AN INVESTIGATION INTO THE CORRELATION BETWEEN DEPRESSIVE SYMPTOMS AND SOCIAL PARTICIPATION ACTIVITIES AMONG OLDER ADULTS IN NIGERIA AND ITS IMPLICATIONS FOR NURSING

CHAPTER ONE

INTRODUCTION

Background of the study

Depression, a common mental condition, affects about 5% of the global adult population [WHO, 2023], significantly diminishing quality of life and incurring a substantial health cost. Depressive symptoms account for 7.5% of all years lived with disability [Moreno-Agostino, 2020] and are linked to self-harm and suicide, hence exacerbating the global illness burden. Depressive symptoms are more prevalent among older persons and constitute a significant danger to their health. The worldwide prevalence of depressive symptoms among older individuals was found to be 13.3% [Abdoli et al, 2022]. The prevalence of depressive symptoms among older individuals in Nigeria was 47.8% for those living alone, 33.2% for those living as a pair, and 39.5% for those living with children [Fu, Cao & Yang, 2023]. Consequently, mitigating and diminishing the risk of depression in older persons is a critical public health issue. Social involvement may influence depressed symptoms. While a globally acknowledged definition of social involvement in academics is lacking, Levasseau's term is often used [Liao & Zhou, 2022]. Levasseur conducted a content and activity analysis of 43 studies and stated that social participation denotes an individual's engagement in activities that facilitate connections with people in society or the community [Levasseur, Richard, Gauvin & Raymond, 2020]. The current evidence indicates that social involvement enables people to engage in significant everyday activities and cultivate more important social roles. Likewise, there is no agreement on the categorisation of social involvement. This research has identified 10 representative categories of social activities among older persons in Nigeria, considering the diverse cultural and social practices. Engaging in card games or drafts, together with socialising with friends over holidays, is a well entrenched practice in Nigeria, especially favoured by older Nigerian people [Liao & Zhou, 2022]. Tai-chi and square dance, as forms of physical fitness, provide additional social environments and subjects for discussion among older folks. In Nigeria, a growing number of older adults are organising groups to collectively establish exercise schedules and locations. Engaging in activities such as reading, watching television, and listening to the radio serves as a passive method for older adults to absorb social information [Wang, Fu, Hsieh, Lin & Yang, 2022], enabling them to remain informed about societal advancements. Household chores, gardening, and the care of domestic animals are prevalent activities in the daily lives of many elderly Nigerians, facilitating family connection and embodying their familial values [Fu, Cao & Yang, 2023]. Political actions among elderly persons in Nigeria are rather rare. Nonetheless, the quantity of community-organized services for senior citizens has progressively risen.Growing data indicates that social engagement activities may improve the psychological well-being of elderly individuals. A longitudinal research [13] shown that sustained social activity in later life was strongly associated with reduced depression symptoms. Comparable outcomes were seen in cohort studies including older persons in Japan, Korea, and the United States [Guo, Qin & Lee, 2022]. Social capital theory posits that social activity may enhance the social capital of older persons, hence fostering psychological well-being via strengthened emotional and material connections with other individuals [Fu, Cao & Yang, 2023]. The notion of social integration may also serve to elucidate. Social involvement enables older persons to participate with society and fosters a feeling of belonging, imparting significance to their life. This sensation of achievement and satisfaction is advantageous to their mental well-being. Certain forms of social involvement may negatively affect psychological well-being. Yue et al. [2015] discovered that household chores were predictive with heightened depressed symptoms. Consequently, we may postulate that different forms of social involvement exert differing directions and magnitudes of impact on depression symptoms. It is crucial to differentiate the effects of various forms of social interaction on depression symptoms. Unfortunately, there is a paucity of literature addressing this problem. Furthermore, the influence of sociodemographic characteristics must be highlighted while analysing the correlation between social involvement and mental health. Initially, gender disparities may be present. Takagi et al. [2015] indicated that females with increased social activity had reduced depressed symptoms. Older males had more pronounced correlations between depressive symptoms and membership in social and interest groups than older women. Secondly, elderly individuals residing in urban and rural environments participate in distinct social involvement activities, resulting in disparate effects on mental health. The inverse correlation between organised volunteer activities and depression is seen only in urban older individuals, whereas the protective effect of participating in hobby groups (e.g., playing mahjong and cards) is exclusively found among rural populations [Wang, Li & Fu, 2021]. Thirdly, older persons across various age cohorts may demonstrate distinct correlations between depression and social engagement. As abilities deteriorate and life expectancy decreases, elderly adults experience heightened alienation from society, resulting in less social involvement. Therefore, the researcher sought to investigate the correlation between depressive symptoms and social participation activities among older adults in Nigeria and its implications for nursing.

Statement of the problem

Depression is a substantial public health issue, particularly among the elderly, since it profoundly affects their entire quality of life and well-being. The incidence of depressive symptoms in senior people is intensified by several socioeconomic, health, and environmental variables, often resulting in isolation and diminished social engagement (Okoye, 2013). Social engagement, including involvement in community events, familial connections, and recreational endeavours, is seen as a crucial element for sustaining mental health in older persons (Levasseur et al., 2010). In Nigeria, cultural, infrastructural, and economic obstacles may impede the full participation of older adults in social activities, thereby exacerbating depressed symptoms. Despite increasing awareness of these challenges, there is a paucity of research investigating the relationship between depressed symptoms and social involvement activities especially among older persons in Nigeria. Considering that the senior demographic is often marginalised in healthcare policies and practices, it is essential to comprehend how their social engagement, or absence thereof, may influence their mental health. Hence, the need to investigate the correlation between depressive symptoms and social participation activities among older adults in Nigeria and its implications for nursing. 

1.3 Objective of the study

The broad objective of the study is to investigate the correlation between depressive symptoms and social participation activities among older adults in Nigeria and its implications for nursing. The specific objectives is as follows

To assess the prevalence of depressive symptoms among older adults in Nigeria.

To examine the types of social participation activities engaged in by older adults in Nigeria.

To investigate the relationship between social participation and the severity of depressive symptoms in older adults.

To recommend nursing interventions that can enhance social participation and reduce depressive symptoms in older adults in Nigeria.

1.4 Research questions

The following questions have been prepared to guide the study

What is the prevalence of depressive symptoms among older adults in Nigeria?

What are the types of social participation activities engaged in by older adults in Nigeria?

Is there a relationship between social participation and the severity of depressive symptoms in older adults?

What are the recommended nursing interventions that can enhance social participation and reduce depressive symptoms in older adults in Nigeria?

1.5 Significance of the study

Findings of the study will be significant for nursing practice, as it provides valuable insights into the role nurses can play in identifying depressive symptoms early and implementing interventions that encourage social participation as part of holistic care. As frontline healthcare providers, nurses are well-positioned to develop tailored care strategies that address both the mental and social needs of older adults. The findings of this study will also aid in designing community-based programs and nursing interventions aimed at reducing depression and enhancing the well-being of elderly individuals, ultimately improving their quality of life.  Findings of the study will also be significant to the academic community as it will contribute to the existing literature, add to library resources and serve as a guide to future academic researchers

1.6 Scope of the study

The study focus on the correlation between depressive symptoms and social participation activities among older adults in Nigeria and its implications for nursing. Empirically, the stsudy will assess the prevalence of depressive symptoms among older adults in Nigeria, examine the types of social participation activities engaged in by older adults in Nigeria, investigate the relationship between social participation and the severity of depressive symptoms in older adults and recommend nursing interventions that can enhance social participation and reduce depressive symptoms in older adults in Nigeria.

Geographically, the study will be delimited to University teaching hospital Ibadan, Oyo State.

1.7 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are: 

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.8 Definition of terms

Depressive Symptoms: Refers to a range of emotional and physical signs that characterize depression, including feelings of sadness, hopelessness, fatigue, and a loss of interest in activities. In this study, it pertains to the presence of these symptoms in older adults as measured by standardized screening tools such as the Geriatric Depression Scale (GDS).

Social Participation: Involves engagement in activities that involve interactions with others, such as community events, family gatherings, religious activities, or social clubs. For the purposes of this study, social participation refers to the frequency and types of social activities that older adults in Nigeria partake in.

Older Adults: Individuals aged 60 years and above, who are typically considered elderly or senior citizens. In this study, it specifically refers to older adults living in Nigeria.

Nursing Interventions: Actions taken by nurses to support the physical, mental, and emotional well-being of patients. In the context of this study, it refers to specific strategies aimed at reducing depressive symptoms and promoting social participation among older adults.

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