“Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Participant Recruitment
2.3. Procedures and Intervention
2.4. Outcome Measures
2.4.1. Geriatric Depression Scale (GDS)
2.4.2. Geriatric Anxiety Inventory (GAI)
2.4.3. Satisfaction with Life Scale (SWLS)
2.4.4. Friendship Scale (FS)
2.4.5. World Health Organization Quality of Life OLD (WHOQOL-OLD BREF)
2.4.6. Blood Stress Biomarkers
2.5. Data Collection and Analyses
3. Results
3.1. Recruitment and Participants’ Characteristics
3.2. Preliminary Efficacy
3.3. Stress- and Anxiety-Related Inflammatory Outcomes
3.4. Qualitative Findings
3.4.1. Impact on Older Adults’ Well-Being
3.4.2. Attitudes toward Intervention
3.4.3. A Way Forward
4. Discussion
Strengths, Limitations, and Future Implications
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total (n = 28), n(%) | Intervention (n = 14), n(%) | Control (n = 14), n(%) | p-Value |
---|---|---|---|---|
Age (mean (SD), range) | 69.4 (6.8), 61—83 | 71.1 (5.9), 62—82 | 67.7 (7.4), 61—83 | 0.185 |
Gender | ||||
Male | 9 (32.1) | 5 (35.7) | 4 (28.6) | 0.686 |
Female | 19 (67.9) | 9 (64.3) | 10 (71.4) | |
Ethnicity | ||||
Chinese | 26 (92.9) | 14 (100) | 12 (85.7) | 0.341 |
Indian | 1 (3.6) | 0 (0) | 1 (7.1) | |
Others | 1 (3.6) | 0 (0) | 1 (7.1) | |
Marital status | ||||
Single | 1 (3.6) | 1 (7.1) | 0 (0) | 0.572 |
Married | 22 (78.6) | 11 (78.6) | 11 (78.6) | |
Widowed | 4 (14.3) | 2 (14.3) | 2 (14.3) | |
Others | 1 (3.6) | 0 (0) | 1 (7.1) | |
Education level | ||||
None | 1 (3.6) | 1 (7.1) | 0 (0) | 0.504 |
Primary | 3 (10.7) | 1 (7.1) | 2 (14.3) | |
Secondary | 9 (32.1) | 3 (21.4) | 6 (42.9) | |
ITE/Poly/JC | 6 (21.4) | 3 (21.4) | 3 (21.4) | |
University | 9 (32.1) | 6 (42.9) | 3 (21.4) | |
Current employment status | ||||
Self-employed | 2 (7.1) | 1 (7.1) | 1 (7.1) | 0.699 |
Full-time | 1 (3.6) | 0 (0) | 1 (7.1) | |
Part-time | 1 (3.6) | 0 (0) | 1 (7.1) | |
Unemployed | 4 (14.3) | 2 (14.3) | 2 (14.3) | |
Retired | 20 (71.4) | 11 (78.6) | 9 (64.3) | |
Living arrangement | ||||
Alone | 1 (3.6) | 1 (7.1) | 0 (0) | 0.494 |
With spouse | 15 (53.6) | 7 (50.0) | 8 (57.1) | |
With children only | 6 (21.4) | 4 (28.6) | 2 (14.3) | |
With others | 6 (21.4) | 2 (14.3) | 4 (28.6) | |
Mobility status | ||||
Independent | 25 (89.3) | 12 (85.7) | 13 (92.9) | 0.541 |
Independent with walking aid | 3 (10.7) | 2 (14.3) | 1 (7.1) | |
Medical comorbidities | ||||
None | 13 (46.5) | 4 (28.6) | 9 (64.3) | 0.062 |
1–2 | 12 (42.9) | 9 (64.3) | 3 (21.4) | |
≥3 | 3 (10.7) | 1 (7.1) | 2 (14.3) |
Scale | Medians (IQR: Q1, Q3) | U | p | |
---|---|---|---|---|
Control Group (n = 11) | Intervention Group (n = 10) | |||
GDS | 1.00 (0.00, 3.00) | 1.50 (0.75, 5.00) | 44.50 | 0.47 |
GAI | 0.00 (0.00, 3.00) | 2.50 (0.75, 9.00) | 32.00 | 0.11 |
SWLS | 28.00 (20.00, 28.00) | 24.50 (18.75, 27.00) | 39.50 | 0.28 |
FS | 27.00 (25.00, 30.00) | 22.50 (18.75, 25.50) | 24.00 * | 0.03 |
WHOQOL-OLD | 51.00 (46.00, 52.00) | 49.50 (43.75, 51.75) | 44.01 | 0.47 |
Scale | Medians (IQR: Q1, Q3) | U | p | Effect Size [95% CI] | |
---|---|---|---|---|---|
Baseline to 3 months | Control (n = 11) | Intervention (n = 9) | |||
GDS | 0.00 (0.00, 2.00) | –1.00 (–2.50, 1.50) | 34.0 | 0.231 | 0.072 [–2, 4] |
GAI | 0.00 (0.00, 0.00) | 0.00 (–3.00, 0.00) | 36.0 | 0.261 | 0.063 [0, 3] |
SWLS | 0.00 (–2.00, 0.00) | –1.00 (–2.50, 2.00) | 47.5 | 0.878 | 0.001 [–3, 3] |
FS | –1.00 (–2.00, 0.00) | –1.00 (–2.50, 2.00) | 48.0 | 0.908 | 0.001 [–4, 2] |
WHOQOL-OLD | 0.00 (–4.00, 0.00) | 1.00 (–3.00, 3.00) | 35.0 | 0.266 | 0.062 [–7, 3] |
Baseline to 6 months | Control (n = 10) | Intervention (n = 6) | |||
GDS | 0.00 (–1.00, 2.00) | 0.00 (–1.25, 2.00) | 29.0 | 0.912 | 0.001 [–5, 3] |
GAI | 0.00 (–1.25, 1.25) | –0.50 (–1.25, 1.25) | 27.5 | 0.782 | 0.005 [–2, 2] |
SWLS | –1.00 (–2.00, 2.50) | 0.50 (–2.50, 6.75) | 26.0 | 0.661 | 0.012 [–7, 3] |
FS | 0.00 (−3.25, 1.25) | 0.50 (–1.25, 1.50) | 25.5 | 0.622 | 0.015 [–4, 2] |
WHOQOL-OLD | –1.50 (–4.25, 1.50) | 1.00 (0.75, 2.50) | 16.0 | 0.123 | 0.149 [–6, 1] |
Scale | Negative | Positive | Test Statistic | ||||||
---|---|---|---|---|---|---|---|---|---|
n | Mean Rank | Sum of Ranks | n | Mean Rank | Sum of Ranks | Ties | Z | p | |
Control (n = 11) | |||||||||
GDS | 2 | 4.50 | 9.0 | 5 | 3.80 | 19.0 | 4 | –0.85 | 0.40 |
GAI | 2 | 3.00 | 6.0 | 2 | 2.00 | 4.0 | 7 | –0.37 | 0.72 |
SWLS | 5 | 3.90 | 19.5 | 2 | 4.25 | 8.5 | 4 | –0.94 | 0.35 |
FS | 6 | 4.25 | 25.5 | 2 | 5.25 | 10.5 | 3 | –1.07 | 0.29 |
WHOQOL | 5 | 7.00 | 35.0 | 5 | 4.00 | 20.0 | 1 | –0.77 | 0.44 |
Intervention (n = 9) | |||||||||
GDS | 5 | 3.40 | 17.0 | 2 | 5.50 | 11.0 | 2 | –0.51 | 0.61 |
GAI | 4 | 42.75 | 11.0 | 1 | 4.00 | 4.0 | 4 | –0.95 | 0.34 |
SWLS | 5 | 4.10 | 20.5 | 3 | 5.17 | 15.5 | 1 | –0.35 | 0.72 |
FS | 5 | 3.10 | 15.5 | 2 | 6.25 | 12.5 | 2 | –0.25 | 0.80 |
WHOQOL-OLD | 3 | 5.17 | 15.5 | 5 | 4.10 | 20.5 | 1 | –0.35 | 0.73 |
Scale | Negative | Positive | Test Statistic | ||||||
---|---|---|---|---|---|---|---|---|---|
n | Mean Rank | Sum of Ranks | n | Mean Rank | Sum of Ranks | Ties | Z | p | |
Control (n = 10) | |||||||||
GDS | 3 | 3.00 | 9.0 | 3 | 4.00 | 12.0 | 4 | –0.32 | 0.75 |
GAI | 3 | 3.67 | 11.0 | 3 | 3.33 | 10.0 | 4 | –0.11 | 0.92 |
SWLS | 6 | 4.33 | 26.0 | 3 | 6.33 | 19.0 | 1 | –0.42 | 0.68 |
FS | 4 | 5.00 | 20.0 | 4 | 4.00 | 16.0 | 2 | –0.28 | 0.78 |
WHOQOL | 6 | 5.83 | 35.0 | 4 | 5.00 | 20.0 | 0 | –0.77 | 0.44 |
Intervention (n = 6) | |||||||||
GDS | 3 | 3.33 | 10.0 | 3 | 3.67 | 11.0 | 0 | –0.11 | 0.91 |
GAI | 3 | 2.83 | 8.5 | 2 | 3.25 | 6.5 | 1 | –0.28 | 0.78 |
SWLS | 3 | 2.50 | 7.5 | 3 | 4.50 | 13.5 | 0 | –0.63 | 0.53 |
FS | 2 | 3.00 | 6.0 | 3 | 3.00 | 9.0 | 1 | –0.41 | 0.68 |
WHOQOL-OLD | 0 | 0.00 | 0.00 | 5 | 3.00 | 15.0 | 1 | –2.06 | 0.04 * |
Markers | Control Group | Intervention Group | ||||||
---|---|---|---|---|---|---|---|---|
Baseline | 6-Month Follow-Up | Difference | p | Baseline | 6-Month Follow-Up | Difference | p | |
Cortisol (ng/mL) | 82 ± 14 | 107 ± 13 | +25 | 0.02 | 74 ± 16 | 92 ± 12 | +18 | 0.30 |
Annexin-A1 (ng/mL) | 32 ± 4 | 12 ± 2 | −20 | 0.002 | 28 ± 6 | 14 ± 4 | −14 | 0.16 |
Interleukin-1β (pg/mL) | 4 ± 1.5 | 3 ± 0.7 | −1 | 0.45 | 6.6 ± 2.3 | 2.4 ± 0.7 | −4.2 | 0.14 |
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Shorey, S.; Kua, E.H.; Tam, W.; Chan, V.; Goh, Y.S.; Lim, H.M.; Lim, L.H.K.; Tian, C.S.; Mahendran, R. “Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study. Int. J. Environ. Res. Public Health 2021, 18, 9514. https://doi.org/10.3390/ijerph18189514
Shorey S, Kua EH, Tam W, Chan V, Goh YS, Lim HM, Lim LHK, Tian CS, Mahendran R. “Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study. International Journal of Environmental Research and Public Health. 2021; 18(18):9514. https://doi.org/10.3390/ijerph18189514
Chicago/Turabian StyleShorey, Shefaly, Ee Heok Kua, Wilson Tam, Valerie Chan, Yong Shian Goh, Hong Meng Lim, Lina Hsiu Kim Lim, Cheong Sing Tian, and Rathi Mahendran. 2021. "“Where-There-Is-No-Psychiatrist Integrated Personal Therapy” among Community-Dwelling Older Adults: A Randomized Pilot Study" International Journal of Environmental Research and Public Health 18, no. 18: 9514. https://doi.org/10.3390/ijerph18189514