Physical disability, perceived dependence and depression in women with osteoarthritis / 農村醫學 地域保健

ABSTRACT

OBJECTIVE: This study assessed whether both physical disability and perceived dependence relate to depression or whether perceived dependence in personal care activities, household activities, community mobility and recreational activities is an intermediate step in the relationship between physical disability and depressive symptoms. METHODS: Data come from a cross-sectional survey of 209 women, aged 55 or older, with osteoarthritis (OA). Mediation analyses occurred in four step and included logistic regression analyses as outlined by Baron & Kenny. RESULTS: The results from step 1 showed that greater difficulty with each domain of physical disabilities was significantly related to greater perceived dependence. In step 2, greater perceived dependence was significantly associated with greater depressive symptoms in all domains. Step 3 analyses showed that greater physical disabilities in each domain were significantly associated with depression. The final step testing mediation indicated that personal care activities, household activities and community mobility were fully mediated by perceived dependence. That was, once dependence was taken into account, the relationship between physical disabilities and depression was no longer significant. Partial mediation was found for dependence and recreational activity limitations. CONCLUSION: It is important to take into account the experience of perceived dependence as a mediator in understanding the relationship between disability and depression in the domains of personal care, household, and community mobility. To conclude, these findings point to the importance of taking into account an individual's reaction to their disability rather than just focusing on the severity of disability.