Loneliness, self-esteem, cognition, physical functioning, and nursing home satisfaction as predictors of depression
Abstract
The purposes of this predictive, repeated measure, correlational study were to explore whether changes occur in loneliness, self-esteem, cognition, physical functioning, nursing home (NH) satisfaction, and depressive symptoms in older adults admitted to a NH for rehabilitation from admission to discharge and to identify whether changes in these same variables can predict the development of depressive symptoms at the time of discharge. The integration of Neuman Systems Model (NSM) with Lazarus and Folkman's Stress, Coping, and Adaptation (SCA) Model provided the theoretical basis for the study. Study approval was obtained by Marquette University Institutional Review Board and from participating NH site administrators. A convenience sample of 29 older adults admitted to four suburban NHs for rehabilitation and meeting study criteria were included. Power analysis was conducted and assuming α= .05, it was determined that a sample size of 29 was needed to obtain 80% power. Instruments used were the UCLS Loneliness Scale, Rosenberg Self-esteem Scale, Folstein Mini-Mental State Examination, Minimum Data Set Physical Functioning Scale, Satisfaction With the Nursing Home Instrument, and the Geriatric Depression Scale. Measures of variables were obtained at NH admission ± 5 days and at NH discharge or 30 days from admission ± 5 days. Paired samples t -tests were conducted to determine the degree of change in variables at two points in time. Pearson's correlational analysis was used to determine the relationships between risk factors and depression. Multiple regression analysis was used to determine whether change in variables was predictive of the variance in depressive symptoms. Significant differences in scores of self-esteem, physical functioning, and depressive symptoms were found between the time of admission and discharge. Increased age, history of depression, and comorbid thyroid disorder were associated with depressive symptoms. A model of loneliness, self-esteem, cognition, physical functioning, and nursing home satisfaction was significantly predictive of depressive symptoms at discharge. Cognitive functioning accounted for 33% of the variance in total depression scores. In conclusion, changes occurred in self-esteem, physical functioning, and depressive symptoms by discharge and changes in cognitive functioning were the most predictive of depressive symptoms at discharge in this NH rehabilitation population.
This paper has been withdrawn.