A Pre-Experimental Study to Evaluate the Effectiveness of Structured Reminiscence Psychotherapy on the Level of Depression among Elderly Residing in Old Age Home

 

Ms. Ranjna Devi¹, Mrs. Sonia Sharma²

¹MSc. Nursing Student, Mata Sahib Kaur College of Nursing, Balongi Mohali

²Assistant Professor, Mata Sahib Kaur College of Nursing, Balongi Mohali

 

ABSTRACT:

 

 

 

INTRODUCTION:

Aging is not a disease, but the final stage of normal life. “Old age is an incurable disease. You do not heal old age, you protect it, you promote it and you extend it”.¹ The three common ways to understanding old age are Physiological, Psychological and socio-cultural. Years wrinkle the skin but worry, doubt, fear and anxiety and self-distrust wrinkle the soul. The degree of adaptation to the fact of aging is crucial to a man’s happiness in the phase of later life. Failure to adapt can result in bitterness, inner withdrawal, weariness of life and depression.²

 

The aging population is increasing globally. India too is witnessing a silent demographic revolution due to the steadily growing older population. Decline in morbidity rate, reduction in birth rate, and increase in life expectancy has led to an increase in elderly population.³

 

Growing old is a Characteristics feature of all living beings. The difficult changes that many especially elderly or older adults face most of time lead to depression. However depression is not a normal part of aging depression in older adults is associated with poor health. Reminiscence therapy considered an alternative intervention for treating depression in older adults. The WHO (2008) Report states that globally the percentage over the age of 60 years is estimated to be 6.5%. By 2030, the world population, aged 65 years, is projected to increase approximately to 973 million; increase from 6.5% to 12% and among them 8.5% had psychiatric problems.⁴

 

Reminiscence therapy is a method of using the memory to protect mental health and improve the quality of life. Reminiscence is not just to recall the past events or experiences. It is a structured process of systemically reflecting on one’s life with a focus on re-evaluation, resolving conflicts from the past, finding meaning in one’s life and assessing former adaptive coping responses. Watt and Wong (1991) defined six types of reminiscence: integrative, instrumental, transmissive, narrative, escapist and obsessive. They identified the integrative and instrumental reminiscence was related to adaptation and well-being among older adults and developed the corresponding intervention manual.⁵

 

In the last several decades, increasing studies indicated that reminiscence therapy is effective for the elderly with depression. Besides alleviating the depression symptoms, reminiscence therapy was proved to improve self-esteem, life satisfaction, psychological well-being, personal mastery and loneliness. However, the conclusion is not consistent. The reasons may be attributed as some studies did not follow randomized controlled trial (RCT) design, lack of strict protocol and had high dropout rates.⁶

 

OBJECTIVES:

·       To assess the pre-test level of depression among elderly residing in old age home.

·       To administer the structured reminiscence psychotherapy among elderly residing in old age home.

·       To assess the post-test level of depression among elderly residing in old age home.

·       To evaluate the effectiveness of reminiscence psychotherapy on the level of depression among elderly residing in old age home.

·       To find the association between research findings and selected socio-demographic variables.

 

MATERIAL AND METHOD:

A quantitative research approach was adopted for the study with pre-experimental research design to achieve the objectives of the study. Non probability convenient sampling technique was used to draw sample of 60 elderly residing in old age home who fulfilled inclusion criteria. Beck’s Depression Inventory (Standardized tool) used to assess the level of depression among elderly. Analysis and interpretation of data was done according to the study by using descriptive and inferential statistics.

 

RESULT AND DISCUSSION:

Demographic variable:

According to age (in years), majority of elderly 17(28.3%) were in age group of 60 to 65 years, 16(26.7%) were in the age group of 76-80 years, 15(25.0%) were in the age group of 66-70 years and minority 16(26.7%) were in the age group of 71-75 years of age.

 

According to gender 31(51.7%) were female and 29(48.3%) were male.

 

According to marital status, majority 25(41.7%) were married, 16(26.7%) were widow, 11 (18.3%) were divorcee and minority 8 (13.3%) were unmarried.

 

According to educational status, majority 19(31.7%) had primary education, 18(30.0%) had senior secondary education, 17(25%) had no formal education, in minority 6(10.0%) had graduation and above education.

 

According to duration in old age home, majority 25(41.7%) were living from 2 years, 21(35.0%) were living from ≥3 years and minority 14(23.3%) were living from ≤1 year.

 

Table 1: To assess the pre-test level of depression among elderly

Level of Depression	Frequency (f)	(%)
These ups and downs are considered normal (0-10)	0	0
Mild mood disturbance (11-16)	6	10
Borderline clinical depression (17-20)	0	0
Moderate depression (21-30)	28	46.7
Severe depression (31-40)	26	43.3
Extreme depression (over 40)	0	0
Mean Median ±SD	28.033 29.5±6.563

 

Table 1: depicts that pre-test level of depression among elderly. Depression was assessed by using Beck’s Depression Inventory. Level of depression classified according to severity. In present study, in pre-test majority of elderly had moderate depression 28 (46.7%), 26 (43.3%) had severe depression, 6 (10%) had mild mood disturbance, and none of them had ups and downs are considered normal, borderline clinical depression and extreme depression. 

 

Table 2: To assess the post-test level of depression among elderly

Level of Depression	Frequency (f)	(%)
These ups and downs are considered normal (0-10)	4	6.7
Mild mood disturbance (11-16)	9	15.7
Borderline clinical depression (17-20)	26	43.3
Moderate depression (21-30)	15	25.04
Severe depression (31-40)	6	10
Extreme depression (over 40)	0	0
Mean Median ±SD	21.366 21±6.436

 

Table 2: depicts that post-test level of depression among elderly. Depression was assessed by using Beck’s Depression Inventory. Level of depression classified according to severity. In present study, in post-test majority of elderly had borderline clinical depression 26 (43.3%), 15 (25.04%) had moderate depression, 9 (15.7%) had mild mood disturbance, 6 (10%) had severe depression, 4 (6.7%) had ups and downs considered normal and none of them had extreme depression. 

 

Table 3: To evaluate the effectiveness of reminiscence psychotherapy among elderly

Beck's Depression Inventory	Mean	Std. Deviation	t-value	df	p-value
Pre Test	28.033	6.593	5.834	59	.0001**
Post Test	21.366	6.436

**Significant, p<0.01 

 

Table 3: This table depicts the difference between pre-test and post-test depression score among elderly. In present study, present study mean was 28.016, SD was 6.593 that is higher than post test i.e. mean was 21.366, SD was 6.436. Paired t-test value was 5.834 i.e. highly significant.

 

Thus it was evident that after intervention the score of post test was less from pre-test score. Hence, the research hypothesis (H₁) is significant which states that there is significant difference between the pre-test and post-test scores on the level of depression is accepted.

 

To find out association between research finding and selected socio-demographic variables:

Table 4: shows that an association between level of depression with socio-demographic variables among elderly residing in old age home which was calculated by χ² with software application.

The association between age and level of depression shows (χ² = 10.454, 0.576; p<0.01) non significance because the p<0.01 level of significance. Hence there is no association between age and level of depression in post-test.    

 

The association between gender and level of depression shows (χ² = 4.056, 0.399; p<0.01) non significance because the p<0.01 level of significance. Hence there is no association between gender and level of depression in post-test.

 

The association between marital status and level of depression shows (χ² =19.560, 0.076; p<0.01) non significance because the p<0.01 level of significance. Hence there is no association between marital status and level of depression in post-test.  

 

The association between educational status and level of depression shows (χ² =14.110, 0.294; p<0.01) non significance because the p<0.01 level of significance. Hence there is no association between educational status and level of depression in post-test. 

 

The association between duration in old age home and level of depression shows (χ² =8.076, 0.426; p<0.01) non significance because the p<0.01level of significance. Hence there is no association between duration in old age home and level of depression in post-test. 

 

CONCLUSION:

On the basis of the findings of the study, it concluded that, structured reminiscence psychotherapy is effective to decrease the level of depression among elderly. Thus, it analyzes the level of depression become decrease in post-test than that of pre-test. So, structured reminiscence psychotherapy was effective on elderly to reduce the level of depression.

 

REFERENCES:

1)     Anderson AJ. Treatment of depression in older adults. International Journal of Psychosocial Rehabilitation 2006 Jan.

2)     Sharma OP. Geriatric care: A textbook ///of geriatric and gerontology. 3^rded. New delhi: Sanat Printers;2008.

3)     Bloom, David E, Axel Boersch-Supan, Patrick Mc Gee, Atsushi Seike (2011) Population Aging: Facts, challenges, and Responses.

4)     Suddarth’s and Brunnerhealth care of older adult. Medical surgical nursing. 9^th ed. Philadelphia: Lippincott company; 2000.

5)     Atchey RC. A Continuity Theory of Normal Aging. Gerontologist. (2009); https://doi:10.10931/geront/29.2.183.

6)     Tadaka, Etsuko; Kanagawa, Katsuko (1June 2007). “Effects of reminiscence group in elderly people with Alzheimer disease and vascular dementia in a community setting” Geriatrics and Gerontology International. https://doi:10.1111/j.2007.00381.

 

 

 

 

Received on 25.09.2018          Modified on 31.10.2018

Accepted on 17.11.2018     © A&V Publications all right reserved