|Year : 2015 | Volume
| Issue : 1 | Page : 13-17
Effectiveness of self enhancement programme on depression and self esteem among elderly residing in old age homes
B Debasmita1, TK Ajesh2, MD Bibin2
1 Lecturer, Tripura Institute of Paramedical sciences, Tripura, India
2 Assistant Professor, Maharishi Markandeshwar College of Nursing, Haryana, India
|Date of Web Publication||19-Jun-2019|
Lecturer, Tripura Institute of Paramedical sciences, Tripura
Source of Support: None, Conflict of Interest: None
Older adults, make important contributions to society as family member and in any work of the society, at the same time if not very active they can also be at high risk of developing mental disorders. A Pre-experimental one group pre-test post-test study design was used to assess the effectiveness of self enhancement programme (SEP) on depression and self esteem among elderly residing in selected old age homes of Agartala, Tripura. 31 elderly were selected using Purposive sampling. The data were collected through interview technique. Self enhancement programme (SEP) consists of self introduction, guided imaginary, group therapy, role play and closing session given for one hour for continuous 7 days. The study results revealed that majority of subjects 17(54.8%) were in the age group of 75 years and above, 25 (80.6%) were female, 20(64.5%) widow/widower. The findings of this study indicated that SEP is effective in reducing depression (t value=5.208, p value = <0.05) and increasing self esteem (t-value=5.933,p value = <0.05) among elderly in institutionalized elderly. Moderately significant negative correlation was found between depression and self esteem at the level of 0.05 level of significance which indicates depression decreases with increase in self esteem. The study concluded that SEP is effective method for reducing level of depression and enhancing self-esteem of elderly.
Keywords: Effectiveness, Self enhancement programme, Depression, Self-esteem, Elderly, Old age home.
|How to cite this article:|
Debasmita B, Ajesh T K, Bibin M D. Effectiveness of self enhancement programme on depression and self esteem among elderly residing in old age homes. Indian J Psy Nsg 2015;10:13-7
|How to cite this URL:|
Debasmita B, Ajesh T K, Bibin M D. Effectiveness of self enhancement programme on depression and self esteem among elderly residing in old age homes. Indian J Psy Nsg [serial online] 2015 [cited 2021 Oct 16];10:13-7. Available from: https://www.ijpn.in/text.asp?2015/10/1/13/119337
| Introduction|| |
Ageing is a natural process. In the words of Seneca “old age is an incurable disease”. The National Policy on Older Persons defines ‘senior citizen’ or ‘elderly’ as a person who is of age 60 years or above. The world population is rapidly ageing. Between 2000 and 2050, the proportion of the world's population over 60 years will double from about 11% to 22%. For the developing countries like India, the ageing population may pose mounting pressures on various socio economic fronts including pension outlays, health care expenditures, fiscal discipline, savings levels etc. Besides physical illnesses, the aged are more likely to be victims of poor mental health, which arises from senility, neurosis and extent of life satisfaction.
There have been a number of studies of the prevalence of depression in community and primary or general health care settings in South Asia and the reported rates vary considerably from 5% to over 50%. A meta-analysis reported that the diagnosis of depression is linked with a 70% increase in subsequent all-cause mortality for persons aged more than 65 years. Globally, the lifetime prevalence of depression is 12.1%. It accounts for 5% of total burden of disease from all causes. Depression affects 121 million people worldwide. Depression can cause great suffering and leads to impaired functioning in daily life. Symptoms of depression in older adults are often overlooked and untreated because they coincide with other late life problems. The changes that often come in later life like retirement, the death of loved ones, increased isolation and medical problems can lead to depression. Symptoms that indicate depression are intensive, pervasive sense of guilt, thoughts of suicide or a preoccupation with dying, feelings of hopelessness or worthlessness, slow speech and body movements, inability to function at work, home, Seeing or hearing things that aren’t there. Most cases of depression are the result of low self esteem.
Various programmes have come up these days to prevent mental illness at the root level. Evidences have been found that SEP plays a great role in boosting one's self esteem, reducing depressive symptoms, promoting mental well being. The Self-Enhancement Programme is suited to people who need support and ongoing therapeutic input to help them achieve and maintain stability and live successfully in the community. Various studies have been conducted which showed the effectiveness of different psychological treatment modalities on depression and self esteem, but very less literature was available on effectiveness of SEP on both the parameters i.e. depression and self esteem. This motivates the investigator to undertake the present study i.e. SEP for the elderly in old age home setting to promote their self esteem and to prevent or reduce depression at the grass root level as they leads a life where they lacks family support.
| Materials and Methods|| |
The present study was conducted in two old age homes in Agartala, Tripura, one at Narsingarh i.e. Mahatma Gandhi Memorial Old age home and the other at Gandhigram i.e. Sandhyaneer Old age home with the objectives to assess and evaluate the level of depression and self esteem among elderly before and after the administration of SEP, to determine the relationship between depression and self esteem in elderly and to find out the association of level of depression and self esteem in elderly with the selected sample characteristics. A pre-experimental (one group pre-test posttest) research design was used. The convenient sampling technique was used to select the old age homes and purposive sampling technique was adopted for selecting the study subjects. Thirty-one elderly meeting the inclusion criteria participated in the study. Out of which thirteen elderly had only depression, five elderly had low self esteem and thirteen elderly had both depression and low self esteem. Self enhancement programme is a structured group programme which consists of self introduction, guided imaginary, group therapy, role play and closing session given for one hour for seven days, a form of motivational programme that works to make people feel good about themselves and to maintain self- esteem and reduce depression. The sample was recruited on the criteria that elderly who were of 60 years and above, residing in selected old age homes of Agartala, Tripura, having score either above 5 on Geriatric depression scale or below 15 on Rosenberg's self esteem scale or both and willing to participate in the study. The tools for data collection were Geriatric Depression Scale (reliability- ranges from 0.80 to 0.94) which had fifteen items and Rosenberg Self-Esteem Scale (reliability - ranges from 0.85 to 0.88) which had ten items. The technique used for data collection was interview technique. Ethical clearance from university, permission from old age homes and written consent from participants were obtained. Tool was translated to Bengali language and back translated.
The data obtained was analyzed using both descriptive and inferential statistics i.e. mean, median, standard deviation, chi- square test, Karl Pearson's formula,Paired ‘t’- test. All hypotheses were tested at 0.05 level of significance.
| Results|| |
In order to determine the significance of the difference between the means of depression score before and after self enhancement programmed’ value was computed for correlated means.
As the [Table 2] shows that the calculated t value i.e. 5.208 is more than table value 2.04 at df (30) at 0.05 level of significance. This shows that difference in the mean depression score before and after self enhancement programme is a true difference and not by chance. This indicates that self enhancement programme was effective in decreasing the depression among elderly population significantly.
|Table 1: Frequency and Percentage Distribution of sample characteristics n = 31|
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|Table 2: Mean, Mean difference, standard deviation of difference, Standard Error of Mean difference and ‘t’ value of depression score of Elderly before and after self enhancement programme n =31|
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In order to determine the significance of the difference between the means of self esteem score before and after self enhancement programme’t’ value was computed for correlated means.
As given in [Table 3] that the calculated t value i.e. 5.933 is more than table value 2.04 at df (30) at 0.05 level of significance. The difference in the mean self esteem score before and after self enhancement programme is a true difference and not by chance which indicates that self enhancement programme was effective in increasing the self esteem among elderly significantly.
|Table 3: Mean, Mean difference, standard deviation of difference, Standard Error of Mean difference and‘t’ value of Self esteem score of study subjects before and after self enhancement programme. n =31|
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To determine relationship between pre depression scores and pre SEP self esteem scores, pre SEP depression scores and post SEP self esteem scores, post SEP depression scores and pre SEP self esteem scores, post SEP depression scores and post self esteem scores ‘r’ value was computed for correlation coefficient.
As given in [Table 4] that significant negative correlation was found between depression and self esteem at the level of 0.05 level of significance which indicates depression decreases with increase in self esteem. The calculated ‘r’value between pre depression scores and pre SEP self esteem scores i.e. 0.671 is more than table value 0.553 at df (11) at 0.05 level of significance and the negative sign with the value. This indicates that there was negative significant relationship between pre depression scores and pre SEP self esteem scores i.e. when depression decreases self esteem increases. Again the calculated ‘r’ value between post SEP depression scores and post SEP self esteem scores i.e. 0.719 is more than table value 0.553 at df (11) at 0.05 level of significance and the negative sign with the value indicates that there was moderately negative significant relationship between post SEP depression scores and post SEP self esteem scores i.e. when depression decreases self esteem increases.
|Table 4: Correlation between pre depression scores and pre self esteem scores and post depression scores and post self esteem scores in elderly. n=31|
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There was no significant association of depression and self esteem with the selected sample characteristics except for disease, having association with the level of depression.
| Discussion|| |
The findings of the study results indicated that majority of subjects 17(54.8%) were in the age group of 75 years and above, 80.6% were female, 64.5% were widow/ widower, 67.7% came to old age home on decision taken by others or relatives,67.7% were illiterate, 24(77.4%) were from nuclear,family19 (61.3%) were unemployed before coming to old age home,29(93.6%) had personal income less than Rs.5000, 20(64.5%) were having some diseases commonly diabetes and hypertension. 100% subjects were Hindus and had no health insurance. The findings of the present study is also consistent with the findings of another study by Swarnalatha N(2013) which shows that depression was females (56.5%), illiterates (59.0%), those who were below the poverty line (86.1%), those who were living alone (87.3%), those who were economically partially dependent (63.3%) and those depended totally for the activities of daily living(100%) which was in line with the present study findings.10 Navdeep Bansal(2011) reported in his study that majority of the subjects had depression who were in the age group of 75 years and above(43%), were widow(83%), illiterate(33%), Hindu(64%).
The findings of this study indicated that Self Enhancement Programme (SEP) is effective in reducing depression among elderly in institutionalized elderly (t value=5.208, p value = <0.05). These results was in agreement with previous studies; Navdeep Bansal in his work found reminiscence therapy is effective in reducing depression level as it was evidenced by an significant increase in post SEP test mean score of 16.50 which was 7.87 as in pre SEP test mean score. Anna Forsman et al(2011) concluded psychosocial interventions had a positive effect on life satisfaction, quality of life and positive mental health outcomes among intervention participants compared to no-intervention controls.
The present study findings revealed that Self Enhancement Programme (SEP) is effective in improving the self esteem of institutionalized elderly (t value=5.933, p value = <0.05). Similar findings were reported by a previous study done by Kavitha,2010, results of her study revealed that there was an increase in mean self esteem score of five and it was found to be effective in improving self esteem (t value=-8.56, p<0.01). M. Aswathy (2011) in a study reported that the mean pre SEP test and post SEP test self esteem score of experimental group were 16.77 and 20.3 respectively. The mean difference of 3.53 indicated that there was a significant increase in self esteem score of experimental group after SEP (t value = -5.62, p value = 0.001) which supported the findings of the present study.
The results of the current study discovered a moderately negative significant relationship between pre SEP depression scores and pre SEP self esteem scores (r=-0.671, p<0.05) and a moderately negative significant relationship between post SEP depression scores and post SEP self esteem scores (r=-0.719,p<0.05). The results were similar to a meta analysis conducted by Sowislo whose analysis revealed a strong relationship between self-esteem and depression. Specifically, he found that decrease in self-esteem were predictive of increase in depression.
In a study by Rauch et al (2006) that targeted the Japanese elderly, revealed that the elderly who perceived themselves not to be in good health were more depressed. Results of study by Sundru M, Goru K (2013) also contended various disease conditions lead to depression. The results of these both the studies mentioned above indicates that poor health affects depression levels which is in line with our present study findings which reveals that elderly those who were having disease had depression. Current study has shown no association of self esteem with socio demographic variables which was inconsistent with the findings of Shahbazzadeghan B (2010), who in his work points out significant association of self esteem with the variables like number of children, marital status, education, job, the number of the previous jobs, gender and visits and education and the last time visit.
| Conclusion|| |
It can be concluded that elderly showed a decrease in level of depression and increase in level of self esteem after the administration of self enhancement programme. Depression and self esteem were inversely related. Periodical educational sessions by nurses may be conducted for self enhancement for elderly in different settings.
| References|| |
Swarnalatha N. Journal of Clinical and Diagnostic Research [Internet] 2013 July [cited: 2013, Jul7]; 7:1356-1360. Availableat: h ttp://www. jcdr.net/back_issu es. as p?issn =09 73- 709x&year=2013&month=July&volume=7&issue=7&page=135 6-1360&id=3141
Navdeep Bansal. Effectiveness of Reminiscence therapy on depression among geriatric population.[M. Sc Nursing thesis]. Haryana. Maharishi Markandeshwar University;2011.
Forsman Anna, Nordmyr Johanna and Prof. Wahlbeck Kristian. Psychosocial interventions for the promotion of mental health and the prevention of depression among older adults. Health Promotion International. 2011; 26(1): i85-i110.
M.R. Aswathy, Prabha Valsaraj Blessy and Castelino Flavia. Effectiveness of self enhancement programme on self esteem of institutionalized elderly. Indian Journal of Gerontology. 2011; 25(2):200-207.
Sowislo, Julia Friederike; Orth, Ulrich. Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychological Bulletin. 2013. 139(1): 213-240.
Sundru M, Goru K. Epidemiological study of depression among population above 60 years in Visakhapatnam, India. International Journal of Medical Science and Public Health. (2013), [cited April 13, 2014]; 2(3): 695-702. doi:10.5455/ ijmsph.2013.030520133
Shahbazzadeghan B. The study of the effect of the regular exercise programme on the self esteem of the elderly in the old people home Rasth. European Journal of Social Sciences. 2010 Nov; 13(2):271-276
[Table 1], [Table 2], [Table 3], [Table 4]