Effects of a peer-assisted tai-chi-qigong programme on social isolation and psychological wellbeing in Chinese hidden elders: a pilot randomised controlled trial

Abstract

BackgroundThe term hidden elder is used in Chinese society to describe older adults who are socially isolated and refuse social participation. Substantial evidence has indicated the important role of social isolation in increasing psychiatric morbidity and mortality risks in later life. Innovative service is promptly needed to address the social and psychological health needs of hidden elders. We aimed to test the feasibility and the preliminary effectiveness of a peer-assisted tai-chi-qigong programme in strengthening social networks and enhancing psychosocial wellbeing of Chinese hidden elders. MethodsThis randomised controlled trial recruited 46 people aged 60 years or older who did not engage in any social activities, through the social network of two community centres in Hong Kong. Participants were randomised to receive either peer-assisted tai-chi-qigong (n=24) or usual care (n=22) with computer-generated random codes. In the 3-month tai-chi-qigong programme, participants practiced two 60-min sessions each week, during which they were paired up with socially active older adults. Both groups received usual care, which included regular home visits by social workers. The primary outcome was social network using the Lubben social network scale-6 (LSNS-6). Secondary outcomes were De Jong Gieveld loneliness scale score, SF-12 quality of life score, and mental health inventory score. Data were collected at baseline and 3 months thereafter. We used a generalised estimating equations model for intention-to-treat analysis. Ethics approval was obtained from the Joint Clinical Research Ethics Committee of the Chinese University of Hong Kong and New Territory East Cluster. Written informed consent was obtained from every eligible person. Trial registration number CUHK_CCRB00489. FindingsThe improvement in the primary outcome, LSNS-6, did not differ significantly between the groups (regression coefficient of group by time interaction B=0·76, 95% CI −1·39 to 2·92, p=0·487; Cohen's d effect size 0·304). Participants who received the peer-assisted tai-chi-qigong programme generally showed better improvement in outcomes than the control group. With support from peer elders, the compliance rate of elders participating in tai-chi-qigong was 71% (ranged from 66–100%). InterpretationThis pilot study showed that peer-assisted tai-chi-qigong is a feasible social intervention for hidden elders. A full-scale trial is needed to assess the possible benefits for social and physical health. FundingThis study was funded by the School Seeding Fund, the Nethersole School of Nursing, the Chinese University of Hong Kong.