Older Hispanics Explanatory Model of Depression

Researchers have reported a high prevalence of depression among older Hispanics
in the United States when compared to other ethnic groups. Cultural variations in the
perception of depression sometimes make it difficult to recognize the disorder resulting in
older Hispanic patients not being diagnosed and not receiving appropriate treatment. The
purpose of this study was to explore older Hispanics’ explanatory model of depression
and identify culture-specific factors that may help in the recognition and treatment of
depression. A mixed-method design that combined qualitative and quantitative methods
was used. Fifty participants were interviewed using Kleinman’s Explanatory Models
ethnographic approach with a vignette variation, the Center for Epidemiologic Studies
Depression Scale (CES-D), and the Cross Cultural Measure of Acculturation (CCMA).
The findings suggest that this group of older Hispanics did not recognize
depression as an illness but rather as the result of life stressors and personal weaknesses.
People who experience depressive symptoms were described as being crazy, bored,
worried, or having a problem of the nerves. These culturally coded terms may confound diagnosis among many Hispanics who find depression an unacceptable and shameful
condition. This cultural pattern seemed to prevail among low and high-acculturated
individuals which may complicate the diagnosis of depression by health care providers.
This study highlights the complexity and diversity of this group of older
Hispanics’ conceptual model of depression. The results of this study will contribute to
nursing care by providing additional information that will help professionals when
working with Hispanic patients with depression. Findings expand our understanding of
older Hispanics (high and low-acculturated, depressed and non-depressed) groups’
conceptualization of depression and can be used to inform the adaptation of culturally
relevant approaches to better serve the Hispanic community in this country.