Cargando…

Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework

OBJECTIVE: The objective of this study was to assess depressive symptoms among rural health workers (RHWs) through a multi-factorial socio-ecological framework (SEF) encompassing personal, interpersonal, organizational and community components. PATIENTS AND METHODS: A random sample of 394 RHWs in al...

Descripción completa

Detalles Bibliográficos
Autores principales: Bakhtari, Fatemeh, Sarbakhsh, Parvin, Daneshvar, Jalil, Bhalla, Devender, Nadrian, Haidar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7519861/
https://www.ncbi.nlm.nih.gov/pubmed/33061403
http://dx.doi.org/10.2147/JMDH.S255436
_version_ 1783587658280206336
author Bakhtari, Fatemeh
Sarbakhsh, Parvin
Daneshvar, Jalil
Bhalla, Devender
Nadrian, Haidar
author_facet Bakhtari, Fatemeh
Sarbakhsh, Parvin
Daneshvar, Jalil
Bhalla, Devender
Nadrian, Haidar
author_sort Bakhtari, Fatemeh
collection PubMed
description OBJECTIVE: The objective of this study was to assess depressive symptoms among rural health workers (RHWs) through a multi-factorial socio-ecological framework (SEF) encompassing personal, interpersonal, organizational and community components. PATIENTS AND METHODS: A random sample of 394 RHWs in all rural areas of East Azerbaijan and fulfilling our other inclusion criteria were recruited. The participants underwent the Short-Form Beck’s Depression Inventory and a validated researcher-constructed SEF questionnaire, including subscales on personal, interpersonal, organizational and community factors associated with depressive symptoms. Internal consistency and factor structure parameters of the SEF were also calculated. RESULTS: A total of 394 RHWs were screened, of whom 170 (43.2%) had mild to major depressive symptoms. Only 6.8% were identified with major depressive symptoms. The SEF-based scale was found to have acceptable content validity (content validity index and ratio were 0.80 and 0.77, respectively) and reliability (Cronbach’s alpha=0.7). In the structural equation modeling, the fit indices showed our model to fit the data well (χ(2)=14.06, df=14, χ(2)/df=1.00, CFI=0.967, RMSEA=0.032). The highest direct contribution to depressive symptoms was found from the personal factors component (β=−2.32). Also, “work load and roles interference” (from organizational level, β=−0.76) and “family/colleague support” (from community level, β=−1.28) made significant direct contributions towards depressive symptoms. Besides the SEF components, female gender (β=1.69), family history of mental illness (β=−1.48), having chronic illnesses (β=−1.64) and being religious (β=3.43) were the strongest direct contributors to depressive symptoms. CONCLUSION: Depressive symptoms were common among RHWs, arising from all personal-, interpersonal-, organizational- and community-level factors. Our SEF had adequate internal consistency and factor structure parameters to be applied in the Middle East and North Africa (MENA) region countries, such as Iran, as a theoretical framework to plan for interventional efforts aiming at preventing depressive symptoms among RHWs. The burden of depressive symptoms should be reduced through multi-factorial interventions and rational perspectives.
format Online
Article
Text
id pubmed-7519861
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-75198612020-10-14 Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework Bakhtari, Fatemeh Sarbakhsh, Parvin Daneshvar, Jalil Bhalla, Devender Nadrian, Haidar J Multidiscip Healthc Original Research OBJECTIVE: The objective of this study was to assess depressive symptoms among rural health workers (RHWs) through a multi-factorial socio-ecological framework (SEF) encompassing personal, interpersonal, organizational and community components. PATIENTS AND METHODS: A random sample of 394 RHWs in all rural areas of East Azerbaijan and fulfilling our other inclusion criteria were recruited. The participants underwent the Short-Form Beck’s Depression Inventory and a validated researcher-constructed SEF questionnaire, including subscales on personal, interpersonal, organizational and community factors associated with depressive symptoms. Internal consistency and factor structure parameters of the SEF were also calculated. RESULTS: A total of 394 RHWs were screened, of whom 170 (43.2%) had mild to major depressive symptoms. Only 6.8% were identified with major depressive symptoms. The SEF-based scale was found to have acceptable content validity (content validity index and ratio were 0.80 and 0.77, respectively) and reliability (Cronbach’s alpha=0.7). In the structural equation modeling, the fit indices showed our model to fit the data well (χ(2)=14.06, df=14, χ(2)/df=1.00, CFI=0.967, RMSEA=0.032). The highest direct contribution to depressive symptoms was found from the personal factors component (β=−2.32). Also, “work load and roles interference” (from organizational level, β=−0.76) and “family/colleague support” (from community level, β=−1.28) made significant direct contributions towards depressive symptoms. Besides the SEF components, female gender (β=1.69), family history of mental illness (β=−1.48), having chronic illnesses (β=−1.64) and being religious (β=3.43) were the strongest direct contributors to depressive symptoms. CONCLUSION: Depressive symptoms were common among RHWs, arising from all personal-, interpersonal-, organizational- and community-level factors. Our SEF had adequate internal consistency and factor structure parameters to be applied in the Middle East and North Africa (MENA) region countries, such as Iran, as a theoretical framework to plan for interventional efforts aiming at preventing depressive symptoms among RHWs. The burden of depressive symptoms should be reduced through multi-factorial interventions and rational perspectives. Dove 2020-09-22 /pmc/articles/PMC7519861/ /pubmed/33061403 http://dx.doi.org/10.2147/JMDH.S255436 Text en © 2020 Bakhtari et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Bakhtari, Fatemeh
Sarbakhsh, Parvin
Daneshvar, Jalil
Bhalla, Devender
Nadrian, Haidar
Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework
title Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework
title_full Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework
title_fullStr Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework
title_full_unstemmed Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework
title_short Determinants of Depressive Symptoms Among Rural Health Workers: An Application of Socio-Ecological Framework
title_sort determinants of depressive symptoms among rural health workers: an application of socio-ecological framework
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7519861/
https://www.ncbi.nlm.nih.gov/pubmed/33061403
http://dx.doi.org/10.2147/JMDH.S255436
work_keys_str_mv AT bakhtarifatemeh determinantsofdepressivesymptomsamongruralhealthworkersanapplicationofsocioecologicalframework
AT sarbakhshparvin determinantsofdepressivesymptomsamongruralhealthworkersanapplicationofsocioecologicalframework
AT daneshvarjalil determinantsofdepressivesymptomsamongruralhealthworkersanapplicationofsocioecologicalframework
AT bhalladevender determinantsofdepressivesymptomsamongruralhealthworkersanapplicationofsocioecologicalframework
AT nadrianhaidar determinantsofdepressivesymptomsamongruralhealthworkersanapplicationofsocioecologicalframework