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MA/PhD Theses Abstracts of Current Students & Alumni |
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Lamm, Rosemarie Santoro, December 1997 THE ASSOCIATION BETWEEN DEPRESSION, CHRONIC ILLNESS AND HEALTH CULTURE AMONG THE ELDERLY IN THREE ETHNICALLY DISTINCT COMMUNITIES.
Abstract: The
association between depression, chronic illnesses and culture in older
persons is studied by comparing three populations of persons over fifty-five
years of age from Polk County, Florida, San Ildefonso, New Mexico,
and Lincolnshire, England with respect to the variables of age, presence
of chronic illnesses, and culture. A biographical questionnaire (Age,
Illness, Depression and Ethnicity), the Geriatric Depression Rating
Scale (Short Form), a chronic illness questionnaire, and Block=s Ethnic/Cultural
Assessment were administered to selected persons from each community.
Cultural identity, support systems, and learned behaviors were identified
and measured. Other variables included marital status, the number of
children and grandchildren, the number of their visits, the number
of visits with friends, work status, medical costs, years of education,
languages spoken, religion, income, and how many persons reside with
the respondent. The data were analyzed using Pearson=s Chi-Square,
rank order correlation, factor analysis, regression analysis, and scalogram
analysis. Analysis was also done on the ethnographic information to
identify cultural themes. Significant differences in depression rates
between these cultures were reported. The culture of individuals often
directs them in the development of beliefs that shape their value system
expressed in attitudes and behaviors related to the aging process. Culture
also provides the value placed on the elderly in society which can influence
feelings of hopelessness producing low self-esteem. Differences are
found in attitudes toward age-related changes that might alter the development
of symptoms of depression in chronically ill elderly and in cultural
lifeways that affect the perception of physical change in these populations.
Differences in depression rates were discovered between the three culture
groups. The depression rate in the total population (n=77) is 28%.
When each population was measured separately, the British (n=29) have
the most depressed population with a rate of 32% as contrasted to the
Native Americans (n=23) who are the least depressed with a rate of 22%
and the Euro-Americans rate of (n=25) 25%. The British have the highest
representation among the depressed population, accounting for 42% of
the 21 persons categorized as depressed. When each population is viewed
separately, differences are found in the relationships between each of
the variables and the dependent variable of depression. Depression is
a cross-cultural mood alteration and this study gives further evidence
that it is a significant health problem. The Guttman Technique was used
to analyze the items on the Geriatric Depression Rating Scale (Short
Form) for scalability. The results suggest a lack of universality and
some items may be differentially related to depression in the several
populations. These results also support the need for the development
of a culturally sensitive instrument to detect the presence of depression
in diverse populations. There is a need for methods to better identify
the cultural context of relationships in order to prevent depression
in aging persons.
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