-0.333）（p<0.001）。在养老院生活的内化耻辱感是报告有抑郁症状的养老院居民的最强预测因素（优势比=9.165）。
认为在养老院生活有高度内化耻辱感的老年人报告有抑郁症状的可能性是其他人的九倍多。减少或预防内化耻辱感的努力可能有助于减轻抑郁症状。干预措施可能包括媒体合作、在养老院环境中进行教育干预以及为居民及其家人组织社交活动。
