The Effect of Orientation Program Based on the Activities of Daily Living on Stress, Anxiety and Depression in the Elderly

Document Type: Original Article

Authors

1 Student of Master of Geriatric Nursing, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

2 Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

3 Department of Nursing Education, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

4 Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

Abstract

Background: This study aimed to analyze the effect of the Orientation Program based on Activities
of Daily Living on depression, anxiety, and stress in the elderly.
Methods: This is an experimental study on 65 elderly individuals living in 5 nursing homes in
Tehran in 2017 for 6 months (May to October). Samples were selected using non-random available
sampling methods and randomly assigned to intervention and control groups. Demographic
information questionnaire and 21-item version of the Depression Anxiety Stress Scale (DASS- 21)
were used. The elderly in the intervention group were subjected to the Orientation Program based on
Activities of Daily Living for 6 one-hour sessions for 1 month. DASS- 21 was measured before the
intervention, one month and two months after the intervention. Data were analyzed using SPSS V.
24 and Independent T-test, Mann-Whitney, Chi-Square and repeated measure ANOVA tests with a
significance level of P<0.05.
Results: The results showed differences between the two groups regarding depression, anxiety, and
stress one month after the intervention (P=0.003, P=0.005 and P<001, respectively). One month after
the intervention, the mean scores of depression, anxiety, and stress in the intervention group decreased
to 8±4.54, 4.5±3.09 and 7.53±5.42, respectively, and two months after the intervention, they decreased
to 8.25±4.44, 4.71±3.05 and 8.21±5.71, respectively.
Conclusion: According to the results, the Orientation Program based on Activities of Daily Living is
effective on depression, anxiety, and stress in the elderly. Considering the instability of the intervention
on the depression variable, further studies and long-term interventions are recommended.
Trial Registration Number: IRCT20180504039528N1

Keywords


 

  1. World Health Organization. World Health Statistics (Large Gains in Life Expectancy). Geneva: World Health Organization; 2014.
  2. Darabi S, Torabi F. Analysis and Comparison of Aging Population in Europe and Asia During 1950 to 2015. Iranian Journal of Ageing. 2017;12:30-43.[In Persian]
  3. World Health Organization. Aging and Life Course. Geneva: World Health Organization; 2014. [cited 4 April 2014]. Available from: http://www.who.int/ageing/en.
  4. Statistical Centre of Iran. Selected results of the 2016 national population and housing census. Tehran (Iran): Statistical Centre of Iran; 2016.
  5. Mojadam M, Eshghizadeh M, Johari Naeimi A. Assessing interpersonal communication skills of elderly in Gonabad city. Journal of Geriatric Nursing. 2015;2:29-38. [In Persian]
  6. Aghajanian A, Thompson V. Gender and living arrangements of the elderly in Iran. Asian Population Studies. 2016;12:177–86.
  7. Robinson KM. Policy issues in mental health among the elderly. The Nursing Clinics of North America. 2010;45:627-34.
  8. Shahrki SK, Abazari F, Nayer ND, Pouraboli B. An ethnographic study in nursing homes in Iran. International Journal of Palliative Nursing. 2018;24:540-7.
  9. Rajabizadeh G, Ramezani A. Prevalence of depression in elderly people in Kerman province in 2002. Journal of Rafsanjan University of Medical Sciences. 2003;3:58-65. [In Persian]
  10. Bryant C, Jackson H, Ames D. The prevalence of anxiety in older adults: methodological issues and a review of the literature. Journal of Affective Disorders. 2008;109:233-50.
  11. Zeraati M, Haghani*Zemeidani M, Khodadadi*Sangdeh J. The Comparison of Depression and Death Anxiety among Nursing Home Resident and Non-Resident Elderlies. Iran Jounal of Nursing. 2016;29:45–54. [In Persian]
  12. Unsar S, Dindar I, Kurt S. Activities of daily living, quality of life, social support and depression levels of elderly individuals in Turkish society. Journal of the Pakistan Medical Association. 2015;65:642-6.
  13. Bonder BR, Dal*Bello-Haas V. Functional performance in older adults. Philadelphia: FA Davis; 2008.
  14. Jeon HG, Sim JM, Lee KC. An empirical approach to analyzing effects of disease and activity limit on depression prevalence rate in the elderly depending on stress experience: Knhanes Data Analysis. Korean Journal of Health Education and Promotion. 2016;33:13-22. [In Korea]
  15. Zhilian GU, Yanwei CH. Change of mobility of urban elderly and effects on their daily life: a narrative analysis of the life of a retired couple living in an urban community. Progress in Geography. 2015;34:1617-27.
  16. Davin B, Paraponaris A, Verger P. Demographic and socioeconomic factors associated with needs for home assistance among community-dwelling elderly: a study from the French Home Survey Handicaps-Disabilities-Dependence. Rev Epidemiol Sante Publique. 2005;53:509-24. [In French]
  17. McPhee JS, French DP, Jackson D, et al. Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology. 2016;17:567-80.
  18. Millan-Calenti JC, Tubío J, Pita-Fernández S, et al. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Archives of Gerontology and Geriatrics. 2010;50:306-10.
  19. Taylor C, Lillis C, LeMone P. Fundamentals of nursing: The art and science of nursing care. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2001.
  20. Pourhossein*Alamdari M. The effect of using continuous care model on sleep quality and depression, stress and anxiety in patients with multiple sclerosis. [thesis]. tehran: Tarbiat Modares University; 2015. [In Persian]
  21. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy. 1995;33:335-43.
  22. Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. Journal of Iranian Psychologists. 2005;1:36-54. [In Persian]
  23. Moradipanah F, Mohammadi E, Mohammadil AZ. Effect of music on anxiety, stress, and depression levels in patients undergoing coronary angiography. Eastern Mediterranean Health Journal. 2009;15:639-47.
  24. Wood BM, Nicholas MK, Blyth F, et al. The utility of the short version of the Depression Anxiety Stress Scales (DASS-21) in elderly patients with persistent pain: does age make a difference? Pain Medicine. 2010;11:1780–90.
  25. Shah S, Muncer S. Sensitivity of Shah, Vanclay and Cooper’s modified Barthel index. Clinical Rehabilitation. 2000;14:551-2.
  26. Kutner MH, Nachtsheim CJ, Neter J, Li W. Applied Linear Statistical Models. 5th ed. New York: McGraw-Hill; 2005.
  27. Montazeri N, Sorbi MH, Ahmadi SM, Yazdanpoor S. Comparative study of depression, anxiety and stress between athletics and nonathletic elderly in 1392. Rehabilitation Medicine. 2014;3:15-21.
  28. Teixeira CM, Vasconcelos-Raposo J, Fernandes HM, Brustad RJ. Physical activity, depression and anxiety among the elderly. Social Indicators Research. 2013;113:307-18.
  29. Khajavi D, Khanmohamadi R. Predicting Depressive Symptoms of the Elderly According to Physical Activity Level and Demographic Characteristics: Examining the Role of Age and Gender. Development and Motor Learning (HARAKAT) .2015;7:87-103. [In Persian]
  30. Park IS, Kim NC. The effect of integrated recreation program on mood state, flexibility and stress of elderly women. Journal of the Korea Academia-Industrial cooperation Society. 2016;17:70–80. [In Korea]
  31. Salmon P. Effects of physical exercise on anxiety, depression, and sensitivity to stress: a unifying theory. Clinical Psychology Review. 2001;21:33-61.
  32. Pasco JA, Williams LJ, Jacka FN, et al. Habitual physical activity and the risk for depressive and anxiety disorders among older men and women. International Psychogeriatrics. 2011;23:292-8.
  33. Wegner M, Helmich I, Machado S, et al. Effects of exercise on anxiety and depression disorders: review of meta-analyses and neurobiological mechanisms. CNS & Neurological Disorders Drug Targets. 2014;13:1002–14.
  34. Herring MP, O’connor PJ, Dishman RK. The effect of exercise training on anxiety symptoms among patients: a systematic review. Archives of Internal Medicine. 2010;170:321–31.