Factors influencing self-management of depression in older adults: a qualitative study

Abstract

Objectives: A considerable body of work addresses prevalence and treatment options for depression in older adults. However, less is known about their capacity to selfmanage their depression. Effective self-management of depression has the potential to improve individuals' quality of life through information, empowerment and perceived control, while enabling more efficient health service utilisation. The aim of this paper was to identify the barriers and facilitators to self-management of depression in older adults. Method: A qualitative study comprising in-depth, semi-structured interviews with 32 older adults with a diagnosis of moderate depression. Results: Three over-arching themes captured the barriers and facilitators to participants' capacity to self-manage their depression. Perspectives on age and depression represented how views of older age and mental health influenced the approach to self-management. Ability to access the health care system concerned the ability to identify and engage with different services and support. Individual capacity for self-management reflected participants' views on and the resources required for effective self-management. Conclusion: This study offers a better understanding of the factors that positively or negatively influence older adults' ability to self-manage their depression. Strategies to improve self-management should address misconceptions about age and depression, and older adults' interest in and capacity to embrace self-management practices.

A Theory on the Components of Depression Self-Management in Older Adults

“…The commencement of the transition may have been experienced with some uncertainty, while the diagnosis formalized the transition. Despite the uniqueness of each participants' change event, two common triggers became apparent from the current data: the realization that something was wrong with how they were feeling and the experience of receiving a formal diagnosis of depression (Polacsek et al, 2018(Polacsek et al, , 2020a.…”

“…By drawing on the internal and external resources available to them as individuals—not simply as members of a group of older adults or people with depression—participants demonstrated a sense of empowerment in their efforts to achieve mastery over their own lives (Polacsek et al, 2018, 2020a). Self-empowerment is strongly associated with self-determination and self-management (Coulombe et al, 2016), both of which were embraced by participants as preferred approaches to meeting their own needs and preferences as older adults living with depression.…”

Prevalence and Influencing Factors of Depression Self-Management Among Chinese Community Residents: A Cross-Sectional Study

“…For instance, family members were crucial in providing practical support for individuals with mental health problems by offering medication reminders and promoting physical activities (21). Encouraged by their family, members seek diagnosis, receive treatment and take steps to better manage themselves (23). In addition, families provide emotional support for their members, reduce isolation and enhance members' autonomy in self-management (21,40).…”

“…Participants who were more open to seeking help (such as psychotherapy and psychological counseling) during an emotional crisis were noted to have better DSM knowledge. Having access to the health care system can also improve self-management abilities (23). Being willing to seek assistance and receiving practical guidance and feedback on SM from health care professionals promotes better self-management abilities (20).…”

“…Another influence on SM is help-seeking attitude. An individual's effective DSM relies on timely and appropriate diagnosis and treatment of depression (23). These factors have a proven impact on DSM.…”