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A study to assess the effectiveness of reminiscence therapy on level of depression among elderly people at selected old age home ,karaikal.

Mrs. G.RAJI1*, Prof.Dr. K. KAMALA2

1Ph.D Scholar, Professor – Vinayaka Mission’s College of Nursing, Karaikal, Vinayaka Mission’s Research Foundation - (Deemed to be University) Salem

2 Research Guide, Principal - Vinayaka Mission’s College of Nursing, Karaikal, Vinayaka Mission’s Research Foundation - (Deemed to be University) Salem

1EMAIL ID: [email protected]

ABSTRACT

Depression is a most common problem among older adults, but it is NOT a normal part of aging. Geriatric depression is a mental and emotional disorder affecting older adults. Feelings of sadness and occasional “blue”

moods are normal. Depression in older adults can reduce quality of life, and it increases risk of suicide.

OBJECTIVE: To evaluate the effectiveness of reminiscence therapy on level of depression among elderly people in a selected old age home. MATERIAL AND METHODS: It was a Pre experimental Research Design.60 elderly people selected by purposive sampling technique. The tool used for data collection was demographic variables and GDS (Long form). RESULTS: The study revealed that during pre-test among 60 elderly people, 11(18%) elderly were normal 25 (42%) elderly were mild depression, and 24(40%) elderly were severe depressed. After reminiscence therapy 51(85%) were normal and 09(15%) were mild depressed. This shows that after reminiscence therapy depression level has decreased. Over all mean difference 12.80 and’t”value 18.831 .The study concluded reminiscence therapy was effective to decrease the depressive level among elderly people.

Keywords:

COVID-19, SARS-CoV-2, MERS, Symptoms, Novel corona virus

1. Introduction

According to WHO 60 years and above 60 years of age group is considered as an elderly. During 2001 census in India overall constitution of elderly is 7% and elderly population is increased by 2016 it is 8%, Overall proportion of the elderly population in world was 5.8% during 2000 and it is expected to increase to 8.7% by the year 2025 and 15.0% by the year of 2050

Currently, the growth rate of individuals aged 60 years and older is three times that of the population as a whole. Rapid advances in medicine, public health, nutrition, and sanitation have led to large cohorts advancing to old age. The aging population is >100 million, and projections predict a figure of 324 million, i.e., 20% of the total population, by 2050.

Geriatric populations are facing more physical and mental health problem than the younger population. India has nearly 120 million elderly people with various physical, psychosocial, economic, and spiritual problems.

Depression is a most common psychological disorder which is characterized by lack of interest in life, day to day activity, pleasure, guilty feeling, low self-esteem, sadness, poor memory, disturbed sleep pattern, poor appetite and tiredness. 20% of the geriatric population is facing mental or neurological problem, depression and dementia are the most common problem Depression is treatable but in 50 % of the populations goes untreated and treatment is also not taken properly, it happen because of negligence, lack availability of services, social stigma and/or undiagnosed .Depression is one of the main contributors to the mental health problems in India.

Nowadays Mental health has been gaining major attention and various treatments are available for depression, 10 percentage of population are taking antidepressant medications as well as psychotherapies and cognitive behavioural therapy (CBT). Psychotherapies and cognitive

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behavioural therapy (CBT) are equally effective as like antidepressant drugs. Based on traditional interventions, reminiscence therapy is specially recommended for geriatric depressive adults.

This psychotherapy has been designed and developed because of the recognition of the unique needs and concerns involved in adaptation to the late stage of life Reminiscence is defined as the process of thinking or telling someone about past experiences that are personally significant.

Reminiscence seeks to evoke meaningful memories from the past by relating experiences, facts, or actions associated with certain stimuli.

2. Statement of the Problem

A study to assess the Effectiveness of Reminiscence therapy on level of depression among elderly people at selected old home, Karaikal

3. Objectives

1. To assess the pre- test level of depression among elderly people in a selected old age home.

2. To evaluate the effectiveness of reminiscence therapy on level of depression among elderly people in a selected old age home.

3. To associate pre-test level of depression among elderly people with their selected demographic variables.

4. Hypothesis

H1-There is a significant difference between pre test and post test levels of depression among elderly .

H2-There is a significant association between pre test levels of depression and selected demographic variables

5. Material and Methods

The Quantitative Pre Experimental Research design was adopted for the study to assess the effectiveness of Reminiscence therapy on level of Depression among elderly at selected old age home. The study setting was selected St. Joseph old age home, Karaikal. The population for this study was Elderly people. A total 60 elderly people were selected by purposive sampling technique. The data was collected by using the demographic variables and Geriatric Depression Scale (long Form). Depression scale consists of 30 questions. Of the 30 items 20 Questions have positive scoring while the rest (question numbers 1, 5, 7, 9, 15, 19, 21, 27, 29, 30) have negative scoring. The scoring was Normal / No depression- (0-9), Depression (10-19) and severe Depression (20-30)

Criteria for sample selection Inclusion Criteria:

Age group between 65 - 85 years.

Both Male and Female

Willing to participate in this study.

Able to oriented, conscious and attention.

Able to understand and communicate in tamil

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Exclusion Criteria:

 Psychologically unstable

 Critically ill

 Bed ridden

 With medical complication such as paralysis etc.

 Visual and Hearing impairment Data collection Procedure

Ethical clearance was obtained from institutional research committee members and written permission obtained from the St.Joseph old age home, Karaikal. 60 elderly persons were selected using inclusion criteria and were informed regarding the research study and written consent was obtained. Elderly persons were divided into 6 groups A, B, C, D, E and F each groups had 10 elderly people. In pretest, levels depression was assessed by Depression long form scale and after that Elderly people had 4 session of reminiscence therapy on selected topic such as Childhood days, Work, Marriage and old songs. Elderly persons discussed on all the topic for once in a week 2 hours for a period of 4 weeks under the supervision of the researcher. Each group had intervention once in a week. Focus group discussion was used by researcher for reminiscence therapy. After four weeks of reminiscence therapy levels of depression was assessed by using geriatric depression long form scale.

Plan for data analysis

Distribution of demographic variables is analyzed by descriptive statistics (mean, standard deviation). To find out the effectiveness of reminiscence therapy, inferential statistics (paired ‘t’

test) is used. To find out the association between pre -test levels of life depression and selected demographic variables, inferential statistics (chi square) is used.

6. Results and Discussion

Table:1 Frequency And Percentage Wise Distribution Of Demographic Variables Of Study Participants

N: 60

S.NO. DEMOGRAPHIC VARIABLES FREQUENCY PERCENTAGE (%)

1. Age in years

a) 65-70 Yrs 18 30 b) 71-75 Yrs 18 30 c) 76 -80 Yrs 15 25

d) 81-85 Yrs 09 15

2. Sex

a. Male 15 25

b. Female 45 75

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3. Educational level

a. Primary education 27 45

b. Secondary education 21 35

c. Higher secondary education 06 10

d. Diploma/degree 03 05

e. Illiterate 03 05

4. Marital Status

a. Married 27 45

b. Unmarried 06 10

c. Divorce - -

a. Widow/Seperated 27 45

5. Religion

a. Hindu 42 70

b. Christian 15 25

c. Muslim 03 05

6. No of Children

a)One 24 40 b) Two 21 35 c) Three 06 10

d) Above Three 03 5

e) No children 06 10

7. Income

a) Up to Rs3000 21 35 b) Rs 3001- 5000 - - c) Rs .5001- 10,000 - - d) Above Rs. 10,000 09 15

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e) No Income 30 50 8. Mode of Income

a) Pension 06 10 b) From Children’s - - c) Previous savings 03 05 d) Old age pension 15 25

e) None 36 60

9. Duration of stay in old age home

a) Less than a year 15 25 b) 1Yr - - c) 2 Yrs 09 15

d)3Yrs 09 15

e) Above 5 Yrs 27 45 10. Reason for staying in old age home

a) Conflict with family members 33 55 b) Neglected by children / Family 21 35 c) Poverty 03 05 d) Acceptance to live Independent 03 05 e) Any other - - 11. Level of Dependency

a) Independent 54 90 b) Partially Dependent 06 10 c) Completely Dependent --

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Table 2: Frequency and percentage distribution of level of depression among elderly adults (n=40)

S No Level of Depression Pre Test Post Test Frequency

(n)

Percentage (%)

Frequenc y (n)

Percentage (%)

1 Normal (0-9score) 11 18 51 85

2 Depression (10-19 score) 25 42 09 15

3 Severe Depression(20-

30score) 24 40 - -

Table 2 shows during pretest that 11(18%) elderly were normal 25 (42%) elderly were depressed, and 24(40%) elderly were severe depressed. After reminiscence therapy 51(85%) were normal and 09(15%) were mild depressed. This shows that after reminiscence therapy depression level decreased. Hence hypotheses H1 was accepted

Table 3: Effectiveness of reminiscence therapy on level of depression among elderly.

(n=60)

The above table 3 shows that pre-test mean value is 16. 90 and standard deviation is 5. 853 After reminiscence therapy the post-test mean value is 4.10 and standard deviation is 2.628. The mean difference is 12.80. The calculated‘t’ value 18.831 is greater than that of the table value. This shows that reminiscence therapy was highly effective in reducing the levels of depression among elderly adults at p<0.001 level.

S. No Level of Depression

Mean Standard Deviation Mean Difference Paired ‘t’ Test

1 Pre test 16.90 5.853

12.80 18.831

2 Post test 4.10 2.628

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Table: 4 Associations Between Pre Test Level Of Depression Among Elderly With Selected Demographic Variables

S.NO. DEMOGRAPHIC

VARIABLES X2 Value P- value LEVEL OF

SIGNIFICANCE

1. Age 26.250 0.000* SIGNIFICANT

2. Duration of Staying Old

age Home 17.222 0.001* SIGNIFICANT

3. No.of Children 16.250 0.000* SIGNIFICANT

4. Level of Dependency 18.705 0.001* SIGNIFICANT

*Significant at 5% p < 0.05 level

The above table 4 shows that there is a significant association between pre test level of depression and demographic variables like age, gender, number of children, and level of dependency at (p<0.05)level. Hence it is interpreted that the difference in mean score was true difference and not by chance and hence hypothesis H2 was accepted and there is nosignificant association with marital status, education, religion , income ,duration of staying old age home and reason for staying old age home.

7. Discussion

In this study findings depict during pre-test that 11(18%) elderly were normal 25 (42%) elderly were depressed, and 24(40%) elderly were severe depressed. After reminiscence therapy 51(85%) were normal and 09(15%) were mild depressed. The present study was supported by Revathy .N (2018 ) was to find out the Effectiveness of group reminiscence therapy on levels of life satisfaction and depression among elderly adults at Sri Narayani Hospital and Research Centre, Vellore.The research design selected for this study was pre experimental one group pretest- posttest design. Purposive sample technique was adopted to select 40 elderly adults in Sri Narayani Hospital and Research Centre, Vellore. Tool used was life satisfaction scale to assess the levels of life satisfaction and geriatric depression scale to assess the levels of depression.Findings of the study showed that pre test mean value level of life satisfaction is 25, level of depression is 7 and after reminiscence therapy post test mean level of life satisfaction is 27, level of depression is 4. The mean difference for life satisfaction is 2, depression is 3. The computed ‘t’ value for life satisfaction is 85.4, depression is 103.3 was higher than the table value life satisfaction is 2.63, depression is 2.62 at P<0.005 level

Another study was also supported the present study by K.Rajammal (2016) conducted a study to assess the effectiveness of reminiscence therapy on level of depression and satisfy among elderly people. Methodology: A pre- experimental one group pre and post-test. Design was chosen to assess the effectiveness of reminiscence therapy on level of depression by using Geriatric depression scale among 50 elderly people at selected old age home of Chennai. The samples were selected based on purposive sampling. Results: The analysis of the study findings revealed that the pre-test mean was 21.66 with a standard deviation of 5.02 and the post-test mean was 18.46 with a standard deviation of 2.12. The calculated paired “t” value 4.417 was found to be statistically significant at p 0.001 level.

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8. Conclusion

The present study assessed the effectiveness of reminiscence therapy on levels of depression among elderly at selected old age , Karaikal. After Reminiscence therapy a level of depression was decreased this shows that reminiscence therapy was effective.

References

[1] Sathyanarayana Rao TS, Shaji KS. Demographic aging: Implications for mental health.

Indian J Psychiatry 2007;49:78-80. Back to cited text no. 7

[2] Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet 2007;370:859-77. Back to cited text no. 8

[3] Leveille SG, Guralnik JM, Ferrucci L, Langlois JA. Aging successfully until death in old age: Opportunities for increasing active life expectancy. Am J Epidemiol 1999;149:654-64. Back to cited text no. 9

[4] Desai SB, Dubey A, Joshi BL, Sen M, Shariff A, Vanneman R. Human Development in India. New York: Oxford University; 2010. Back to cited text no. 10

[5] .Liebig PS, Rajan SI. An aging India: Perspectives, prospects, and policies. J Aging Soc Policy 2003;15:1-9. Back to cited text no. 11

[6] Lilian D’souza RT. Prevalence of depression among elderly in an urban slum of Bangalore, a cross sectional study. Inter J Interdisciplinary and Multidisciplinary Studies. 2015;pp:1-4.

[7] WHO Depression: Definition. Retrieved from World Health Organization. 2012.

[8] India G.o. POPULATION COMPOSITION. 2011;pp:19-20.

[9] Report W. Technical paper: Health care of the elderly in the Eastern Mediterranean Region: Challenges and Perspectives. WHO/EMR. 2003.

[10] Ibrahim NK, GT (n.d.). Morbidity profile of elderly attended/admitted in Jeddah health facilities, Saudi Arabia. WHO

[11] Revathy N and Dr. P Muthumari Effectiveness of group reminiscence therapy on levels of life satisfaction and depression among elderly adults at Sri Narayani Hospital and Research Centre, Vellore. International Journal of Applied Research 2019 ; 5 (3 ):

165-168

[12] Watt LM. Integrative and instrumental reminiscence therapies for the treatment of depression in older adults. PhD thesis, Ottawa, Canada: University of Ottawa; 1996

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