S.Habibollah
Kavari, PhD
Assistant Professor of School of Management
and Medical Information Sciences,
Shiraz.
University of Medical Sciences, Shiraz,
Iran.
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In
a cross-sectional survey, depression prevalence
of 130 nurses in Shiraz Namazi hospital,
Iran, has been investigated by using long
form test items (21 questions) of Beck depression
questionnaire. Also necessary data for independent
variables was collected by interview.
The findings of this study indicated that
depression rates of mild, moderate and severe
types were 73.1%, 21.5% and 5.4%, respectively.
In this study a statistically significant
association has been found between depression
and marital status (P<0.0001), level
of education (P<0.005), overtime hours
at work (P<0.02) and parent's death in
childhood (before 11th year of age) (P<0.001).
Key Words: Depression; Nurses; Prevalence;
Beck questionnaire
Depression
encompasses feelings of indisposition, shortage
of energy, despair, uselessness, disinterestedness
and pessimism that may lead to suicide.
The prevalence of this disease in society
is 9 to 20 percent, but when more exact
criterion was taken into consideration for
measurement of mature depression, its prevalence
is 3% in men and 4 to 9% in women.(3).
Probability of suffering from depression
in duration of life, for women is almost
20% and for men 10% and that only 20 to
25 percent of people have criterions of
depression that have been cured. The prevalence
of depression is in women twice that of
men and age of beginning of depression varies
from childhood until the age of retirement
but in 50% of cases disease begins between
the ages 20 to 50. (Average age at the beginning
of this disorder is about age 40.) (3).
There is a direct relationship between onset
of depression and physical stress. In a
work environment physical, psychological
and social stimulants can contribute to
stress (4). In nurses a variety of stressors,
create a state of chronic weariness and
depression is the result of despair (5).
Nurses don't only assume the role of carers
but are also administrators and supervisors
of patients.(6). They perform the role of
advisor on the subject of hygiene and are
members of a group trained to be responsible
for public health, disease prevention, and
advocates for the full health of individuals,
of families and of society (7).
Nursing is a profession where depression
is apparent and documented ( 8). The abandonment
of nursing as a profession and a decrease
in the number of volunteers in this field
has been due to different reasons, with
one factor lack of job satisfaction. If
expectations of a nursing career, both professional
and personal are not met, discouragement
and disillusionment contribute to an abandonment
of the profession (9).Absenteeism due to
depression also causes problems ( 10)
In our research one aim was to compare the
rates of depression between our nurses and
those in other societies. Research focused
particularly on upper levels of stress in
nurses in Iran, compared to nurses in other
societies. 75.6% nurses have job stress
in the little and middle categories. (11).
It
is important to have a stress and depression
free, nursing profession, as nurses are
responsible for many services including
hygiene and the guaranteeing of a healthy
society. The present study was devised for
with the purpose of finding the levels of
depression in nurses in Shiraz Namazi hospital
and the connection with some effective factors..
These factors consisted of: age, marital
status, educational qualification, occupation
of spouse, education of spouse, number of
children, parent's death before 11th age
(at childhood), absence of support by relatives
in the preceding 6 months, continuous use
of contraceptives in the previous three
months, existence of present pregnancy,
rate of over time hours worked and rate
of night-shift hours.
Namazi
hospital is an important center of sciences
and medical technology in the south of the
country that performs many services which
entail heavy workloads and shortages of
staff leading to fatigue and depression.
The
type of study was cross-sectional. The study
population consisted of: 130 nurses from
Namazi hospital.
Information
was gathered by a questionnaire consisting
of two original parts, and included gathering
of social and occupational information.
A test of 21 questions, by Beck, was completed
first, by the nurses., Beck test appoints
different rates of depression from mild
till severe. The maximum grade in the test
is 63.This test is independent from culture
and isn't specific to any class or economic
or educational levels.
For
analyzing, information was used from statistical
tests analyzing variance and T test, in
SPSS software.
In
this study, 130 nurses were interviewed
and 73.1% of subjects had mild depression,
21.5% had moderate depression and 5.4% had
severe depression. (Table 1).
Table
1- Distribution of proportional abundance
of intensity of depression in Namazi hospital
nurses
Percent
|
Number
|
Intensity
of depression
|
73.1
|
95
|
Mild
|
21.5
|
28
|
Moderate
|
5.4
|
7
|
Severe
|
100
|
130
|
Total
|
The
depression prevalence according to independent
variables of marital status and parent's
death before 11th age (at childhood) has
been shown in Table 2.
The
maximum prevalence of severe depression
was observed in widowed persons and a group
that had lost their parents before 11th
year of age.
|
|
Statistical
specification of depression according to
independent variables has been shown in
Table 3. Between age, occupation of spouse,
education of spouse, number of children,
absence of relatives in last 6 months, continuous
using of contraception in last three months,
existence of present pregnancy and rate
of night-shift hours (hour per week) there
wasn't any meaningful connection with the
state of depression.
Between
depression prevalence with marital status
(P<0.0001), educational qualification
(P<0.006), parent's death before 11th
year of age (P<0.001) and rate of over
time hours per week (P<0.02) there was
a meaningful connection.
Table
2
- Distribution of depression intensity according
to different variables, before recent 6
months
Total
|
Severe
|
moderate
|
mild
|
Depression
|
percent
|
number
|
percent
|
number
|
percent
|
number
|
percent
|
number
|
Independent variables
|
Marital status
|
30.8
|
40
|
2.5
|
1
|
20
|
8
|
71.5
|
31
|
Single
|
59.2
|
77
|
2.6
|
2
|
16.9
|
13
|
80.5
|
62
|
married /
divorced
|
4.6
|
6
|
16.6
|
1
|
66.6
|
4
|
16.6
|
1
|
widow
|
5.4
|
7
|
42.9
|
3
|
42.9
|
3
|
14.3
|
1
|
parent's
death
before 11th age
|
12.3
|
16
|
25
|
4
|
43.8
|
7
|
31.2
|
5
|
yes
|
87.7
|
114
|
2.6
|
3
|
18.4
|
21
|
78.9
|
90
|
no
|
Table
3 - statistical specifications of depression
privilege according to independent variables
in Namazi hospital nurses
P<0.0001
|
|
marital status |
9.37 |
11.2 |
40 |
Single |
8.82 |
11.27 |
77 |
Married |
9.46 |
25.67 |
6 |
Divorced |
8.49 |
26.14 |
7 |
Widow |
P<0.006
|
|
educational document |
11.39 |
17.54 |
26 |
|
9.21 |
11.51 |
104 |
parent's death before
11th age |
P<0.001
|
9.97 |
23.56 |
16 |
Yes |
9.98 |
11.19 |
114 |
No |
P<0.02
|
|
rate of over times
hours (hour per week) |
9.57 |
12.03
|
72 |
Hours per
week |
12.33 |
18.5 |
22 |
0 - zero |
8.69 |
10.95 |
20 |
lower than 14 |
6.80 |
9.79 |
14 |
lower than 14 |
The
findings of this study showed that 21.5%
people studied have moderate depression,
and 5.4% have severe depression.
Therefore
it can be said that in total 26.9% have
notable depression.
In
this study the connection between depression
prevalence and marital status was meaningful
(P<0.0001). Divorced and widowed people
were more depressed than single and married
persons.
In
this concern we can say that social support
among family relations and matrimony have
an inverse relationship with creation of
stress and physical illness(12) and in subjects
without support, there are increased rates
of occupational stress. (13) Married nurses
experienced less occupational depression
due to support from family. (14). In the
research 41% of nurses studied supported
themselves 18% had a spouse and family (11)
37.5% divorced and widowed persons were
inclined to change their profession, while
this was 27.7% in married persons.
In
this study the inclination to change employment
was an issue for nurses(15) and with attention
to family and lack of formal support (16)
divorced and widowed persons had enjoyed
less social support from family memebers,
than married and single subjects.
In
this study there was a meaningful and inverse
relationship between intensity of depression
and level of education (P<0.005). When
nurses do not have sufficient clinical information
or training, this causes lack of confidence
(17) and we can conclude that with increasing
of levels of education and clinical information
income will increase and depression decrease.
The
correlation between depression prevalence
an parent's death before 11th age was seen
as a meaningful connection (P<0.001).Persons
who had lost parents before 11th year of
age, have been deprived of important support
in early years, and have undergone hardships
in formative years and this problem has
culminated in the appearance of the disorder.
In
our research on overtime hours per week
and the intensity of depression there was
a meaningful connection (P<0.02) between
the probability of increased work hours
leading to increased income for nurses and
in relation to occupational stress connected
with the rate of income of nurses (17) which
decreases depression.
Existence
of social supports is very important in
the workplace because there is an inverse
relationship between support by head nurses
and colleagues with occupational stress
of nurses (14).
Head
nurses and supervisors are the frontline
people best able to show attention, supporting
and cooperation (17). In our research only
45% of nurses mentioned receiving support
from these personnel. (11). Head nurses
especially should pay more attention to
young nurses requiring support because with
maturity such problems decrease with an
increase in support. (12).
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