Effect of pain on depression among nursing home residents: Serial mediation of perceived social support and self-rated health. A cross-sectional study

Geriatr Gerontol Int. 2020 Dec;20(12):1234-1240. doi: 10.1111/ggi.14067. Epub 2020 Oct 22.

Abstract

Aim: The aim of this study was to investigate how perceived social support and self-rated health together could mediate the relationship between pain and depression among Chinese nursing home residents with pain.

Methods: The study was conducted in 38 nursing homes in 13 cities in China. A convenience sample of 2154 older adults responded to the questionnaire survey. A mediation analysis was performed on the data of 990 participants with pain. The data were collected by a questionnaire consisting of socio-economic and demographic characteristics, the Geriatric Depression Scale-15, the Multidimensional Scale of Perceived Social Support, Self-rated Health Scale and the Numerical Rating Scale of pain. The sample was subdivided by sex. Descriptive analysis, t-tests, chi-squared tests, Mann-Whitney U-tests, Spearman correlation analyses and the bootstrap method were used to analyze data.

Results: The prevalence rate of pain and depression among nursing home residents were 46.0% and 20.7% respectively. Pain, perceived social support and self-rated health were all significantly correlated with depression (r = 0.217, P < 0.01; r = -0.216, P < 0.01; r = 0.385, P < 0.01, respectively). Perceived social support and self-rated health independently and in series partly explained the relationship between pain and depression.

Conclusions: The results of the study showed that pain was associated with low perceived social support first, and then poor self-rated health, which was in turn related to the development of depression among nursing home residents with pain. For nursing home residents, perceived social support and self-rated health as an internal resource can affect the ability to overcome the suffering of pain and reduce the level of depression. Geriatr Gerontol Int 2020; 20: 1234-1240.

Keywords: depression; pain; perceived social support; self-rated health; serial mediation.

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Depression* / epidemiology
  • Humans
  • Nursing Homes*
  • Pain
  • Social Support