Link between self-esteem, anxiety and depression in the elderly

Cilj: Cilj rada je ispitati razlike u razini samopoštovanja, anksioznosti i depresije u osoba starije dobi smještene u Domu za starije i nemoćne osobe u odnosu na osobe smještene u vlastitom kućanstvu. Socijalno okruženje i vrsta skrbi u starijoj dobi od velike su važnosti u prilagodbi osoba na promjene koje donosi starost. Promjene u psihologiji starenja kao što su povećana napetost, stres, nezadovoljstvo i brige utječu na mentalno zdravlje starijih. Metode: U ovom presječnom istraživanju sudjelovalo je 300 ispitanika. Osnovni skup ispitanika sastojao se od dva uzorka: osobe starije dobi smještene u Domu za starije i nemoćne (150 ispitanika) i osobe starije dobi smještene u vlastitom kućanstvu (150 ispitanika). Istraživanje je provedeno u svibnju i lipnju 2018. godine u Domu za starije i nemoćne osobe Zadar, vlastitim kućanstvima i ambulantama Doma zdravlja Zadarske županije. Korišten je upitnik o sociodemografskim obilježjima, Skala samopoštovanja (eng. Rosenberg Self Esteem Scale), Skala za procjenu anksioznosti (eng.Generalised Anxiety Disoreder, GAD-7) i Skala za procjenu depresije (eng.Patient Depression Questionnare PHQ-9). Primjenom deskriptivne statistike i linearne regresije ispitana je razlika u samopoštovanju, anksioznosti i depresiji osoba starije dobi smještenih u Domu i vlastitom kućanstvu. Rezultati: Osobe starije dobi smještene u Domu za starije i nemoćne osobe imaju niže samopoštovanje, veću razinu anksioznosti i depresije u odnosu na osobe starije dobi koji žive u vlastitom kućanstvu. Žene u starijoj dobi koje su smještene u vlastitom kućanstvu pokazuju veću razinu anksioznosti i depresije od muškaraca. Međutim, u Domu nije nađena razlika s obzirom na spol. Starije osobe s višom naobrazbom i dubljom starosti imaju niže samopoštovanje i veću razinu anksioznosti i depresije. Osobe starije dobi bez bračnog partnera su depresivnije od ostalih dok je veća anksioznost prisutna samo kod osoba smještenih u Domu. U osoba starije dobi razina anksioznosti i depresije se ne mijenja s obzirom na dužinu boravka u Domu ali je depresija prisutnija u osoba smještenih u dvokrevetne sobe. U osoba smještenih u vlastitom kućanstvu anksioznost je najjača kod onih na selu, a najmanja kod starijih na otocima. U većine osoba starije dobi u vlastitom kućanstvu prisutna je minimalna anksioznost i minimalna depresija dok je u osoba starije dobi smještenih u Domu prisutna umjerena anksioznost i blaga depresija. Najveća povezanost uočena je između anksioznosti i depresije, a najmanja između samopoštovanja i anksioznosti. Rezultati pokazuju veći doprinos prediktora depresije u objašnjenju varijance samopoštovanja od prediktora anksioznosti. Zaključak: Vrsta skrbi za osobe starije dobi ima znatan učinak na mentalno zdravlje osoba starije dobi. Stoga je važno osigurati one oblike smještaja koji će omogućiti skladnu i dostojanstvenu starost. Pri tome je potrebno uključiti stručnjake i širu društvenu zajednicu kako bi se prevenirale poteškoće mentalnog zdravlja i potaknulo aktivno zdravo starenje.Objective: The objective of this work is to examine differences of self-esteem, anxiety and depression levels in the elderly people placed in the Elderly care in comparison with those situated in their own homes. Social surroundings and type of a care in the elderly are of great importance for the adjustment of people to changes which come with senior age. Changes in the psychology of aging such as increased tension, stress, discontent and worries affect mental health of the elderly. Methods: There were three hundred examinees who took part in this intersected research. The basic group of examinees consisted of two patterns: the elderly placed in the Elderly care (150 examinees) and those placed in their own homes (150 examinees). The research was done in May and June, in 2018, in the Elderly and disabled people's home in Zadar, in their own homes and in the Health center surgeries of Zadar county. The questionnaire including sociodemographic features is used, as well as self-esteem scale (Rosenberg), anxiety disorder scale and patient depression questionnaire. The difference in self-esteem , anxiety and depression of the elderly placed in the Elderly care and in their homes is examined by using descriptive statistics and linear regression. Results: The elderly situated in the Elderly and disabled care have lower self-esteem, increased level of anxiety and depression in comparison with the elderly placed in their own homes. The older females living in their own homes show higher level of anxiety than the males, while in the Elderly care there was not found any difference according to gender. The elderly people with better education and at the very old age have lower self-esteem and show higher level of anxiety and depression. The elderly without merital status are more depressed than the others, while the higher anxiety is present only in the elderly people placed in the Elderly care. The level of anxiety and depression of the elderly does not vary in regard to the length of time of their staying in the Care, however, depression is more present in the people placed in double –bedded rooms. The people who live in their own homes in the countryside show greater anxiety than the ones living on the islands. Most elderly people who live in their own homes show minimal anxiety and depression, while the ones living in the Elderly care show moderate anxiety and mild depression. The greatest connection is the one between anxiety and depression and the least one is between self-esteem and anxiety. The resullts show higher contribution of depression in explanation of variance of self-esteem than the anxiety predictor. Conclusion: Type of a care for the elderly has significant impact on their mental health. As it is mentioned above , it is important to ensure the type of accomodation which enables the old age with harmony and dignity . Moreover, the experts and wider social community should be involved in this, in order to prevent mental health difficulties and to encourage active and healthy growing old