A framework to understand depression among older persons

Aims and objectives.  To develop an explanatory framework to understand depression among community-dwelling Chinese older persons in Macau.

Background.  Depression has been described as the most common psychological problem among Chinese older persons. Dominant psychosocial theories are derived from research conducted mainly in western societies and similar research in Chinese populations is scant.

Design.  Mixed methods.

Methods.  Qualitative and quantitative methods (mixed methods) were employed to collect data from 31 participants between 2007–2009 in Macau.

Results.  Four categories of factors related to depression emerged: (1) negative thinking, (2) physical limitations and complaints, (3) present living conditions and social support and (4) past experiences. Each category interacts with the others and, consequently, one category both affects and is affected by others. The categories captured participants’ life-long hardship and bio-psycho-social-cultural disability that lay at the root of their negative thinking. The consequences and impacts of their negative thinking appear to feed and sustain depression.

Conclusion.  The framework offers a deeper understanding of the nature and meaning of the experiences of depressed older persons in a Chinese context.

Relevance to clinical practice.  The findings have several implications for clinical practice. First, the cultural context of Chinese older persons should be emphasised in nursing practice. Second, the root of depression among Chinese older persons is seen to lie in their social, family, cultural and day to day living issues. Finally, this study illustrates the potential for incorporating psychosocial nursing interventions as a therapeutic approach on its own or as an adjunct to other therapy.