|Year : 2014 | Volume
| Issue : 6 | Page : 728-731
Perceived levels of stress and its correlates among residents of old age home in Kanchipuram District, Tamil Nadu
Geetha Mani, Sharath Udayakumar, Kalaivani Annamalai, D Jegadeesh Ramasamy
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kanchipuram, Tamil Nadu, India
|Date of Web Publication||18-Nov-2014|
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Thirupporur-Guduvancherry Main Road, Sembakkam Post, Kanchipuram - 603 108, Tamil Nadu
Source of Support: This study was supported by the Indian Council
of Medical Research-Short Term Studentship Program 2012 (ICMRSTS
2012)., Conflict of Interest: None
Introduction: Elderly are vulnerable to stress from various causes. The elderly in old age homes are a distinct population with lack of family and social support contributing to an increased prevalence of stress. This study was carried out to assess the perceived stress among inmates of an old age home in Kanchipuram District, Tamil Nadu. Materials and Methods: A descriptive, cross-sectional study was conducted among 100 inmates of an old age home in Kanchipuram District, Tamil Nadu between May and July 2012, using a semi-structured questionnaire. Perceived levels of Stress among elderly were assessed using the perceived stress scale-10. Results: Nearly 18% of the participants had high stress scores and 60% had moderate stress scores. Gender, co-living status with spouse was found to be significantly associated with stress scores. Conclusion: The perceived stress was high among inmates of old age homes. There is a need for organized family and social support to improve the physical and psychological health of elderly. Exploratory research studies are necessary to identify the problems among elderly, especially those in old age homes.
Keywords: Elderly, old age homes, perceived stress scale, stress
|How to cite this article:|
Mani G, Udayakumar S, Annamalai K, Ramasamy D J. Perceived levels of stress and its correlates among residents of old age home in Kanchipuram District, Tamil Nadu. Med J DY Patil Univ 2014;7:728-31
|How to cite this URL:|
Mani G, Udayakumar S, Annamalai K, Ramasamy D J. Perceived levels of stress and its correlates among residents of old age home in Kanchipuram District, Tamil Nadu. Med J DY Patil Univ [serial online] 2014 [cited 2022 Nov 26];7:728-31. Available from: https://www.mjdrdypu.org/text.asp?2014/7/6/728/144860
| Introduction|| |
The world is ageing. By 2050, the population of people aged 60 and over is expected to reach 2 billion or 21% of the total global population. Today over 60% of the world's older persons 60 and over live in the developing world. This figure is expected to rise to 85% by 2050.  India's current older population of 60 million is projected to exceed 227 million in 2050, an increase of nearly 280% from today. 
The ageing of the world's population in both developed and developing countries is an indicator of improving global health. However, ageing also challenges society to adapt to these improvements, in order to maximize the health and functional capacity of older people as well as their social participation and security. 
With ageing comes an increased risk of developing chronic diseases and disability. Apart from physical health issues, they are more likely to suffer from mental and psychological distress.  Stigmatizing attitudes and common stereotypes often prevent them from participating fully in society and cause undue stress. There are several causes of stress, unique to or more common in elderly. The most frequent stressful life circumstances that affect older adults involve health, interpersonal, financial or work-related events. Loss of a spouse or separation, deaths in the family and lack of social integration are common stressors, which may themselves cause physical and mental ill-health. Physical incapacity, decline in the mental faculties and feeling of the generation gap, add to the problems. ,,,,, Chronic and prolonged stress in turn are potentially pathogenic.  Elderly in old age homes are a distinct population with lack of family support. The issues of loneliness and loss or separation from loved ones add to the already existing social insecurities decreasing their ability to cope with problems of old age.
Institutional care was not a regular feature in developing nations like India until recent times. Caring for elderly had been part of the joint family system in India. However, with an increasing economic demands forcing more people to take up employment to meet the demands, with migration to urban areas and foreign countries, the traditional extended family system is slowly crumbling and more elderly are being left to the care of old age homes. At present, there are about 250 old age homes in Tamil Nadu.  There is a paucity of studies assessing the health status of elderly in old age homes in Tamil Nadu. This study was carried out to assess the perceived levels of stress among elderly residing in an old age home in Kanchipuram District.
| Materials and Methods|| |
This is a descriptive cross-sectional study conducted among elderly, aged 60 years and above residing in an old age home in Kanchipuram District of Tamil Nadu during the period May 2012 to July 2012. Sri Kumaran Home for aged in Kanchipuram District was selected for the study.
A semi-structured questionnaire was prepared in English, translated into the local language, back translated into English to test for consistency and clarity. The schedule consisted of 3 parts, Part A - socio-demographic profile, Part B - other personal information, Part C - perceived stress scale. Part C of the questionnaire was adopted from Olpin and Hesson stress assessment.  This scale was developed by Cohen et al. and has been demonstrated to have satisfactory internal consistency and construct validity. , This schedule contains 10 items. Among the 10 items, 6 items - 1, 2, 3, 6, 9, 10 are negatively worded and 4 items - 4, 5, 7 and 8 are positively worded. When computing the total score, the four positive items were reversely coded and then added to the six negative items and hence that a higher total score denotes greater perceived stress. The schedule was pretested by applying to a population similar to the study population, the data of which was not included in the study.
Institutional Ethics Committee approval was obtained for conduction the study. All the 100 residents aged above 60 years were included in the study. The participants were explained about the study in the local language. The participation was voluntary. A written informed consent was obtained. The questionnaire was administered by the investigator in the local language.
Data was entered in Microsoft Office Excel version 2007 (Microsoft Corporation) spreadsheet and analysis was carried out using Statistical Package for Social Sciences software version 12.0 (SPSS Inc.). Descriptive statistics and perceived levels of stress were expressed in percentages. Chi-square test was used to analyze the significance of difference between subgroups. Fisher's exact test was used if any of the cells had values less than 5. P < 0.05 was considered to be significant.
| Results|| |
There were 100 persons aged 60 and above and all of them participated in the study (participation rate 100%).
The number of elderly in age groups 61-70 years, 71-80 years and above 80 years was 50, 36 and 14 respectively. Out of a total of 100 participants, 51 were male and 49 were female. Nearly 5% had no formal schooling, 12% had completed primary school, 41% had completed middle school, 25% high school and 17% had completed college respectively. Nearly 86% were married, whereas the remaining 14% were unmarried, widowed or separated.
Other Personal Details of Participants
Nearly 72% were financially independent, 28% were partially or entirely dependent on their families or sponsors for their living. 28% of them had been living in the old age home for less than 2 years, 33% for 2-5 years and 39% for more than 5 years. 26% lived with their spouse and 74% lived alone in the home and 2 persons were addicted to tobacco. 60% of the participants had co-morbid chronic diseases such as Diabetes mellitus (15%), systemic hypertension (13%), coronary heart disease (1%) and chronic obstructive pulmonary disease (31%). 56% spend their leisure time in group activities with others, the remaining 44% spend leisure time alone. The distribution of responses to stress related symptoms are shown in [Table 1].
The mean stress score of the participants was 19.66 with a standard deviation of 7.37 (95% confidence interval 18.2-21.1). The distribution of stress levels among the participants is given in [Table 2]. Distribution of perceived stress scores among subgroups is shown in [Table 3].
|Table 3: Distribution of perceived stress scores among subgroups of the study population|
Click here to view
| Discussion|| |
A total of 100 inmates aged above 60 participated in our study. The mean stress score of the participants was 19.66 with a standard deviation of 7.37. High stress scores were found in 18% of the study participants. Nearly 60% of the participants presented with moderate stress. Only 22% of the participants had low stress scores. Hence close to 80% of inmates suffer from moderate or high levels of stress.
The proportion of study participants with high stress scores increases with increasing age, though the association is not significant. Comparing the stress scores between males and females, higher proportion of females had high stress scores and the difference was statistically significant. Similar association between sex and stress levels among elderly has also been reported by Wang et al. and Castillo et al. ,
A higher proportion of the following subgroups had higher stress scores-those with lower educational levels, unmarried/widowed or separated status, financial dependency, longer duration of stay at home, living alone in the home, associated chronic disease and spending leisure time alone. Abrahams and Patterson in their studies have reported that financial independency and higher socio-economic status played a protective role against psychological stress. 
A proportionately higher number of participants who live in the old age home without their spouses have moderate and high scores compared with those who live with their spouses. This association is statistically significant. Wang et al. has reported a significant association between educational level, living arrangement with spouse and stress levels among rural elderly.  Haseen et al. in his study on self-perception of health among elderly has reported a significant association between poor perception of health and sex, marital status and co-living with spouse.  Narkhede et al. has also reported that elderly who live with their spouses in old age homes had better scores on psychological well-being. 
Our study has few limitations. This old age home was selected by convenient sampling. So the results may not typify the elderly in other old age homes. Responses given by the participants were self-reported, hence the severity of the co-morbid conditions could not be assessed.
| Conclusion|| |
Perceived levels of stress was high with 80% of the study population having moderate to high stress scores. A higher proportion of females had moderate and high stress scores compared to males. Co-living status with spouse was a protective factor against stress. Our study provides useful baseline information on stress among elderly in old age homes. More research activities, especially qualitative research should be encouraged to explore the problems in this population.
| Acknowledgments|| |
The authors are grateful to the participants for their enthusiastic participation in the study.
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[Table 1], [Table 2], [Table 3]
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