METHODS: Using a qualitative interpretative phenomenological approach, we conducted in-depth face-to-face interviews with participants, guided by Kleinman's explanatory model of illness. Nineteen older adults who screened positive for depression were included in the research.
RESULTS: None of the participants explicitly acknowledged experiencing depression. However, they articulated their distress through three primary themes: 'Life is miserable,' 'Depression is a sign of weakness,' and 'Belief in pre-determination.' Remarkably, despite screening positive for depression, participants demonstrated a lack of awareness regarding available professional mental health services. Moreover, they expressed a reluctance to seek such services, citing reasons related to stigma and misconceptions. The predominant themes that emerged concerning help-seeking behaviours were 'Self-efficacy,' 'Social support,' and 'Formal assistance from non-mental healthcare professionals.'
CONCLUSION: The expression of emotion among older adults is restricted by socio-cultural influences. Thus, there is a need to improve mental health literacy among older adults in Malaysia, and their preferred source of support such as religious leaders and non-mental healthcare physicians.
METHOD: This was a prospective intervention study where participants were required to use the SuperMD smartphone application (Digital-Health Technologies Pte Ltd, Kuala Lumpur, Malaysia) for a month. A change in the Medication Adherence Rating Scale-Malay Translation (MARS-M) and Malay Translation of Drug Adherence Inventory-9 (MDAI-9) scores indicated a change in compliance and attitude to medication. Positive and Negative Syndrome Scale (PANSS) was used to assess change in symptoms and insight. Medication compliance was also obtained from the SuperMD application. Paired T-test was used to evaluate the significance of changes in mean scores of research variables over the study period. Wilcoxon signed-rank test was used to analyze the subscale of MDAI-9 and the change in PANSS score. The Kruskal-Wallis test was used to determine the effect of the change of insight on the level of compliance with medication.
RESULTS: There were 36 participants in this study. The results showed statistically significant improvement in compliance (0.65, p ≤ 0.01) but not in attitude towards medication (0.78, p = 0.065). There was also an improvement in PANNS score (-2.58, P ≤ 0.01). There was no significant change in insight (χ2(2) = 3.802, p = 0.15). Conclusion:The use of technology-based strategies like SuperMD is effective in improving medication compliance for individuals with schizophrenia.