Date Available

5-13-2021

Year of Publication

2019

Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation

College

Nursing

Department/School/Program

Nursing

First Advisor

Dr. Deborah Reed

Abstract

Alarming rates of suicide among production farmers have prompted researchers to investigate factors associated with depressive symptoms among this population. Aspects of farm life and farming can contribute to higher levels of depressive symptoms. Higher levels of depression can also increase an individual’s risk of injury and development of chronic disease, impacting overall quality of life. Despite the approximate 3.5 million farm women in the U.S., current research has focused on the male farmer.

Men and women have different responses to stressors, and women in general have a higher prevalence of depressive symptoms. Farm women can be further subjected to stressors associated with farming as an occupation and their gendered role within the agrarian culture. The large number of farm women affected, the relationship of chronic depressive symptoms on health and quality of life, the lack of current research available, and the rising rates of suicide and depressive symptoms among farmers emphasize the need for further investigation of farm women and depressive symptoms.

The overall purpose of this dissertation was to 1) explore the current state of the science of farm women and depressive symptoms and identify variables commonly associated with depressive symptoms among farm women, 2) identify variables influencing levels of depressive symptoms within farm women aged 50 and over and identify differences between those women with high depressive symptoms and those with low depressive symptoms, and 3) establish the reliability and validity of the 12-item John Henry Active Coping Scale (JHAC-12) within the sample.

A systematic review of the literature revealed that there is a need for more research with strong study designs regarding farm women and depressive symptoms within the context of their environment, culture, and occupation. The review identified multidimensional factors from farm women’s lives that influence their level of depressive symptoms. Farm women’s ethnicity, the agrarian culture, family and social relations, as well as specific demographics were identified as key variables associated with an increased risk of higher depressive symptoms. Because of the identification of the multi-dimensional factors, the use of the Modified Biopsychosocial Model (MBPS) was selected as a framework for continued research as it depicts the interrelationship between the factors and their influence on farm women’s depressive symptoms.

The MBPS was applied to data from 358 farm women aged 50 and older from a larger cohort study, and a secondary analysis was performed. Multivariable binary logistic regression was used to identify those variables associated with depressive symptoms among farm women. Depressive symptoms were predicted by race/ethnicity, years of education, adequacy of income for vacation, perceived health status, perceived stress score, and active coping score. Significant differences between those farm women with low CES-D score (< 16) and those with high CES-D score (≥ 16) were noted. Race/ethnicity, years of education, adequate income for vacation and retirement, reported health status of fair or better, perceived stress score, active coping score and satisfaction from farm work were all significant between groups. Women who were non-White, had less education, reported income not adequate for vacation or retirement, reported poor health, higher levels of perceived stress, lower levels of active coping and who were not satisfied with farm work were more likely to be in the high CES-D group.

A principal component analysis with direct oblimin rotation in a sample population of older farm women (n=458) identified two dominant themes of the JHAC-12: “commitment to hard work” and “self-efficacy.” The instrument component structure reflects the culture of the agrarian society. In the two-component solution, 2 items were removed from the scale after revealing low values of communality (< .3). The item reduction resulted in more refined scale, increasing explained variance by 4.1% with less items. Cronbach’s of the JHAC-12 (α = .78) and JHAC-10 (α = .76) indicated high levels of reliability for both scales. Rotation of the items resulted in a simple structure with high loadings within items, no major-cross-loadings and little correlation between components (r = .29), supporting both convergent and discriminant validity in this population. The ability of the JHAC to encompass the socio-culture aspects of active coping among farm women and obtain a quantifiable result supports the JHAC as an important tool to utilize in future studies of depressive symptoms and farm women with use of the JHAC-10 in future studies of farm women decreasing the burden of the participants.

Although there are limitations within each document, each section adds to the science of farm women and depression symptoms and provides directions for future research. The major gaps identified were: 1) the need for current research with stronger study designs, 2) studies of farm women across their life spans, 3) the need for focused studies among minority and migrant women, 4) an understanding of farm women and their leisure time, and 5) a broader application of the MBPS theory to include a large number of social variables shown to be associated with farm women and depressive symptoms that were not available in the dataset.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2019.181

Funding Information

Partial funding was provided by The Central Appalachian Regional Education and Research Center, under CDC/NIOSH Cooperative Agreement 1T42 OH010278-01.

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