LAUSR

AIMS AND OBJECTIVES To clarify beliefs linked with depression among older adults with depression in Japan. BACKGROUND As a result of global population aging, caring for older adults with depression has become an important issue worldwide. In this paper, the concept of "beliefs" pertains to phenomena that lead to distress about disease and can be alleviated through talk therapy. While previous studies focused on illness beliefs in people with mental illness and depression, no studies have yet focused on such beliefs among older adults with depression. DESIGN Qualitative, narrative-research-based method. METHODS Observation and 1-5 narrative interviews lasting 60-90 min were conducted with each of 19 older adults with depression in a Japanese psychiatric ward. The resulting narratives were thematically analyzed to derive relevant themes and subthemes. Reporting of this research adheres to COREQ guidelines. RESULTS Four themes and twelve subthemes were revealed. Depression-linked beliefs among older adults with depression were (1) "guilt and regret," (2) "pessimism," (3) "futility of treatment," and (4) "desire to be needed by loved ones and society." CONCLUSION Depression-linked beliefs among older adults with depression constituted spiritual pain reflecting character tendencies, including experiences of loss and developmental challenges related to aging as well as subjects' natural diligence and consideration for others. RELEVANCE TO CLINICAL PRACTICE (1) Helping nurses better understand distress experienced by older adults with depression, who are prone to feel guilt and regret when reflecting on the past, and to alleviate distress through dialogue and providing positive affirmation for patients. (2) To understand and assuage distress over experiences of loss in old age. (3) To help older adults with depression form a more relaxed attitude toward life, so that even if they have experienced loss as a result of old age, they can maintain their self-esteem and existential sense of self-worth.