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Aims and objectives. To develop an explanatory framework to understand depression among community-dwelling Chinese older persons in Macau. Background. Depression has been described as the most common psychological problem among Chinese older persons. Dominant psychosocial theories are derived from research conducted mainly in western societies and similar research in Chinese populations is scant. Design. Mixed methods. Methods. Qualitative and quantitative methods (mixed methods) were employed to collect data from 31 participants between 2007-2009 in Macau. Results. Four categories of factors related to depression emerged: (1) negative thinking, (2) physical limitations and complaints, (3) present living conditions and social support and (4) past experiences. Each category interacts with the others and, consequently, one category both affects and is affected by others. The categories captured participants' life-long hardship and bio-psycho-social-cultural disability that lay at the root of their negative thinking. The consequences and impacts of their negative thinking appear to feed and sustain depression. Conclusion. The framework offers a deeper understanding of the nature and meaning of the experiences of depressed older persons in a Chinese context. Relevance to clinical practice. The findings have several implications for clinical practice. First, the cultural context of Chinese older persons should be emphasised in nursing practice. Second, the root of depression among Chinese older persons is seen to lie in their social, family, cultural and day to day living issues. Finally, this study illustrates the potential for incorporating psychosocial nursing interventions as a therapeutic approach on its own or as an adjunct to other therapy. [ABSTRACT FROM AUTHOR]

Aim. To determine the prevalence of depression level of older men in Macau and identify factors that predict depression. Background. Studies have revealed the contribution of psychosocial factors such as stress, dissatisfaction at work and stressful life events to older men and the mental health burdens pose a grave threat to their quality of life. Design. A descriptive survey. Method. The study was conducted from July-August 2004 in six parishes in Macau; 839 older men aged 60+ completed a structured questionnaire. Outcome measures. Predisposing characteristics, social and daily activities, health history and need/behaviours and depression level were collected. Multiple logistic regression models were used to identify factors to predict older men who will have depression. Results. The prevalence rate of depression of older men was 8·6%. It showed that a history of stroke ( p = 0·039), insomnia ( p < 0·001), palpitations ( p = 0·014), poor social network ( p = 0·005) and self-perceived health status ( p = 0·001) and perceived low ability to meet living costs ( p < 0·001) were significant risk factors for depression. Conclusion. We should focus on older men by reducing their burden to meet living costs, improving their sleep quality and helping them to expand their social network. These should help in both prevention and recognition of the onset of depression. Those with the low social network scores could be targeted for more intensive support from the beginning. Relevance to clinical practice. It is important to screen regularly for depression status among older men in the community. Attention to poor perceived health and not enough on the ability to meet living costs were needed and important to follow up. [ABSTRACT FROM AUTHOR]