Scientists Explore Link Between Perceptions of Dependence and Depression Symptoms
Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage-the cushioning material at the end of long bones. It can causes changes in the structures around the joint including fluid accumulation, bony overgrowth, and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.
Researchers based at Toronto Western Research Institute in Ontario, Canada say they were intrigued by disparities in older women''s feelings about needing help with activities due to the physical limitations caused by their OA.
"We heard some people say that when they got help from people, that made them feel independent. But other times, we heard people say that when they got help, they felt dependent," says Monique Gignac, PhD, a senior scientist in health care and outcomes research. She and her colleagues, including epidemiologist Elizabeth Badley, PhD, wanted to find out more about why people with OA may perceive seeking help differently, and whether perceived dependence would relate to negative moods.
The researchers conducted surveys of a cross section of 209 women with OA, all 55 or older. Their questions delved into how dependent they felt when seeking help in four different areas: personal care, household activities, community mobility and valued activities. Then, they asked the participants how seeking or receiving help for these tasks made them feel, and how they perceived themselves because their OA-related disabilities caused them to seek help. The researchers did not score the participants for clinical depression; but used standardized questions to gauge mood problems and perceptions.
Results showed that on average, participants all had mild to moderate disability related to their OA, and perceived dependence. The findings showed that 28.7 percent of the women surveyed had depression scores greater than or equal to 16, indicating depressive symptomology. Greater perceived dependence was associated with greater depressive symptoms, such as feeling blue, crying often or worrying. Needing help may have had a negative impact on these women''s self-image, which then contributed to their negative mood.
The researchers suggest that needing help may have had a negative impact on these women''s self-image, which then contributed to their negative mood. "We found that if you had difficulties or activity limitations that led you to feeling dependent, you were more likely to have a depressed mood," says Dr. Badley. "Feeling you are dependent on others, rather than independent, may give you poorer mental well-being."
Health care professionals may use these findings to explore ways to help older OA patients perceive themselves differently when they seek help for daily activities like housework or personal care, says Dr. Gignac. "There may be a need for relabeling feelings you have about getting help. It''s up to you. You can tell yourself, 'I''m getting help so I can get around and do the things I want to do, and isn''t that great?'' That would be an important step toward feeling better."
Funding for this study was provided by grant 410970184 from the Social Sciences and Humanities Research Council of Canada and by the Ontario Ministry of Health, Health System-Linked grant to the Arthritis Community Research and Evaluation Unit.