Loading...
Depression and self-care in older adults with multiple chronic conditions : A multivariate analysis
Iovino, Paolo De Maria, Maddalena Matarese, Maria Vellone, Ercole Ausili, Davide Riegel, Barbara
Iovino, Paolo
De Maria, Maddalena
Matarese, Maria
Vellone, Ercole
Ausili, Davide
Riegel, Barbara
Abstract
Aims
To investigate the relationship between depression and self‐care behaviours in older individuals with multimorbidity.
Design
Cross‐sectional study. Data were collected between April 2017 – June 2019.
Methods
Patients were enrolled from community and outpatient settings and included if they were ≥65 years, affected by heart failure, diabetes mellitus or chronic obstructive pulmonary disease and at least another chronic condition. They were excluded if they had dementia and/or cancer. Patient Health Questionnaire‐9 was used to measure depression and Self‐Care of Chronic Illness Inventory was used to measure self‐care maintenance, monitoring, and management. The relationship between depression and self‐care was evaluated by performing two sets of univariate analyses, followed by multivariate and step‐down analyses. The second set was performed to control for the number of chronic conditions, age, and cognitive function.
Results
The sample (N = 366) was mostly female (54.2%), with a mean age of 76.4 years. Most participants (65.6%) had mild to very severe depressive symptoms. Preliminary analysis indicated a significant negative association between depression and self‐care maintenance and monitoring and a significant negative association between depression and multivariate self‐care. Step‐down analysis showed that self‐care maintenance was the only dimension negatively associated with depression, even after controlling for the number of chronic conditions, age, and cognitive function.
Conclusion
In multimorbid populations, depression is more likely to be associated with self‐care maintenance than the other self‐care dimensions. Therefore, self‐care maintenance behaviours (e.g., physical activity and medication adherence) should be prioritized in assessment and focused on when developing interventions targeting depressed older adults with multimorbidity.
Impact
The results of this study may help guide clinical practice. In patients with depressive symptoms, self‐care maintenance behaviours should be assessed first, as a potential first indicator of poor self‐care.
Keywords
age, chronic obstructive pulmonary disease, cognition, depression, diabetes mellitus, heart failure, multimorbidity, multiple chronic conditions, self-care
Date
2020
Type
Journal article
Journal
Journal of Advanced Nursing
Book
Volume
76
Issue
7
Page Range
1668-1678
Article Number
ACU Department
Mary MacKillop Institute for Health Research
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
Published as green open access
License
File Access
Open
Controlled
Controlled