Abstract
Depression is a common issue in institutionalized elderly people. The “Attentively Embracing Story” theory is applied to help individuals transform negative thoughts into positive, and reflect on spiritual healing. This study aimed to examine the effectiveness of a “Story-Centred Care Intervention Program” based on the “Attentively Embracing Story” theory in improving depressive symptoms, cognitive function, and heart rate variability in institutionalized elderly people. Seventy long-term care residents were recruited from two long-term care facilities and randomized into the story-centred care intervention (n = 35) and control groups (n = 35). We excluded five long-term care residents who did not complete the post-test measures and five long-term care residents who had interference events on the outcome measures. Finally, sixty long-term care residents (40 women and 20 men; age 84.3±5.98 years) were included in the final analysis. Data were collected at four times (pre-intervention and post-intervention, 1 and 3-month follow-up) and analyzed with the generalized estimating equation approach.Instruments, including Geriatric Depression Scale, Short Portable Mind Status Questionnaire, and a CheckMyHeart device to measure heart rate variability, were used in study. The degree of improvement in depressive symptoms was significantly higher in the story-centred care intervention group than in the control group after providing the story-centred care intervention program (p < .001) and at 1 and 3-month follow-up (p = .001, p = .006, respectively; GDS-15 score reduced 1.816 at the 3-month follow-up). Participants receiving the story-centred care intervention program showed significantly greater improvement than those in the control group in the cognitive function at 1and 3-month follow-up (p = .009, p = .024, respectively; SPMSQ score reduced 0.345 at the 3-month follow-up). The heart rate variability parameters (SDNN, RMSSD) did not show a statistically significant increase. However an increasing trend in the parameters was observed in the intervention group (SDNN increased 16.235ms at the 3-month follow-up; RMSSD increased 16.424 ms at the 3-month follow-up). In conclusions, the story-centred care intervention program was effective on the improvement of depressive symptoms and cognitive status in institutionalized elderly people.
Highlights
Aging adults experience increased chronic diseases, and reduced physical activity, which requires more assistance and care from others [1, 2]
This study developed an intervention program based on the “Attentively Embracing Story” theory to examine the effects of a “Story-Centred Care Intervention Program” on improving depressive symptoms, cognitive function, and heart rate variability (HRV) in older adults living in a long-term care facility
Four weeks after the intervention, participants in the Intervention Group (IG) showed a significant decrease in depression, improvement in cognitive function, and a trend towards improved standard deviation of the normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD) compared with the control group (CG)
Summary
Aging adults experience increased chronic diseases, and reduced physical activity, which requires more assistance and care from others [1, 2]. In Taiwan, families are the main caregivers for older adults [3]. Older adults cared for in institutional settings have fewer social interactions and support from family and friends [4], which could influence physical and mental health [5], and development of severe depressive symptoms [6, 7]. Depression can lead to irritability, anxiety, and somatic symptoms. Severe depressive symptoms can lead to feelings of isolation, recurrent thoughts of death, and even suicide [10]
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