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INTRODUCTION
This study explored the level of social isolation and depression among Cambodian
elderly in Long Beach, California. Its purpose was to examine the level of social
isolation and depression among this population. The questions to be asked in this study
were how socially isolated and depressed were they twenty years after the war? And to
what extent these factors affect their health and livelihood?
Before arriving in the United States, most Cambodian elderly experienced and
witnessed the atrocities of the Cambodian holocaust during the mid ‘70s. As refugees,
they arrived in the United States with psychiatric impairments such as post-traumatic
stress disorder, anxiety, and depression. In a comparative study of mental health, Carlson
and Rosser-Hogan (1993) reported that among Southeast Asian refugees, the Cambodian
population shows the highest rates of depression, anxiety, and post-traumatic disorder.
It has been suggested that many Cambodian elderly (age 65 and above) are
isolated due to a lack of family and community support. This form of social isolation
may result in under-utilization of mental and medical health services. Consequently, the
population is at risk in terms of poor health and high mortality rate.
Research findings (Monk, 1988; Creecy et al, 1985; Ernst et al., 1978; Busse,
1967) showed that long term social isolation among mainstream elderly results in mental
and physical impairments such as dementia, decline of perceptions (sight, hearing,
smelling, tasting), depression, unreliable memory, personality dysfunction, diabetes,
peptic ulcer, and respiratory ailments.
In addition to the risk factors of social isolation and depression, the Cambodian
elderly are vulnerable to cultural conflict between their rural, low socioeconomic
background and their isolated, foreign status in the U.S. They not only must adjust to the
American culture, but they must also adjust to the transition from a rural to an urban area
(Dolk, 1985) while at the same time coping with their psychiatric impairments and
cultural barriers.
Statement of the Problem
Many research findings (Cheung, 1993; Mollica et al., 1993; Uba & Chung, 1991;
Kinzie et al.,1984) focus upon the nature of post-traumatic stress disorder among
survivors of mass violence. Seldom do these findings help to shed light upon the social
problems they confront daily in the U.S., such as the difficulties of depression and social
isolation, as well as language and cultural barriers. Additionally, research studies have not
been found to address the issues of depression and social isolation among the Cambodian
elderly.
Another barrier for the Cambodian elderly is the lack of appropriate outreach
services to them in the Long Beach community. For example, social services and
mental/physical health providers may lack competent cultural and linguistic services for
this population.
Purpose of the Study
The purpose of the study was to explore the level of social isolation and
depression among the Cambodian elderly in Long Beach, California. This study also
sought to shed light upon the needs of the Cambodian elderly by means of their own
perceptions of depression and social isolation. It was hoped that the results of this study
concerning health care and social service providers might encourage development of
effective mental health and social services facilities for this population.
Operationalization of Variables
Social isolation is characterized by an individual not feeling integrated or not
included in a supportive network (Dugan & Kivett, 1994). The authors further suggested
that the factors contributing to social isolation include instability of residence, infrequent
contact with friends, children, and siblings, and lack of participation in social group
settings. In this study, social isolation was based upon the subjects’ relationship with
their spouse, children, and friends, distance traveled outside the home, current activities,
and the perception of boredom in their daily lives. These isolation factors may also relate
to the population’s non-utilization of mental health and social services.
Depression is characterized by an individual feeling persistent sadness, guilt,
worthlessness, helplessness, or hopelessness. The individual may also have a loss of
interest or pleasure in usual activities. The measurement of depression among the
Cambodian elderly was based on the short-form version of the Geriatric Depression
Scale (GDS). The GDS is designed to measure the level of depression among
mainstream elderly by asking them fifteen short questions. The GDS explored
respondents’ level of feelings such as hopelessness, helplessness, worthlessness, life
satisfaction, memory loss, and boredom.
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