INTRODUCTION:

“Believe that life is worth living and your belief will help create the fact.’’

William James

Health and illness are defined according to the value of society to which a person belongs. When a person is able to adjust and adopt to his environment, he is said to be healthy. A person with good health functions comfortably with society. He is satisfied with himself and his achievements. Health status of the individual gets distorted when he falls sick or diseased.

An individual need to do lots of modification in his routine lifestyle. This can cause lots of stress and strain on individual. When he fails to cope up with the increased demand of lands up into anxiety and depression. Depression is one among such we can distort the life of an individual in and out. People have known about depression for thousands of years but have not understood it yet. In the ancient time kraepelin wrote about the depression. They thought that depression was caused by demons attacking the person. Different spirit was thought to cause the different kind of disorders.

BACKGROUND OF THE STUDY:

Depression is not only highly co-morbid with anxiety disorder but it also closely associates with dementia. The affective and behavioral symptoms of depression are influence by the negativistic cognitive pattern that generates a tendency to react negatively in the face of difficulties and losses. In depression, the thought flow is more related to the danger and suicidal thought to deal with situations that are appraised as threatening or without control, causing sensation of personal vulnerability. In client with depression, the psychosocial impact of depression is overwhelming. Depression is chronic disease and it requires specific treatment and therapies. Because most of depressive patients may have suicidal ideation as they have feeling of being ruthless, hopeless and low self -esteem. Education and psychological support are the most effective ways to treat depression.

NEED OF THE STUDY:

Depressive disorders constitute one of the major mental health problems. The cross and intercultural differences in etiologic, clinical features and course and outcome vary maximally in depressives than in any other mental illness. As per the World Health Organization’s Report “Depression and Other Common Mental Disorders – Global Health Estimates” released in 2017, the estimated prevalence of depressive disorders in India is 4.5% of the total population. The Central Government conducted National Mental Health Survey through National Institute of Mental Health and Neuro Sciences, Bangalore in 12 states of the country. As per the survey, the prevalence of depressive disorders in India is estimated to be 2.7% of the total population.

OBJECTIVES OF THE STUDY:

1. To assess the existing knowledge regarding depression among the elderly people.

2. To associate the knowledge score with selected demographic variables.

ASSUMPTIONS:

1. Elderly people with depression will have certain level of suicidal ideation.

2. There may be correlation between depression and demographic data.

LIMITATION:

· A study is limited to client in selected rural areas.

· A study is limited to 100 samples only.

· A study is limited to elderly people willing to participate in study.

· A study is limited to the age group of above 60.

· Elderly available at the time of data collection.

HYPOTHESIS:

· Null Hypothesis (H0): There is no significant association between knowledge score and demographic variables of elderly people.

· Alternative Hypothesis (H1): There is significant association between knowledge score and demographic variables of elderly people.

Conceptual Frame Work:

The conceptual framework which is used for the study based on General system theory which was first introduce by Ludwig Von Bartalanffy in 1980n. General System theory is one type of exchange theory. General System theory is composed of structural and functional components. according to general system theory ,a system consist of set of component that is input throughput and output within the boundary that filter the type and rate of exchange with the environment .living system is open because there is an ongoing exchange of matter, energy and information.

Review of literature:

Review of literature is one of the most important steps in research. It is an account of what is already to know about particular phenomenon. The main purpose of literature review is to convey is reader about the work already done and knowledge and ideas that of research. A literature is an account of previous efforts and achievement of scholars and researchers.

Study related to Depression among Elderly:

A study was conducted by “Tasi YF i, to determine the self-care strategies and risk factors for depressive symptoms among residents of public elder care home in Taiwan 2007 March April. A cross sectional design was used two of 18 public elder care home were chosen by random sampling through-out Taiwan. the result of study shows that nearly half of the participant was identified by the geriatric depression. The study was concluded with older person tended to engage with in activities and to interact with other to manage their depressive symptoms.

A study was conducted by Mc Dougall FA, Mathews FE, ETAC prevalence and symptomatology of depression in older people living in institutions in England and wales 2007 September. Sample size of 2, 640 participants aged 65 and above, from five sites across England and Wales were selected through automated geriatric examination for computer- assisted taxonomy system the result of the study shows that the prevalence of depression in those living institution was 27.1% compare to 9.3% in those living home. The study was conducted with depressive symptoms might improve quality of life for people in institution.

A study was conducted by Al-Jawad M, Rashid AK, in 2007 December on Prevalence of undetected cognitive impairment and depression in residents of an elderly care home.A sample size of 167 people over 60 years of age living in a state-run residential home in Malaysia, selected through interview method, validated assessment tools were used to measure dependency, cognitive impairment the result shows that the prevalence of depression is 67% with more depression in males and in the Indian population. The study was concluded with none of the identified cases had been investigated or treated for depression.

A study was conducted by Gerge K, Moore K, ETAL Treatment of depression in low level residential care facilities for the elderly. 2007 December. The participants comprised 300 elderly residential care facilities from various suburbs in metropolitan Melbourne were selected through structured clinical interview method. The result of the study shows that the low treatment for currently depressed residents with less than half of those in the sample who were depressed receiving treatment. The study that concluded with there is high numbers receiving antidepressant who are not currently depressed.

A study was conducted by Pinquart, Duberstein and Lyness Assessed the effect of psychotherapy and other behavioral intervention on depression symptoms in clinically depressed older patients. In 2007 using meta-analysis theory they examined the effects of 57 samples on controlled interventions studies. From the result it was found that on average, self-rated depression improved by d= 0.84 standard deviation units and clinician rated depression improved by d=0.93. It concluded that effect size was large cognitive and behavioral therapy (CBT) and reminiscence; and medium for psychodynamic therapy, psychoeducation, physical exercise and supportive intervention.

A study was conducted by Vankova H, Holmerova 1, “Functional status and depressive symptoms among older adults from residential care facilities in the Czech Republic 2008 May. The objectives of this study were examined the relationship between functional status and depressive symptoms. A sample size of 308 older adult from the residential care facilities in the Czech Republic were selected through questioner method. This study was used baseline data from two randomize controlled trails testing the effect of dance reminiscences the rapies on quality of life in order. Ref resident’s depressive symptoms were measure using the 15-item geriatric depressive scale. The result of the study revealed that suggest factors that may be important in efforts to improve the psychological wellbeing in this population.

Study related to Prevention of Depression among Elderly:

The study conducted by Michael J. Bird and Ruth A Parslow in 2002 on potential for the community programme to prevent depression in elderly people. In this study the participant involved and the method followed by prospective study. The epidemiological studies suggest that the prevalence of major depression in community dwelling older people (usually defined as above 60 years) is between 1% and 3%. The different method of measurement produces very different result. The finding of this study a large population of elder people with significant depressive symptom and consequences of this symptom include development of other illness.

The study conducted by Oscar L. Lopez in 2006 on effects of depressive symptom in vascular diseases and mild cognitive impairment. In this study the total sample population was 2200 and the method used for this study random sampling with design prospective, population based longitudinal study. The depressive symptom were measured at baseline using the 10 item centre for epidemiological studies depression scale and were classified as none (0-2 points), low (3-7 points), and moderate or high (>8 point) Mild cognitive impairment was diagnosed after 6 years of follow up based on consensus of a team of dementia expert using standard clinical criteria. The result of this study is depressive symptom at baseline were associated with increases risk of mild cognitive impairment and this association was independent of underline vascular disorder.

This study was done by Agnieska Ederveen in March 2006 on opportunity for cost effective prevention of late life depression. In this study the sample was 2200 community residential aged 55-85 years. The method was used population-based cohort study over 3 years. The onset of clinically relevant depression was measured with the centre for epidemiological studies depression scales. The result of the study consequently, depression prevention has to play a key role in reducing influence of new cases.

MATERIALS AND METHODS:

Research approaches used for this study was quantitative approach descriptive survey approach was used in this study and Descriptive survey approach design, Non-experimental descriptive survey design. The study was conducted in the selected rural area. The population of the study was all elderly people who met the inclusion and exclusion criteria. The sampling technique used was non-probability convenient sampling. The study was approved by the ethical committee and the study was conducted in accordance with the ethical guidelines In inclusion criteria of the study are all elderly people who are willing to participate, available at the time of data collection, and age group is above 60 years. Elderly people, who are absent at the time of data collection. Elderly who are not willing participate in the study. The analysis was done with the help of inferential and descriptive statistics.

RESULT:

Table 1: Assessment with level of knowledge score (n=100)

Level of knowledge	Score Range	Level of Knowledge Score
		No of elderly people	Percentage
Poor	(1-5)	4	4
Average	21-40% (6-10)	56	56
Good	41-60% (11-15)	39	39
Very Good	61-80% (16-20)	1	1
Excellent	81-100% (21-25)	0	0
Minimum score		4
Maximum score		17
Mean knowledge score		9.98±2.69
Mean % Knowledge Score		39.92±10.78

The above table shows that 4% of the elderly people had poor level of knowledge score, 56% had average, 39% had good and only 1% of elderly people had very good level of knowledge score. Minimum knowledge score was 4 and maximum knowledge score in pretest was 17. Mean knowledge score was 9.98±2.69 and mean percentage of knowledge score was 39.92±10.78.

Graph 1: Assessment with knowledge score

Association of Level of Knowledgescore Regarding Depression Among elderly People in Relation to Demographic Variables

The association of knowledge score with age in years of elderly people regarding depression. The tabulated ‘F’ values was 2.68(df=3,96) which is much higher than the calculated ‘F’ i.e. 1.79 at 5% level of significance. Also, the calculated ‘p’=0.15 which was much higher than the acceptable level of significance i.e., ‘p’=0.05. Hence it is interpreted that age in years of elderly people is statistically not associated with their knowledge score.

The association of knowledge score with gender of elderly people regarding depression. The tabulated ‘t’ values was 1.98(df=98) which is much higher than the calculated ‘t’ i.e., 1.82 at 5% level of significance. Also, the calculated ‘p’=0.07 which was much higher than the acceptable level of significance i.e., ‘p’=0.05. Hence it is interpreted that gender of elderly people is statistically not associated with their knowledge score.

The association of knowledge score with marital status of elderly people regarding depression. The tabulated ‘F’ values was 2.68(df=3,96) which is much higher than the calculated ‘F’ i.e. 0.21at 5% level of significance. Also, the calculated ‘p’=0.88which was much higher than the acceptable level of significance i.e. ‘p’=0.05. Hence it is interpreted that marital status of elderly people is statistically not associated with their knowledge score.

The association of knowledge score with type of family of elderly people regarding depression. The tabulated ‘t’ values was 1.98(df=98) which is much higher than the calculated ‘t’ i.e. 1.22 at 5% level of significance. Also, the calculated ‘p’=0.22 which was much higher than the acceptable level of significance i.e., ‘p’=0.05. Hence it is interpreted that type of family of elderly people is statistically not associated with their knowledge score.

The association of knowledge score with monthly family income of elderly people regarding depression. The tabulated ‘F’ values was 2.68(df=3,96) which is much higher than the calculated ‘F’ i.e. 1.01at 5% level of significance. Also, the calculated ‘p’=0.38which was much higher than the acceptable level of significance i.e., ‘p’=0.05. Hence it is interpreted that monthly family income of elderly people is statistically not associated with their knowledge score.

DISCUSSION:

The findings of the study were discussed with reference to the objectives stated in chapter I and with the findings of the other studies in this section. The present study undertaken was “A descriptive study to assess the knowledge regarding depression among elderly people in selected rural areas.”

A study was conducted to determine knowledge regarding depression among elderly people in selected rural areas.”

It is observed that, 36% of the elderly people were in the age group of 60-64 years, 29% were in the age group of 65-69 years, 25% were in the age group of 70-74 years and 10% of them were in the age group of more than 75 years respectively.

Assessment of knowledge the depression among elderly people in selected rural areas.

CONCLUSION:

After the detailed analysis, this study leads to the following conclusion:

1. The above table shows that 4% of the elderly people had poor level of knowledge score, 56% had average, 39% had good and only 1% of elderly people had very good level of knowledge score.

2. Minimum knowledge score was 4 andmaximum knowledge score in pretest was 17.

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Received on 13.01.2021 Modified on 27.01.2021

Int. J. Nur. Edu. and Research. 2021; 9(2):197-201.

DOI: 10.5958/2454-2660.2021.00048.X