| This study aims to document and interpret the lived experiences of older persons with depression in Macau; to identify the principal influences on depression among older persons in Macau; and to construct an explanatory framework based on the medical and socioeconomic factors related to depression as a basis to indicate possible risk factors for depression and inform the future development of interventions for depression among older persons in Macau.;A mixed methods research design, using both quantitative and qualitative approaches, was employed to interpret the lived experiences of these older persons. Using a purposive sampling approach, the final study involved 31 older persons with depression, and seven caregivers; all consented to participate. A range of standardised, validated scales including the MSQ, GDS-15, BI, Lawton IADL, LSNS, SF-36QOL, and instruments to collect demographic data, were employed to determine eligibility to participate and to quantify a variety of psychosocial factors that may be associated with the lives of these older persons. Questions raised by these quantitative results were then reflected on through in-depth interview, that generated data collected using an open-ended interview guide to identify the life events, issues and common thinking patterns in older persons that relate to depression in Macau.;These lived experiences clustered into four broad dominant categories. The first dominant category, negative thinking, consisted of the themes of feeling useless, hopelessness, sadness, and helplessness. The second dominant category, physical limitations and complaints, covered the themes of limited mobility, dependence on others, chronic joint pain, problems with sleep, poor appetite, poor memory, complex medication regimens, and difficulties in getting to hospital. The third dominant category, present living conditions and social support, consisted of the themes of being poor, being illiterate, injustice, being widowed, living alone, conflict with adult children, being neglected by children, being looked down upon by others, and lack of social contact. The final dominant category, the lives they have lived, included the themes of hard labour with low reward, being fatherless, having a bad marriage, and trauma from wars and revolutions.;Three meta-categories are drawn from the dominant categories and themes reflected across the findings; physical/material meta-category, social/family meta-category, and mental suffering meta-category. These three meta-categories illuminate the complex phenomenon of depression among these older persons in Macau. The associated explanatory framework models the relationships between the three meta-categories. Each interacts with the others, consequently one meta-category both causes and also results from others. The three meta-categories capture their life-long hardship and bio-psycho-social-cultural disability, which lay at the root of their negative thinking. The consequences and impacts of their negative thinking appear to feed and sustain depression among the older persons.;Findings from this study offer a deeper understanding of the nature and meaning of the negative feelings experienced by this depressed population in Macau. Through its fully grounded interpretative research approach, the present study has advanced previous research describing depression among Chinese older person by allowing a wider and more complete picture to be produced. Furthermore, these findings help to inform future health service development for older persons and the future development of interventions for older persons with depression in Macau, and in other Chinese contexts. |
