Stress management behaviors to prevent depression among the elderly in Thailand: a structural equation modeling analysis based on Self-Efficacy and Social Support Theories

The world is experiencing a rapid demographic shift towards an aging population, with every country undergoing a significant transition to an aging society. As a result, understanding and promoting effective stress management behaviors among older adults has become important to support their mental health. This cross-sectional study aimed to develop and validate a structural equation model of stress management behaviors for preventing depression among elderly in the community. The model was grounded in Self-Efficacy Theory and Social Support Theory. The sample consisted of 345 individuals aged 60 years and above residing in Samut Songkhram Province, Thailand. Simple random sampling was employed to minimize selection bias, using a computer program to generate random numbers. The study instruments included measures of general demographic information, self-efficacy, social support, stress management behaviors, the Suanprung Stress Test (SPST-20) for assessing stress, and The Thai Geriatric Depression Scale (TGDS-15) for assessing depression. Data were analyzed using descriptive statistics and structural equation modeling via Jamovi software version 2.5. The findings indicate that stress management behavior has a direct negative effect on stress (β=-0.87, p < 0.05) and an indirect negative effect on depression through stress (β=-0.71, p < 0.05). Furthermore, behavioral competence and social support have direct positive effects on stress management behavior in preventing depression among elderly people in the community (β=0.52; β=0.45; p < 0.05). Depression in older adults impairs daily functioning, worsens chronic conditions, and increases suicide risk. Therefore, community nurses should implement programs focusing on stress management skills, self-efficacy enhancement, and social support to sustain the mental well-being of the elderly. Keywords: Elderly, prevention of depression, self-efficacy, social support, stress management behavior, structural equation modeling