Paolo Iovino1,2, Maddalena De Maria1, Maria Matarese3, Ercole Vellone1, Davide Ausili4, Barbara Riegel5. 1. University of Rome Tor Vergata, Rome, Italy. 2. Australian Catholic University, Melbourne, Australia. 3. Campus Bio-Medico University of Rome, Rome, Italy. 4. Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy. 5. University of Pennsylvania, Philadelphia, PA, USA.
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.
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.
Authors: Maddalena De Maria; Federico Ferro; Davide Ausili; Rosaria Alvaro; Maria Grazia De Marinis; Stefania Di Mauro; Maria Matarese; Ercole Vellone Journal: Int J Environ Res Public Health Date: 2020-10-26 Impact factor: 3.390
Authors: R Johnson Pradeep; Maria L Ekstrand; Sumithra Selvam; Elsa Heylen; Prem K Mony; Krishnamachari Srinivasan Journal: J Affect Disord Rep Date: 2021-01-02