Predicting factors of depression among persons with chronic medical illness in Bhutan

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Yezer Tshomo nujjaree Chaimongkol Pornpat Hengudomsub



This predictive study aimed to determine the factors associated with depression including age, gender, income, duration of illness, number of medical illness, physical activity, and social support among persons with chronic medical illness in Bhutan. A simple random sampling technique was conducted to recruit 120 adults diagnosed with chronic medical illness in a hospital, Bhutan. Data were carried out from March to April 2018. Research instruments were self-report questionnaires, including a demographic, the patient health, the global physical activity, and the medical outcomes study social support survey. Their reliability were range from .88-.93. Descriptive statistics and Stepwise multiple regression analysis were used to analyze the data.

Prediction analysis revealed 35.3% variance in the prediction of depression from five significant predictors. The best predictor was gender (male) (β = -.242), followed by age (β = -.218), physical activity (β = -.229), social support (β = -.202), and duration of chronic medical illness (β = -.168). These findings suggest that nurses and related health care providers could utilize to plan and develop an activity or intervention to lessen depression in persons with medical chronic illness by promoting social support and physical activity focusing on female, young and newly diagnosed patients.


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Bishwajit, G., O’Leary, D. P., Ghosh, S., Yaya, S., Shangfeng, T., & Feng, Z. (2017). Physical inactivity and self-reported depression among middle-and older-aged population in South Asia: World health survey. BMC geriatrics, 17(1), 100.

Boing, A. F., Melo, G. R., Boing, A. C., Moretti-Pires, R. O., Peres, K. G., & Peres, M. A. (2012). Association between depression and chronic diseases: results from a population-based study. Revista de saude publica, 46(4), 617-623.

Dhillon, P. K., Jeemon, P., Arora, N. K., Mathur, P., Maskey, M., Sukirna, R. D., & Prabhakaran, D. (2012). Status of epidemiology in the WHO South-East Asia region: burden of disease, determinants of health and epidemiological research, workforce and training capacity. International journal of epidemiology, 41(3), 847-860.

Dorji, G., Choki, S., Jamphel, K., Wangdi, Y., Chogyel, T., Dorji, C., & Nirola, D. K. (2017). Policy and governance to address depression and suicide in Bhutan: The national suicide-prevention strategy. WHO South-East Asia Journal of Public Health, 6(1), 39.

Goldberg, D. (2010). The detection and treatment of depression in the physically ill. World Psychiatry, 9(1), 16-20.

Gottlieb, S. S., Khatta, M., Friedmann, E., Einbinder, L., Katzen, S., Baker, B., . . . Fisher, M. L. (2004). The influence of age, gender, and race on the prevalence of depression in heart failure patients. Journal of the American College of Cardiology, 43(9), 1542-1549.

Grav, S., Hellzèn, O., Romild, U., & Stordal, E. (2012). Association between social support and depression in the general population: the HUNT study, a cross‐sectional survey. Journal of clinical nursing, 21(1‐2), 111-120.

Gunn, J. M., Ayton, D. R., Densley, K., Pallant, J. F., Chondros, P., Herrman, H. E., & Dowrick, C. F. (2012). The association between chronic illness, multimorbidity and depressive symptoms in an Australian primary care cohort. Social psychiatry and psychiatric epidemiology, 47(2), 175-184.

Hare, D. L., Toukhsati, S. R., Johansson, P., & Jaarsma, T. (2013). Depression and cardiovascular disease: a clinical review. European heart journal, 35(21), 1365-1372.

Kaewmart, N., Koedbangkham, J., & Nabkasorn, C. (2011). Factors influencing Depression among nursing students of Burapha University. Journal of Faculty of Nursing, Burapha university,19(Suppl 2), 83-95.

Katon, W. J. (2011). Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues in clinical neuroscience, 13(1), 7.

Khuwaja, A. K., Lalani, S., Dhanani, R., Azam, I. S., Rafique, G., & White, F. (2010). Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetology & metabolic syndrome, 2(1), 72.

Nan, H., Lee, P. H., McDowell, I., Ni, M. Y., Stewart, S. M., & Lam, T. H. (2012). Depressive symptoms in people with chronic physical conditions: prevalence and risk factors in a Hong Kong community sample. BMC psychiatry, 12(1), 198.

Neupane, D., Panthi, B., McLachlan, C. S., Mishra, S. R., Kohrt, B. A., & Kallestrup, P. (2015). Prevalence of undiagnosed depression among persons with hypertension and associated risk factors: a cross-sectional study in urban Nepal. PloS one, 10(2), e0117329.

Pelzang, R. (2012). The pattern of psychiatric admissions in a referral hospital, Bhutan. WHO South-East Asia Journal of Public Health, 1(1), 52.

Spearing, R., & Bailey, J. (2012). Depression and chronic physical illness: its prevalence and diagnosis, and implications for therapeutic practice. International Journal of Therapy & Rehabilitation, 19(7).

Tsai, T.-Y., Livneh, H., Lu, M.-C., Tsai, P.-Y., Chen, P.-C., & Sung, F.-C. (2013). Increased risk and related factors of depression among patients with COPD: a population-based cohort study. BMC public health, 13(1), 976.

Turner, J., & Kelly, B. (2000). Emotional dimensions of chronic disease. Western journal of medicine, 172(2), 124.

Wang, X., Cai, L., Qian, J., & Peng, J. (2014). Social support moderates stress effects on depression. International journal of mental health systems, 8(1), 41.

Weaver, L. J., & Hadley, C. (2011). Social pathways in the comorbidity between type 2 diabetes and mental health concerns in a pilot study of urban middle‐and upper‐class Indian women. Ethos, 39(2), 211-225.