ผลของโปรแกรมการปรับความคิดและพฤติกรรมด้วยตนเองต่อความรู้สึกมีคุณค่าในตนเองและภาวะซึมเศร้าของผู้สูงอายุที่เป็นโรคซึมเศร้า

Abstract

This quasi-experimental research, two-group pretest-posttest design, aimed to examine the effect of a self-guided cognitive behavioral modification program on self-esteem and depression of elders with major depressive disorder. Participants comprised 60 elders with major depressive disorder who were outpatients at the geriatric psychiatry clinic, Suansaranrom Hospital. They were selected using purposive sampling. Thirty participants were assigned to the experimental group receiving the self-guided cognitive behavioral modification program and thirty participants were assigned to the control group receiving usual care. The research instruments consisted of (1) Demographic questionnaire, (2) Self-esteem Scale, (3) Thai Geriatric Depression Scale, and (4) The Self-guided Cognitive Behavioral Modification Program based on the conceptual framework of cognitive behavioral therapy by Beck (2011) and literature reviews. Each participant attended three sessions conducted over a total duration of four weeks. All research instruments were checked for content validity by three experts and tested in subjects with similar characteristics to those of participants. The reliability of the Self-esteem Scale was tested using Cronbach's alpha Coefficient, yielding a value of 85 and the Thai Geriatric Depression Scale was tested using Kuder-Richardson 20, yielding a value of .87. Data were analyzed using frequency, percentage, mean, standard deviation and chi-square. The mean difference of self-esteem score and depression score were analyzed using paired t-test and independent t-test. The results revealed that: 1. After completing the program, the experimental group had a mean score of self-esteem significantly higher than that before participating in the self-guided cognitive behavioral modification program (p <.001) and significantly higher than that of the control group (p <.001) 2. After completing the program, the experimental group had a mean score of depression significantly lower than that before participating in the self-guided cognitive behavioral modification program (p <.001) and significantly lower than that of the control group (p = .005) The finding shows that the self-guided cognitive behavioral modification program could increase self-esteem and decrease depression of elders with major depressive disorder. Therefore, nurses could utilize the program to enhance self-esteem and decrease depression symptoms of elders with major depressive disorder.