@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2019;11(4):223-231

Background
1-4] .... Care and support for the elderly is an important issue for the countries' health systems.
Previous Studies
... [5-10]. It has suggested that elderly caregivers have high levels of responsibility, depression, and stress, as well as reduced quality of life [5]. In a study on 50 veterans’ wives and 50 non-veterans' wives as the control group, it was found that the mean depression in the veterans’ wives was significantly higher than the control group. In this study, the researchers concluded that traumatic injury has a direct impact on their spouses' depression and family members of a veteran, especially his or her spouse facing with particular stressors who have to play different roles at the same time, will have higher levels of behavioral problems [11]. ... [12-23].
Aim(s)
The purpose of this study was to investigate the prevalence of depression among caregivers of elderly chemical veterans and determine the relationship between self-efficacy and depression.
Research type
This study was a cross-sectional descriptive-analytical study.
Research society, place and time
This study was carried out in 2018 in Sardasht city in south-west Azerbaijan.
Sampling method and number
The needed sample size was 131 subjects based on the study by Goodarzi et al. [24], in which the prevalence of depression has reported 21.3% [24] and considering the confidence factor of 93% and error of 5%, which was increased to 151 subjects due to the attrition of 15%. Deleting 8 incomplete questionnaires, finally the results of 142 questionnaires were analyzed.
Used devices&materials
The Sherer General Self-Efficacy Scale [25, 26] and Centre for Epidemiological Studies Depression (CES-D) Scale [27] were used for data collection. Control variables were collected using a demographic checklist, which included gender, age, marital status, employment status, education, place of birth and economic status based on the importance of individual and social variables in Bandura's theory. The economic class was defined based on of three variables: income, housing ownership, and self-perceived economic class using principal component analysis. The data were analyzed using SPSS 21 software and after checking the normal distribution of data by Kolmogorov-Smirnov test, Chi-square, Pearson correlation, multiple linear regression and logistic regression were used for analysis.
Findings by Text
The mean age of participants was 38.9 ± 6.17 years. 78.2% of the participants were men and 21.8% were women. The majority of respondents were in the age group of 31-40 years and most of the participants had high school education or diploma. The majority of caregivers were employed and married. Most caregivers had moderate level of economic status and were born in the city. About 35% of participants had low self-efficacy. Given the cut-off point of less than 5 in the CES-D questionnaires, the prevalence of depression among caregivers was 52.8%. The prevalence of depression was significantly lower in the subjects aged 41-50 years who were born in rural areas and those with high level of economic status (p <0.05; Table 1).There was a significant negative correlation between the mean depression score and the mean scores of self-efficacy and its dimensions (Table 2).There was a significant negative relationship between self-efficacy and depression. This relationship remained significant despite the presence of demographic variables (model 2) (Table 3).Intention and effort had a negative relationship with depression and among the dimensions of self-efficacy, behavioral intention had the greatest effect on changes in depression score. Thus, among three dimensions of self-efficacy, persistence on behavior had no significant relationship with depression (Table 4).After adjusting for demographic variables, self-efficacy, age and economic status were significantly correlated with the prevalence of depression. Caregivers who had higher self-efficacy (OR = 0.918; CI = 0.859-0981) as well as older caregivers (OR = 0.932; CI = 0.875-0.993) had lower level of depression. Also, caregivers with high level of economic status were less likely to be depressed than those in lower levels (OR = 0.267; CI = 0.65-0.948) (Table 5).
Main comparison to the similar studies
In this study, about half of caregivers had symptoms of depression. A similar study in Japan, depression in elderly caregivers was assessed using CES-D and 53.3% had depression [1]. CES-D has not been used in Iranian studies to measure caregivers’ depression; however, in a study by Gooderzie et al., mid-level depression measured by the Beck tool was 21.3% among caregivers, therefore, more than half of caregivers had symptoms of mild to severe depression [24]. ... [28-33]. The relationship between age and depression is also consistent with the results of a systematic meta-analysis conducted in 2018 by Cheng et al. assessing 30 articles. The results showed that age of caregivers had a significant negative relationship with depression [34]. Aging by more compatibility with burden of care and younger age associated with other problems, such as unemployment both can cause a negative relationship between age and depression, which needs to be more assessed in future studies. [15]. ... [35-37].
Suggestions
In future studies, it is suggested to examine in more detail the factors related to the depression of veterans’ caregivers.
Limitations
One of the limitations of the present study was its cross-sectional design, in which causal relationships between variables cannot be examined.
Conclusions
Caregivers of elderly chemical veterans with higher self-efficacy, older age, and higher economic class are less likely to develop depression.
Acknowledgments
Thanks to all the families of Sardasht chemical veterans who accompanied us in this study.
Conflict of interest
None.
Ethical Permissions
The Ethics Committee of the University of Social Welfare and Rehabilitation Sciences approved this study (IR.USWR.REC.1397.37).
Funding Sources
This study was extracted from a research (research ID: 2030) approved by the Center for Aging Research at the University of Social Welfare and Rehabilitation Sciences.

TABLES and CHARTS

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