Soutien social, dépression et estime de soi chez les personnes âgées : les résultats d’une analyse en cluster
Résumé
Objective. – This study investigated the relation in later life between social support and different mental health variables: depression and self-esteem. Social support was considered according to Cutrona and Russell’s approach, which includes six dimensions: attachment, social integration, reassurance of worth, reliable alliance, guidance, and opportunity for nurturance. Several authors attributed to social support a major protective role in mental health. In fact, different links between social support and mental health variables were found in adulthood. More and more studies deal with social support in later life. In particular, the protective role of social support in stressful live events and its relation to mental health or illness have been examined. The objective of this study was to clarify the links between social support, depression and self-esteem in later life, with an alternative statistical method.
Method. – Aclusteranalysiswasperformedinordertogrouptogetherolderpersonsonthebasisoftheir social support level. Ninety-three French older people living in their home were recruited, with a mean age of 70.72 (SD: 7.06). The social support was assessed with Caron’ social support scale (The Social Provision Scale) which measures the six functions of social relationships. Depression and self-esteem were evaluated respectively with the Center for Epidemiologic Studies Depression Scale (CES-D) and the Rosenberg Self-Esteem Scale. Cluster analysis was chosen because it allows to bound natural groupings within data and to determine homogeneous groups inside the sample of the study. Then, ANOVA were performed in order to compare these groups as for their depression and self-esteem scores.
Results. – First, results revealed three social support profiles or groups: High social support level, Moderate social support level and Low social support level. Group with high social support level presents high level for all dimensions of social support: attachment, social integration, reassurance of worth, reliable alliance, guidance, and opportunity for nurturance. In addition, groups with moderate and low levels of social support are characterized respectively by moderate and low levels for all dimensions of social support. Second, different relationships of these profiles with depression and self-esteem were found. The older persons with high level of social support present a low depression level associated high self-esteem. Moreover, participants with moderate or low social support profile present high depression and low self-esteem levels.
Conclusion. – The relationship between social support and mental health was brought to light. The clinical implications and possible interventions are discussed. In particular, different methodological and conceptual approaches of social support interventions are evoked, such as interventions, which include family, friends or peers.
Objectif. – Cette étude porte sur la relation, dans l’âge avancé , entre le soutien social et des indicateurs de santé mentale : la dépression et l’estime de soi.
Méthode. – Une méthodologie statistique innovante a été mise en œuvre : l’analyse en cluster. Quatre- vingt-treize participants âgés vivant au domicile ont été recrutés. Différentes échelles ont permis d’évaluer le soutien social, la dépression et l’estime de soi.
Résultats. – Des analyses en cluster ont permis d’identifier trois profils de soutien social:Élevé, Modéré et Faible. La comparaison de ces trois profils a mis en évidence une forte association entre soutien social et les variables dépression et estime de soi. En effet, les personnes âgées rapportant un haut niveau de soutien social présentent des niveaux de dépression moindres, associés à une estime de soi élevée.
Conclusion. – La relation entre soutien social et santé mentale est confirmée. De possibles implications cliniques sont discutées.