American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) ISSN (Print) 2313-4410, ISSN (Online) 2313-4402 © Global Society of Scientific Research and Researchers http://asrjetsjournal.org/ A Comparative Study on the Level of Depression between Older Women Living in Retirement Homes in the City of Tirana and Those Living with Their Families in Tirana As Well Lorenc Barjami* University of Elbasan, Department of Psychology, Elbasan, Albania Email: lorenc_barjami@yahoo.com Abstract This paper/study examines the level of depression that exists between older women who live in different retirement homes in the city of Tirana in Albania and those who live with their families in Tirana as well. The methodology used for the compilation of this paper/study is predominantly quantitative, based on a sample of 100 older women. The 40 per cent of the sample lives in different retirement homes across the city of Tirana, while the other 60 per cent live with their families. Intentionally, and for the purposes of the study, it was chosen a smaller percentage of women living in retirement homes compared to those living with their families. The age of the sample ranges from 60 to 80 years old. Beck’s Depression Inventory (BDI-II) which is considered of having high reliability, cronbach’s (alpha) with a value.938, has been used for the data collection. The anonymity of the sample was taken into consideration during the application of Beck’s Depression Inventory. The Statistical Package for Social Sciences was used for the data analysis. The T-test analysis indicated a significant statistical difference on the level of depression that exist between the older women who lives in retirement homes (M = 32.78, DS = 10.599) and the depression level of older women who live with their families (M =15.77, DS = 6.253), t (98) = 9.144, p =.000, α < .05. ANOVA data support that older women living in retirement homes, present a higher levels of depression compared to older women living with their families t: F (1, 98) = 101.738, p = .001, α < .05. The argument put forward in this paper/study is that older women living in retirement homes in Tirana have experiences a higher level of depression than those living with their families. Keywords: Depression; Older Women; Retirement Homes; Family; ------------------------------------------------------------------------ * Corresponding author. 80 http://asrjetsjournal.org/ mailto:lorenc_barjami@yahoo.com American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 1. Introduction The world population is getting older very rapidly and the third age is mainly affected and suffering by this phenomenon. In every culture exist a different concept of how the third age is being seen or considered. For many individuals the last third of their life is considered as the last part of their life since during this period they are dealing with many challenges in order to survive. Our attitude toward the third age is often indifferent, making this category of people more vulnerable toward this phenomenon. However, the stance of our society towards the third age is often indifferent, making very difficult the identification of their real needs. Therefore, the third age is the main category of people exposed to psychological problems. According to author in [1], the diagnosis of depression in the last third of people’s life is considered to be a very difficult issue. According to author in [2], the detachment of older women from their families is accompanied by a psycho-social consequences such as the social isolation, and the loss of social interaction. According, author in [3], older women who live in retirement homes tend to present a higher level of depression because the cognitive system of belief to these women is more damaged compared to the system of these women who live with their families. This is happens because of the abandonment by their families which makes them to develop a low self-esteem creating in this way the predispositions for the appearance of depression. The main purpose of this study is identify whether exist any difference in the rate of depression feeling between the older women living in retirement homes in the city Tirana and those who live with their families. 1.1. Depression Depression refers to a wide number of mental illnesses and mental health problems characterized by the absence of positive affect/aspect (the loss of interest in doing every day/daily activities and the loss of enjoying them), the loss of the sense of humor, accompanied by different emotional, cognitive, physical and behavioral symptoms. In practice, it is very difficult to distinguish the behavioral or mood changes which happen normally from the major depression. However, the persistence, the severity, the presence of other symptoms and the level social impairment create the necessary basis for distinguishing them [4]. Some of the physical and behavioral symptoms are: tearfulness and sadness, irritability, social isolation, sleep deprivation, exacerbation of pre- existing pains and of the pains caused by the increase in muscular tension [5], loss of appetite, difficulty in sleep, loss of sexual activity, and the loss of interest in daily activities that produce pleasure. In generally depression is co-morbid with anxiety and with some others disorders to anxiety and mood, prevalence for major depression among 16- to 65-yearoldsin the UK is 21/1000 (males 17, females 25), but, if the less specific and broader category of ‘mixed depression & anxiety’ (F41.2, ICD-10, WHO, 1992) was included, these figures rise dramatically to 98/1000 (males 71, females 124). In mixed depression and anxiety, it can be seen that the gender ratio is more skewed to females [6]. 1.2. Theories of Depression The Psychodynamic View: This theory was written by Freud and it is based on the concept of loss. According to this theory the cause of depression is the loss of something that you love - human being or a subject. This loss can be a reality or an imagined situation [7]. Author in [8], investigated a number of widows and widowers one 81 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 year after the death of their spouses. Author in [8] mentions that 45 percent of his sample fit the criteria for the appearance and the diagnosis of depression. The Behavioral View: This viewpoint protects its idea who the depression is a learned behavior [9], one of the first researchers to suggest a link between depression and behavior, hypothesized depression develops as a result of a lack of positive reinforcement for the depressive's actions [10]. The Cognitive-Behavioral View: According to Beck's theory people who are suffering from depression are thinking in such a way that distorts their reality [3]. Depressed people, according to Beck, distort reality by harboring negative feelings about the future. They tend to take things too personally and have the impression that the future is bleak and dim [3]. These inferior feelings, according to Beck, lead to other negative experiences for the depressed people. Thus, their feeling of inferiority is growing more [11]. Biological View: In the early 1980s, for the first time, it became possible the depiction of brain and how it functions in depressed people [12]. The studies showed that at least the half of the depressed people examined had increased levels of activity in the hypothalamic – pituitary - adrenal axis of the brain [12]. Other medical evidences also support the biological model of depression which are that in the adrenal glands of depressed people it is identified a higher than normal amount of cortisol discharges, and eccentric brain wave patterns as recorded by electroencephalograms (EEGs) [12]. 1.3. Research Questions This study is addressing two main research questions: 1- Is there any difference in the levels of depression that exist between older women living in retirement homes in the city of Tirana and those living with their families? 2- What is the level of depression of older women living in retirement homes in the city of Tirana and the level of depression of older women living with their families? 1.4. The hypothesis Hypothesis of this study is: Older women live in retirement homes in the city of Tirana, appear higher levels/rates of depression than older women who live with their families. 1.5. Methodology Sample The total sample of this study consists of 100 elderly women. The 40 percent of the sample is living in different retirement homes in the city of Tirana, while the other 60 per cent is living with their families. The age of the sample ranges from 60 80 years old. All women participated in this study belong to middle and lower classes. 82 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 1.6. Tools Used Beck’s Depression Inventory (BDI-II) was used for the data collection of the study. The questionnaire consists of 21 multiple-choice questions; Beck’s test is the most popular psychometric tests used for the measurement of depression’s rate. It has higher test reliability (.93) and a high internal consistency (.91). The highest the score of the test, the bigger the level of depression Apart from this positive aspect there are also some limitations: BDI suffers from the same problems as other self-report inventories, since the score of the test can be easily maximized or minimized by the person who completes it. 1.7. Procedures The sample of this study was intentional, and for this reason it was selected a smaller number of older women who lives in different retirement homes in the city of Tirana. More concretely in the only public retirement home in Tirana “The home of elderly “ were living 20 women, in the private retirement home “The Rays of Life” were living 10 women, in the private retirement home “Missionaries of charity for women” were living 18 women and finally, in the private retirement home “Joshua Center” were living 4 women. All this information was taken by the State Social Services in Albania. Confidentiality and anonymity were taken into consideration during the application of Beck’s Depression Inventory. 2. Results 2.1. The sample data Figure 1 shows the distribution of the sample - 40 percent of older women live in retirement homes in the city of Tirana, while the other 60 per cent live with their families in Tirana as well. Figure 1: Distribution of sample in base to domicile 83 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 2.2. The analysis of reliability coefficient Frequency of depression levels Figure 2: Distribution of depression level This figure shows the level of depression experienced by the women who participated in the study: 10 per cent of them have experienced normal level of depression, 32 per cent have experienced small mood disorders, 15 percent have experienced disorders of borderline depression, 18 per cent have experienced moderate depression disorders and finally, 13 per cent have experienced severe levels of depression. 2.3. The Cronbach's alpha coefficient for reliability Results over Cronbach's α (Alpha) in table 1 showed that the reliability of Beck’s Depression Inventory is very high, (21- statements, α = .938). 2.4. Cross Tabulation Analysis The results presented in the table 2 show that none of the women who live in retirement homes in the city of Tirana has experienced normal symptoms of depression. On the contrary, the 16.7 per cent of the women who live with their families have displayed normal symptoms of depression. The 3.6 per cent of them living in retirement homes have experienced light mood disorders, while the percentage for them who live with their families is 51.7per cent. The 17.9per cent of women living in retirement homes has experienced border 84 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 symptoms of depression, while the percentage for them who live with their families is 16.7 per cent. The 46.4 per cent of sample that lives retirement homes has experienced moderate symptoms of depression, while for the other category the percentage is only 8 per cent. The percentage of women who live in retirement homes and have experienced severe symptoms of depression is 32.1per cent, while for them who live with their families is 6.7 percent Table 1: The coefficient of alpha reliability for depression Reliability Statistics Cronbach's Alpha Number of statements .938 21 Table 2: The differences in level of depression between two groups Group of depression/ cross tabulation Group Total Live in residential centers Live in homes The Depression Normal The value 0 10 10 % about depression 0.0% 100.0% 100.0% % about group 0.0% 16.7% 11.4% % total 0.0% 11.4% 11.4% Light disorders of depression The value 1 31 32 % about depression 3.1% 96.9% 100.0% % about group 3.6% 51.7% 36.4% % total 1.1% 35.2% 36.4% Borderline depression The value 5 10 15 % about depression 33.3% 66.7% 100.0% % about group 17.9% 16.7% 17.0% 85 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 % total 5.7% 11.4% 17.0% Depression of moderate The value 13 5 18 % about depression 72.2% 27.8% 100.0% %about group 46.4% 8.3% 20.5% % total 14.8% 5.7% 20.5% Depression of Severe The value 9 4 13 % about depression 69.2% 30.8% 100.0% % about group 32.1% 6.7% 14.8% % total 10.2% 4.5% 14.8% Total The value 28 60 88 % about depression 31.8% 68.2% 100.0% % about group 100.0% 100.0% 100.0% % total 31.8% 68.2% 100.0% Figure 3: Distribution of depression level 86 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 2.5. Analysis through T-test: Analysis through T-test has shown that has statistical main differences regarding depression between elderly women who are living in residential centers to elderly (M = 32.78, DS = 10.599) and elderly women who are living in family(M =15.77, DS = 6.253), t (98) = 9.144, p = .000, α < .05. Table 3: The differences in report of depression between two groups through t-test t-Test Levene's test is used to assess the equality of variances. Levene's test is used to assess the equality of variances. F Sig. t gl Sig. (2- tailed) The difference s In average standard error 95% The differences in interval of reliability down up The depression the supposed equality of variances 30.0 94 .000 10.08 7 98 .000 17.008 1.686 13.662 20.355 the equality of without supposed of variances 9.144 57.16 4 .000 17.008 1.860 13.284 20.733 2.6. Analysis of Depression through ANOVA Table 4: Analysis through ANOVA for depression ANOVA The depression Sum of squares Gl Mean of squares F Sig. Between groups 6942.802 1 6942.802 101.738 .000 Within groups 6687.708 98 68.242 Total 13630.510 99 87 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 The analysis of depression through ANOVA between these two groups showed that exist main statistical differences. F (1, 98) = 101.738, p = .001, α < .05. F's rate (101.738) is important (p = 0.000) in level α < .05. Number 1 is the degrees of freedom in the groups, 98 is the group’s degree of freedom, 101.738 is value of degrees F, 0.000 is the value of P. In this case (H0) that supposed that hasn't differences between two groups in level of depression, which was rejected, in as much as p < α. Figure 4: The differences between two groups of depression From the graph is clear that older women living in retirement homes in Tirana present/appear higher level of depression than older women living with their families. There is a relatively high average between the two groups. The value of the first group (women who live in retirement houses) is about 33 and the value for the second group of women is about 16.Therefore, the difference is evident. 3. Discussion The total sample of this study consists of 100 elderly women. The 40 percent of the sample is living in different retirement homes in the city of Tirana, while the other 60 per cent is living with their families. The age of the sample ranges from 60 80 years old. All women participated in this study belong to middle and lower classe.Beck’s Depression Inventory (BDI-II) which is considered of having high reliability, cronbach’s (alpha) with a value.938, has been used for the data collection. Results for depression have showed that the level of depression experienced by the women who participated in the study: 10 per cent of them have experienced normal level of depression, 32 per cent have experienced small mood disorders, 15 percent have experienced disorders of borderline depression, 18 per cent have experienced moderate depression disorders and finally, 13 per cent have experienced severe levels of depression. Results through cross tabulation have shown that none of the women who live in retirement homes in the city of Tirana has experienced normal symptoms of depression. On the contrary, the 16.7 per cent of the women who live with their families have displayed normal symptoms of depression. The 3.6 per cent of them living in retirement homes have experienced light mood disorders, while the percentage for them who live with their families is 51.7per cent. The 17.9per cent of women living in 88 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 retirement homes has experienced border symptoms of depression, while the percentage for them who live with their families is 16.7 per cent. The 46.4 per cent of sample that lives retirement homes has experienced moderate symptoms of depression, while for the other category the percentage is only 8 per cent. The percentage of women who live in retirement homes and have experienced severe symptoms of depression is 32.1per cent, while for them who live with their families is 6.7 per cent. Analysis through T-test has shown that has statistical main differences regarding depression between elderly women who are living in residential centers to elderly (M = 32.78, DS = 10.599) and elderly women who are living in family (M =15.77, DS = 6.253), t (98) = 9.144, p = .000, α < .05. The analysis of depression through ANOVA between these two groups showed that exist main statistical differences. F (1, 98) = 101.738, p = .001, α < .05. F's rate (101.738) is important (p = 0.000) in level α < .05. Number 1 is the degrees of freedom in the groups, 98 is the group’s degree of freedom, 101.738 is value of degrees F, 0.000 is the value of P. In this case (H0) that supposed that hasn't differences between two groups in level of depression, which was rejected, in as much as p < α. Results over Cronbach's α (Alpha) showed that the reliability of Beck’s Depression Inventory is very high, (21- statements, α = .938). 4. Conclusion It is evident from these findings that the aged women who are living in different residential centers to elderly in Tirana Town (old age homes) are more depressed, than the aged women who are living in their families. It can be said that the well-being of the older adults is markedly affected by the feeling of alienation from the family. Acknowledgements There are many people that I would like to thank for their contribution to this paper. I would particularly like to thank my colleagues Marjo Blloshmi and Leonard Muça who helped me with the field research. A special thank goes also to all these women who participated in this study and to the Retirement Home’s Directors who opened these houses for the realization of my paper. References [1] Rush, A. John. Handbook of Psychiatric Measures. Washington, American Psychiatric Association, 2000, 153-160. [2] Dubey, A. Basin, S., Gupta, N & Sharma, N. (2011). A study of elderly living in old age home and within family set up in Jammu, India, 2011, 94-96. [3] Wetzel, J. W. (1984) Women and health psychology, New York, 2014, 31-50. [4] Mughal, M, Wasim., Fatma, N. Psychological Well-Being and Depression Among Inhabitants of Old Age Homes of Jaipur, Rajasthan. Jaipur, 2015, 271-273. [5] Koul, P., Shekhar, Ch., Kour, T. “Old age and adjustment: Gender differences in Institutionalized non- Institutionalized elderly”, Volume 2, Jammu-Tawi, Oct.-Nov.-Dec. (2013), 31-33. 89 American Scientific Research Journal for Engineering, Technology, and Sciences (ASRJETS) (2015) Volume 14, No 2, pp 80-90 [6] Munk, K. (2007). Late - life Depression, Nordic Psychology, 59 (1), 7-26. : http://dx.doi.org/10.1027/1901- 2276.59.1.7 [7] Robbins, R. (1993) Depression: What is, theories, treatment, hope.: http://www.holysmoke.org/sdhok/why- dep.htm [8] Achterberg, W., Margriet Pot, A., Kerkstra, A., & Ribbe, M .Depressive symptoms in newly admitted nursing home. The International Journal of Geriatric psychiatry.vol.21, 1158-1162, December 2006. [9] Wason, N., Baid, P. Evaluation of Cognitive Status among the Elderly. Indian Journal of Gerontology, Vol. 26,537-542, march 2012. [9] Onya, O N, Stanley, P C. Risk Factors for Depressive Illness among Elderly Gopd Attendees at Upth. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS).vol.5, 77-83, March - April 2013. [10] Moos, R.H., Schuttte, K.K., Brennan, P.L. & Moos, B.S. The Interplay between Life Stressors and Depressive Symptoms among Older Adults. Journal of Gerontology: Psychological Sciences. Vol.60, pp.199- 203, 2005. [11] Daanesh. M, Umrigar.,R.S. Mhaske. Personality Differences Among the Institutionalized and Non- Institutionalized Aged. Indian Journal of Gerontology. Vol. 26, No. 4,502–509, March 2012. [12] Bhatt, M, Bindu., Vyas, Sh., Joshi, P, Janak. Ageing and health: “A Health Profile of inmates of old age home”. Open Access Journal, 5(1), 1-4. Available:www.njcmindia.org (2014). [13] Beck,A .(1996). Beck Depression Inventory BDI-II. (Appendix 14 Beck Depression Inventory). 90 http://dx.doi.org/10.1027/1901-2276.59.1.7 http://dx.doi.org/10.1027/1901-2276.59.1.7 http://www.holysmoke.org/sdhok/why-dep.htm http://www.holysmoke.org/sdhok/why-dep.htm A Comparative Study on the Level of Depression between Older Women Living in Retirement Homes in the City of Tirana and Those Living with Their Families in Tirana As Well Lorenc Barjami* University of Elbasan, Department of Psychology, Elbasan, Albania Email: lorenc_barjami@yahoo.com Abstract References [1] Rush, A. John. Handbook of Psychiatric Measures. Washington, American Psychiatric Association, 2000, 153-160. [2] Dubey, A. Basin, S., Gupta, N & Sharma, N. (2011). A study of elderly living in old age home and within family set up in Jammu, India, 2011, 94-96. [3] Wetzel, J. W. (1984) Women and health psychology, New York, 2014, 31-50. [4] Mughal, M, Wasim., Fatma, N. Psychological Well-Being and Depression Among Inhabitants of Old Age Homes of Jaipur, Rajasthan. Jaipur, 2015, 271-273. [5] Koul, P., Shekhar, Ch., Kour, T. “Old age and adjustment: Gender differences in Institutionalized non- Institutionalized elderly”, Volume 2, Jammu-Tawi, Oct.-Nov.-Dec. (2013), 31-33. [6] Munk, K. (2007). Late - life Depression, Nordic Psychology, 59 (1), 7-26. : http://dx.doi.org/10.1027/1901-2276.59.1.7 [7] Robbins, R. (1993) Depression: What is, theories, treatment, hope.: http://www.holysmoke.org/sdhok/why-dep.htm [8] Achterberg, W., Margriet Pot, A., Kerkstra, A., & Ribbe, M .Depressive symptoms in newly admitted nursing home. The International Journal of Geriatric psychiatry.vol.21, 1158-1162, December 2006. [9] Wason, N., Baid, P. Evaluation of Cognitive Status among the Elderly. Indian Journal of Gerontology, Vol. 26,537-542, march 2012. [9] Onya, O N, Stanley, P C. Risk Factors for Depressive Illness among Elderly Gopd Attendees at Upth. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS).vol.5, 77-83, March - April 2013. [10] Moos, R.H., Schuttte, K.K., Brennan, P.L. & Moos, B.S. The Interplay between Life Stressors and Depressive Symptoms among Older Adults. Journal of Gerontology: Psychological Sciences. Vol.60, pp.199-203, 2005. [11] Daanesh. M, Umrigar.,R.S. Mhaske. Personality Differences Among the Institutionalized and Non-Institutionalized Aged. Indian Journal of Gerontology. Vol. 26, No. 4,502–509, March 2012. [12] Bhatt, M, Bindu., Vyas, Sh., Joshi, P, Janak. Ageing and health: “A Health Profile of inmates of old age home”. Open Access Journal, 5(1), 1-4. Available:www.njcmindia.org (2014). [13] Beck,A .(1996). Beck Depression Inventory BDI-II. (Appendix 14 Beck Depression Inventory).