Elderly Community Centers Research Articles

The moderating effects of mobile applications on the use of urban green space and mental health of older people: A mixed-method investigation in Hong Kong

Existing literature on the relationship between urban green space (UGS) use and mental health of older people was mainly conducted before the widespread adoption of digital technologies in daily life. In particular, the COVID-19 pandemic outbreak has fostered the use of mobile applications (apps) at a time city dwellers, including older people, were required to stay home. Drawing upon the insights from emerging literature on the changing relationship between UGS use and mental health of older people in the digital era in urban and gerontological studies, this paper offers a vivid mixed-method to investigate whether mobile app use has supplemented or substituted UGS visits and activities that further influence on the mental health of older people. This is achieved by conducting 360 questionnaire surveys in elderly community centers amid the pandemic and 23 semi-structured interviews in local neighbourhood parks after the pandemic by the authors. Results demonstrates mobile app use frequency may moderate the proximity-mental health relationship, but only among the older people with lower mental health levels. Among this sub-group, digital consumption app use frequency weakens the proximity-mental health relationship on marginal significance, which illustrates digital consumption apps may substitute the role of urban parks on improving older people’s mental health. Furthermore, digital communication and recreation mobile app use frequency strengthens the proximity-mental health relationship on marginal significance, which suggests these mobile apps may supplement the role of urban parks on improving older people’s mental health, particularly during the pandemic. The research pleas for more research on how digitalization of everyday activities is transforming the use of UGS such as neighbourhood parks and subsequent impact on the mental health of older people in the widespread adoption of digital technologies.

The association between satisfaction with life and anxiety symptoms among Chinese elderly: a moderated mediation analysis

BackgroundPrevious studies have suggested that certain personal psychological variables (e.g., life satisfaction and cognitive function) and physical variables (e.g., body mass index [BMI]) are significantly associated with individuals’ anxiety symptoms. However, relevant research on elderly is lagging and no studies have yet investigated the combined impact of these variables on anxiety. Thus, we conducted the present study to investigate the potential moderator role of BMI and the potential mediator role of cognitive function underlying the relationship between life satisfaction and anxiety symptoms in Chinese elderly based in Hong Kong.MethodsSixty-seven elderly aged 65 years old and above were recruited from the local elderly community centres in this pilot study. Each participant underwent a systematic evaluation using the Satisfaction with Life Scale (SWLS), Hong Kong Version of the Montreal Cognitive Assessment (HK-MoCA), and the Hamilton Anxiety Rating Scale (HAM-A) and were measured for their body weight and height. Regression analysis using the bootstrapping method was employed to test the hypothesized moderated mediation model.ResultsOur findings demonstrated the overall model accounted for 23.05% of the variance in scores of HAM-A (F (8, 57) = 2.134, p = 0.047) in Chinese elderly. There was a significant association between life satisfaction and anxiety symptoms (p = 0.031), indicating that individuals with higher life satisfaction were associated with less anxiety symptoms. Moreover, this relationship was positively moderated by BMI (b = 0.066, 95% CI [0.004, 0.128]), especially in Chinese elderly with BMI at a lower level (b = -0.571, 95% CI [-0.919, -0.224]) and an average level (b = -0.242, 95% CI [-0.460, -0.023]). No significant mediator role was detected for cognitive function (b = -0.006, 95% CI [-0.047, 0.044]) in our model.ConclusionsOur findings suggest that increased life satisfaction can reduce anxiety symptoms among Chinese elderly as their BMI decreases (when BMI ranged between “mean - 1SD” and “mean” of the population). The significant interaction between psychological and physical factors underlying anxiety symptoms found in this study, presents a promising opportunity for translation into multi-level psychological and physical interventions for the management of anxiety in ageing patients during clinical practice.

Challenges, Concerns, and Experiences of Community-Dwelling Older Women with Chronic Low Back Pain—A Qualitative Study in Hong Kong, China

Although chronic low back pain (CLBP) is known to negatively affect multiple aspects of the lives of older people, prior qualitative studies mainly focused on the lived experiences of older people with CLBP in Western countries. Given cultural and contextual differences and poor understanding of CLBP in older women with CLBP, it is important to better understand the concerns and lived experiences of Chinese older women with CLBP. The current study aimed to investigate the experiences, challenges, concerns, and coping strategies of older women with CLBP in Hong Kong. A total of 15 community-dwelling older women with CLBP aged ≥60 years were recruited from a physiotherapy clinic or a community center for semi-structured interviews. The interviews were audio recorded and transcribed 'verbatim'. The transcription was imported to NVivo 12 software. Thematic analysis was conducted using Braun and Clarke's method. Five themes were identified: (1) physical impacts of CLBP on daily life; (2) psychological influences of CLBP; (3) management of CLBP; (4) family support; and (5) social activities and support. Negative physical and psychosocial impacts of CLBP were common among older women, and they adopted diverse pain management strategies, although some of their treatment options were influenced by the Chinese culture. Misbeliefs and responses of family and friends also affected their management strategies. Elderly community centers are a significant source of social support for older women with CLBP, making it an ideal platform for establishing self-help groups to facilitate their self-management of CLBP.

A dyadic advance care planning intervention for people with early-stage dementia and their family caregivers in a community care setting: a feasibility trial

BackgroundAdvance care planning (ACP) is highly relevant for people with early-stage dementia to communicate their care preferences for serious illness conditions with their family caregivers before they become mentally incapacitated.MethodsA multi-centre, quasi-experimental study was conducted to test the feasibility and acceptability of a theory-guided, dyadic ACP intervention (‘Have a Say’ programme) among participants with early-stage dementia–family caregiver dyads. The feasibility of the trial design, intervention procedures, subject recruitment and retention, and study instruments were assessed. Study outcomes were measured at baseline (T0), immediately after the intervention (T1), and at 1 month (T2) and 3 months post-intervention (T3). Acceptability of the intervention was determined by the satisfaction score, completion rate and qualitative interviews as process evaluation with a purposive sample of participants and ACP facilitators. Generalised estimating equations were performed to examine differential changes between groups over time, with covariates adjusted.ResultsSubject recruitment from five elderly community centres yielded a recruitment rate of 60% and resulted in 36 client–caregiver dyads. The intervention was acceptable to the dyads, with a mean satisfaction score of 4.4 out of 5 and completion rate of 94.4%. The attrition rates at T1, T2, and T3 were 8.3%, 13.9%, and 19.4%, respectively. The intervention group reported a significantly greater improvement in the readiness for ACP at T1, self-efficacy for ACP at T3, and dyadic concordance on end-of-life care preferences at all time points than the control group, but not on depressive symptoms. Family caregivers in the intervention group reported a significantly higher caregiving burden at T2 than the control group. The qualitative findings revealed that triadic involvement of and trusting relationships among the dyads and ACP facilitators, and documentation of clients’ views are the programme strengths, while the structured format and discussion about medical issues posed implementation challenges.ConclusionsThis ACP intervention and trial design were feasible and acceptable to the dyads. Several refinements were identified, including adding a nurse-led group-based session for information giving, allowing flexibility in arrangement, and adding measure of ACP engagement of family caregivers. A rigorous trial to test the effects of the ACP intervention is warranted.Trial registrationRetrospectively registered on 14/08/2020 at clinicaltrials.gov (Identifier: NCT04513106).

Impact of additional community services provision on dementia caregiver burden: an interrupted time-series analysis of 12-year interRAI assessments in Hong Kong

ObjectivesTo evaluate the impact of providing additional dementia caregiver support services on caregiver burden.DesignInterrupted time-series analysis using territory-wide panel data.SettingsAll public-funded district elderly community centres in Hong Kong (HK).ParticipantsPrimary caregivers...

PRECISE PREDICTION OF BLOOD PRESSURE LEVELS AFTER CONTROLLING FOR SEASONAL TEMPERATURE: A THREE-YEAR PROSPECTIVE COHORT OF ELDERLY POPULATION IN HONG KONG

Objective: Cardiovascular disease risk has been linked to the environmental temperature changes, but few studies have evaluated the long-term temperature impacts on the blood pressure (BP) projection. Design and method: Regular blood pressure records were uploaded to the data servers from elderly community centres in Hong Kong since 2016. Meteorological data were obtained from the Hong Kong observatory. The Vector Autoregressions, the most common deep learning method was adopted for systolic BP (SBP) projection. Temperature and diastolic BP (DBP) were controlled in the model. The predictions of SBP were compared with the real BP records in the last 6-month and 12-month. The mean absolute percentage error (MAPE) and the mean absolute deviation in terms of mmHg were used to describe the accuracy of prediction. Subgroup analyses were also conducted based on age, gender, social-economic status (SES), drug intake level, and medical diseases (diabetes & hypertension). Results: A total of 733 participants regularly measured BP over three years since 2016. Most of them (67.7%) were aged over 75 years and the majority are female (73.8%). The MAPE of the projection models were 1.8% for 6-month and 1.9% for 12-month BP projections. The mean absolute SBP value in the 6-month projection model was 1.66mmHg with the 95%CI range of 2.3319mmHg. between the projection model and real SBP records. Moreover, the temperature increment of one unit in degree Celsius was associated with a 0.597 mmHg increased in SBP. The temperature effect on BP was more prominent for the participants with hypertension. Subpopulation analysis showed that the impact of gender (p = 0.005) and hypertension status (p = 0.0416) had more significant impacts on the blood pressure projection among the elderly participants. Conclusions: Seasonal temperature showed as a critical factor for the evaluation of hypertension. Understanding the blood pressure readings after removal of seasonal temperatures will help for a better diagnosis.

El Aprendizaje y Servicio como herramienta para laaplicación de los objetivos de Salud Pública en el colectivode personas mayores

Introducción: Las personas mayores recurren con más frecuencia a los servicios sanitarios. El elevado consumo de medicamentos dificulta el cumplimiento terapéutico en este colectivo asociándose a un mayor riesgo de reacciones adversas. El objetivo de este proyecto es evaluar el conocimiento y manejo de los medicamentos en un grupo de personas que acuden a los centros de mayores.
 Material y métodos: Este estudio se enmarca en un proyecto de Aprendizaje y Servicio (ApS) entre la Universidad Complutense de Madrid (UCM) y el Ayuntamiento de Coslada. Los estudiantes diseñaron y elaboraron una encuesta de 32 ítems y entrevistaron a las personas mayores voluntarias (N=366) durante el periodo de Nov-Dic (2019). Tras la recogida de la información, se llevó a cabo un análisis descriptivo estratificado por sexo.
 Resultados: La edad media de los encuestados fue de 70,7 años, siendo mayoritariamente mujeres (70,2%). Más de dos tercios, percibe su calidad de vida entre muy buena y buena, siendo esta percepción ligeramente superior en mujeres. Los encuestados toman una media de 3,4 medicamentos y un 10% afirmo olvidar alguna toma. Pese a que la mayoría una independencia y autonomía a la hora de consumir la medicación, un 38% recurre a un método recordatorio.
 Conclusión: El colectivo de personas mayores de Coslada destaca por su alta calidad de vida percibida y conocimiento del manejo terapéutico. El ApS es una oportunidad única de extrapolación directa de conocimientos de Salud Pública a una realidad y necesidad social Introduction: Elderly are making more use of health services and exhibit a high consumption of medicines. This is associated with a difficulty in treatment compliance and with a greater risk of adverse reactions. The aim of this project is to evaluate the knowledge and handling of medicines in a group of elderly community centers.
 Material and methods: This study is part of a Learning and Service Project (LSP) between the Complutense University of Madrid (UCM) and Coslada Town Council. The students designed and elaborated a survey of 32 items and interviewed the elderly volunteers (N=366) during the period of Nov-Dec (2019). After collecting the information, a descriptive analysis stratified by sex was carried out.
 Results: The average age of participants was 70.7 years, with a majority of women (70.2%). More than two thirds perceived their quality of life to be between very good and good, with this perception being slightly higher in women. Participants take an average of 3.4 medicines and 10% forgot medication intake. Even though most of them are independent and autonomous when it comes to taking their medication, 38% use a reminder method.
 Conclusion: The group of elderly people in Coslada stands out for its highly perceived quality of life and knowledge of their therapeutic management. The LSP is a unique opportunity to directly extrapolate the knowledge of Public Health to a reality and social need.

Suicidal Risk in Older Patients with Depression During COVID-19 Pandemic: a Case-Control Study.

To compare older adults with late-life depression (LLD) and healthy controls in terms of suicidal ideation during the COVID-19 pandemic, and to determine predictors of suicidal ideation. Between March and April 2020, old adults diagnosed with major depressive disorder (single or recurrent episode) as defined by the DSM-5 were recruited from psychiatric clinics or inpatient wards, whereas 31 healthy older adults without a history of depression or other psychiatric illnesses were recruited from voluntary organisations or elderly community centres. Their depressive symptoms, perceived severity of the pandemic, perceived time spent on receiving related information, perceived health, levels of loneliness, perceived coping efficacy, suicidal ideation, and the level of symptomatic responses to a specific traumatic stressor in the past week were assessed. In total, 21 men and 43 women aged 61 to 89 years were interviewed through telephone by trained research assistants. Of them, 33 were older adults with LLD (cases) and 31 were healthy older adults (controls). Older people with LLD had a higher level of suicidal ideation than healthy controls, after controlling for the level of depression and medical comorbidity (F (1, 59) = 5.72, p = 0.020). Regression analyses showed that coping efficacy and loneliness accounted for a significant portion of the variance in suicidal ideation, and loneliness significantly predicted the level of stress. Mediation analyses reveal an indirect effect between group and suicidal ideation through coping efficacy (Z = 2.43, p = 0.015). Older people with LLD are at increased suicidal risk and require timely mental health support. Coping efficacy and loneliness are important predictors for suicidal ideation and stress.

Effectiveness of adductor pollicis muscle thickness as risk marker for sarcopenia in Central-West Brazilian elderly communities.

The aim of this study was to determine sensitivity, specificity, and best cutoff point for adductor pollicis muscle thickness (APMT) for diagnosis of sarcopenia in elderly community centers. This was a cross-sectional study comprising 321 elderly individuals from four community centers in Cuiabá, Central-West region of Brazil. The main outcome variables were calf circumference (CC; cm) and the APMT (mm). A receiver operating characteristic curve was built to assess the accuracy of APMT having CC as a golden pattern for sarcopenia. The best cutoff point was defined by Youden's J statistic. The area under curve of APMT was 0.70 (95% confidence interval [CI], 0.63-0.76; P < 0.001) for all individuals, 0.74 (95% CI, 0.67-0.81; P < 0.001) for women, and 0.71 (95% CI, 0.58-0.85; P =.01) for men. The best cutoff point defined by Youden's J statistic was 17.63 mm for all individuals, the same for women. and 18.51 mm for men. The APMT can be used for the diagnosis of sarcopenia. The optimal cutoff points for APMT are 17.63 mm for women and 18.51 mm for men in elderly communities in the Central-West Region of Brazil.

Rapid Estimate of Inadequate Health Literacy (REIHL): development and validation of a practitioner-friendly health literacy screening tool for older adults.

This study aimed to develop and validate a brief practitioner-friendly health literacy screening tool, called Rapid Estimate of Inadequate Health Literacy (REIHL), that estimates patients' health literacy inadequacy in demanding clinical settings. This is a methodological study of 304 community-dwelling older adults recruited from one community health centre and five district elderly community centres. Logistic regression models were used to identify the coefficients of the REIHL score's significant factors. Receiver operating characteristic (ROC) curve analysis was then used to assess the REIHL's sensitivity and specificity. Path analysis was employed to examine the REIHL's criterion validity with the Chinese Health Literacy Scale for Chronic Care and concurrent validity with self-rated health scale and the Geriatric Depression Scale-15. The REIHL has scores ranging from 0 to 23. It had 76.9% agreement with the Chinese Health Literacy Scale for Chronic Care. The area under the ROC curve for predicting health literacy inadequacy was 0.82 (95% confidence interval=0.78-0.87, P<0.001). The ROC curve of the REIHL showed that scores ≥11 had a sensitivity of 77.8% and specificity of 75.6% for predicting health literacy inadequacy. The path analysis model showed excellent fit (Chi squared [2, 304] 0.16, P=0.92, comparative fit index 1.00, root mean square error of approximation <0.001, 90% confidence interval=0.00-0.04), indicating that the REIHL has good criterion and concurrent validity. The newly developed REIHL is a practical tool for estimating older adults' inadequate health literacy in clinical care settings.

Effects of virtual reality on moods in community older adults. A multicenter randomized controlled trial.

Virtual reality (VR) technology is a potential method to use in cognitive intervention, but the use of VR in cognitive stimulation intervention for older adults has not been investigated. Therefore, the aim of this study was to investigate the mood change of older adults after participating in the VR cognitive stimulation activity. This is a multicenter randomized controlled, cross-over trial. The intervention was a VR cognitive stimulation activity, and the control was a paper-and-pencil activity. The participants were older adults with age over 60 and recruited in the elderly community centers. The Positive and Negative Affect Score (PANAS) was used to measure mood change. Mean difference (MD) with 95% confidence interval (95% CI) was calculated. The Simulator sickness questionnaire was used to measure adverse events. A total of 236 participants from 19 community centers were recruited. After the VR activity, the participants had a significant increase in total PANAS positive affect score (MD = 2.09, 95% CI = 0.69 to 3.49), and a significant reduction in total negative affect score (MD = -1.99, 95% CI = -2.55 to -1.43). The reduction in negative affect score was significantly larger in VR activity than paper-and-pencil activity (MD = -0.48, 95% CI = -0.98 to 0.00). Besides, only three participants reported severe advance events after VR activity. The use of VR technology is well accepted by older adults. Therefore, the use of VR technology through smartphone and a mobile app can be a potential method for future cognitive training interventions.

How Cultural Values Affect Subjective Well-Being Among Older Adults: The Role of Proximity of Clothing to Self

This study examined how cultural values (self-construal) affect subjective well-being through the proximity of clothing to self among older adults in Taiwan. Data included survey responses from 249 older adults from elderly community centers in Taiwan. Structural equation modeling and bootstrapping were employed to test the hypotheses. This study found that older adults with interdependent selves were more likely to have high subjective well-being through self-esteem derived from proximity of clothing to self. In contrast, older adults with independent selves tended to have high subjective well-being through self as structure derived from proximity of clothing to self. These findings inform researchers, family members, caregivers, and government policymakers about the mechanism behind the relationship between cultural values and subjective well-being, and how psychological closeness of clothing to self mediates the relationship between cultural values (self-construal) and subjective well-being. Further, the results inform useful strategies on how to employ clothing to enhance subjective well-being.

Gait Stability in Older Adults During Level-Ground Walking: The Attentional Focus Approach.

The objective of this study was to investigate the effect of attentional focus instructions on gait stability during level-ground walking among older adults. We recruited 140 community-dwelling older adults (mean age = 70.3 years, SD = 4.7 years) from elderly community centers in Hong Kong. The experiment included assessments on participant's characteristics and walking trials. During walking trials, each participant was invited to walk at a self-selected pace along a 6-m walkway. Internal focus instructions (Internal condition), external focus instructions (External condition), or no instruction (Control condition) were given in a randomized order for three trials per condition, giving a total of nine walking trials. Spatial and temporal gait parameters were measured. Results showed significantly higher body sway and variability of swing and stance time under Internal condition relative to External and Control conditions. Moreover, reduced velocity and shorter steps were demonstrated under Internal condition relative to External and Control conditions. External focus instructions did not improve gait stability in older adults when compared to Control condition. Internal focus instructions appear to compromise gait stability. Future research should investigate if walking instructions that refer to body movements explicitly compromise gait rehabilitation for older adults in clinical settings.

Psychometric Properties of the 15-item Fatalism Scale in a Chinese Older Adult Sample: A Cross-validation Study

This study aims to evaluate the factor structure and reliability of the revised 15-item Fatalism Scale. A convenience sample of Chinese older adults (n = 260) was recruited from three elderly community centers in Hong Kong between May and June 2013. Data from 252 participants who completed all 15 items of the scale were used in the current analysis. We examined the scale’s factorial structure by confirmatory factor analysis, reliability by Cronbach’s alpha, and construct validity by correlation with cancer fear. Both a three-factor model at the first level and a one-factor model at the second level provided excellent fits to the data. A high Cronbach’s alpha value of the scale (0.945) and a significant positive correlation between fatalism and cancer fear (r = 0.262; p < 0.001) were observed. We conclude that the revised Fatalism Scale is a valid and reliable instrument to assess fatalism of Chinese older adults.

Tai chi qigong as a means to improve night-time sleep quality among older adults with cognitive impairment: a pilot randomized controlled trial.

PurposeAge-related cognitivee decline is a growing public health concern worldwide. More than a quarter of adults with cognitive impairment experience sleep disturbance. The objective of this pilot study was to evaluate the preliminary effects of tai chi qigong (TCQ) on improving the night-time sleep quality of older adults with cognitive impairment.ParticipantsOlder adults with cognitive impairment who complain of sleep disturbance.MethodsA randomized controlled trial with two groups. Fifty-two subjects were recruited from two district elderly community centers and randomly assigned to either the TCQ group (n=27) or the control group (n=25). The intervention group received TCQ training consisting of two 60-minute sessions each week for 2 months. The control group was advised to maintain their usual activities. Sleep quality was measured by the Chinese Pittsburgh Sleep Quality Index. Quality of life was measured by Short-form 12, cognitive functions measured by mini-mental state examination, and subjective memory deficits measured by the memory inventory for Chinese.ResultsData were collected at baseline, 2 months, and 6 months. Significant results were noted at 6 months in the Chinese Pittsburgh Sleep Quality Index global score (P=0.004), sleep duration (P=0.003), habitual sleep efficiency (P=0.002), and the Short-form 12 mental health component (P<0.001). The TCQ participants reported better sleep quality and a better (quality of life) mental health component than the control group.ConclusionTCQ can be considered a useful nonpharmacological approach for improving sleep quality in older adults with cognitive impairment.Clinical trial registrationCUHK_CCT00448 (https://www2.ccrb.cuhk.edu.hk/registry/public/287).

Contributory Factors to critically wrong road-crossing judgements among older people: an integrated research study

Introduction Older people are having higher risk of vehicle-pedestrian collisions. This study examines the relative importance of different environmental, physical and cognitive factors in contributing to critically wrong road-crossing judgements. Methods An integrated research design is adopted. Older pedestrians were recruited through Elderly Community Centres in Hong Kong. Data about their physical and cognitive ability were collected through setting up outreach laboratories within the participants' neighbourhood communities. In addition to obtaining two walking speeds, three clinical tests (the visual acuity test, Timed Up and Go test and Mini Mental State Examination [MMSE] test) were conducted. A questionnaire survey collected personal information and activity data. Eighteen different road-crossing scenarios showing the same dual-lane one-way local road with different traffic conditions (a vehicle approaching at different distances, at different speeds, and on different lanes) were captured in videos and presented to the participants. Their decision time and judgement for each scenario were recorded in a computer. Apart from descriptive statistics, a binary logistic generalised estimating equation model was estimated. The dependent variable is whether a road-crossing judgement was critically wrong or not. Results and Conclusions A total of 7,182 road-crossing judgements of 399 older people were collected. The most statistically significant factors contributing to critically wrong road-crossing judgements are the road environment variables of the speed and distance of the oncoming vehicle. On physical variables, walking speed is the most important factor. Lastly, the cognitive variable of MMSE score is significant. For the mild and moderate impairment groups, the chances of making a critically wrong judgement are 1.83 and 2.01 times that of the normal group respectively.

Social needs of the elderly and active aging in public open spaces in urban renewal

Urban renewal districts have a relatively high concentration of elderly people. Open spaces are important for the elderly for enhancing social interaction and active aging. However, planning and design of open spaces tend to stress on the physical and safety needs of the elderly, while social needs are not frequently addressed. This study intends to identify whether the social needs of the elderly regarding the use of public open spaces in urban renewal districts are addressed in the standard planning and design guidelines which newly planned development and districts are often based upon. Eight focus groups were conducted in elderly community centers in two urban renewal districts in Hong Kong. The results indicate that elderly people consider ‘social and physical activities’, ‘community life facilities and services’ and ‘social network’, as well as a ‘clean and pleasant environment’ to be their most important needs. Thus, planners and designers should take into consideration these criteria for enhancing the social well-being of the elderly and active aging in public open spaces in urban renewal. Furthermore, it stresses that urban renewal districts are part of the elderly's past living experiences and established social networks, which is not the case in new developments and areas. As such, the users' actual needs should be elicited rather than perceived by planners and designers.

Effectiveness of the Modified Instrumental Reminiscence Intervention on Psychological Well-Being Among Community-Dwelling Chinese Older Adults: A Randomized Controlled Trial.

The current study aimed to examine the effectiveness of the Instrumental Reminiscence Intervention-Hong Kong (IRI-HK) on alleviating depressive symptoms and improving life satisfaction in Chinese older adults living in empty nests (i.e., living alone or with a spouse only) in the community. A longitudinal, randomized, controlled design was adopted. Experimental and wait-list control groups were provided with the IRI-HK immediately and 12 weeks after the baseline assessment, respectively. Participants were 114 older adults living in empty nests and recruited via local elderly community centers. This high-risk population with detectable depressive symptoms were randomized into experimental (N = 46) and control (N = 68) groups. The IRI-HK is a group reminiscence intervention modified with cultural adaptations for Chinese older adults. It emphasizes the use of problem-focused coping strategies and comprises six intervention sessions and two follow-up sessions. Participants' depressive symptoms and life satisfaction were measured by the Chinese version of the Geriatric Depression Scale-Short Form and the Life Satisfaction Scale-Chinese, respectively. Findings from this study showed a significant difference in depressive symptoms between groups after the intervention, F(1,77) = 35.62, p <0.001. Life satisfaction of the experimental group after the second follow-up was found to be significantly higher than that of the control group, F(1,68) = 5.67, p <0.05. The IRI-HK was a successful cultural adaption suitable for use in the Chinese context. It was found to be an effective intervention for alleviating depressive symptoms in older adults living in empty nests in the community.

COGNITIVE THERAPY FOR PEOPLE WITH SCHIZOPHRENIA SPECTRUM DISORDERS NOT TAKING ANTIPSYCHOTIC MEDICATION: A RANDOMISED CONTROLLED TRIAL

The current study aimed to examine the effectiveness of the Instrumental Reminiscence Intervention–Hong Kong (IRI-HK) on alleviating depressive symptoms and improving life satisfaction in Chinese older adults living in empty nests (i.e., living alone or with a spouse only) in the community.A longitudinal, randomized, controlled design was adopted. Experimental and wait-list control groups were provided with the IRI-HK immediately and 12 weeks after the baseline assessment, respectively. Participants were 114 older adults living in empty nests and recruited via local elderly community centers. This high-risk population with detectable depressive symptoms were randomized into experimental (N = 46) and control (N = 68) groups. The IRI-HK is a group reminiscence intervention modified with cultural adaptations for Chinese older adults. It emphasizes the use of problem-focused coping strategies and comprises six intervention sessions and two follow-up sessions. Participants' depressive symptoms and life satisfaction were measured by the Chinese version of the Geriatric Depression Scale-Short Form and the Life Satisfaction Scale-Chinese, respectively.Findings from this study showed a significant difference in depressive symptoms between groups after the intervention, F(1,77) = 35.62, p <0.001. Life satisfaction of the experimental group after the second follow-up was found to be significantly higher than that of the control group, F(1,68) = 5.67, p <0.05.The IRI-HK was a successful cultural adaption suitable for use in the Chinese context. It was found to be an effective intervention for alleviating depressive symptoms in older adults living in empty nests in the community.

Motivational interviewing and exercise programme for community‐dwelling older persons with chronic pain: a randomised controlled study

To examine the effectiveness of an integrated motivational interviewing and physical exercise programme on pain, physical and psychological function, quality of life, self-efficacy, and compliance with exercise for community-dwelling older persons with chronic pain. Chronic pain is common among older persons. Indeed, motivation for managing pain is poor, and may cause negative consequences. Motivational interviewing maybe effective in treating chronic pain. Single-blinded randomised control study. Older persons with chronic pain (n = 56) were recruited from two elderly community centres. They were blinded from the group allocation. The programme was conducted by an motivational interviewing-trained physiotherapist and registered nurses. Participants in the experimental group received an 8-week integrated motivational interviewing and physical exercise programme, while the control group received regular activities in the centre. Motivational interviewing used open-ended questions to encourage participants to express and recognise their pain and behaviours and professional feedback was given accordingly. Pain intensity, pain self-efficacy, anxiety, happiness, depression, mobility and quality of life were measured before and after the motivational interviewing and physical exercise programme. Attendance and compliance rate of the programme was calculated in the experimental group. Significant improvements in pain intensity, pain self-efficacy, anxiety, happiness and mobility after the motivational interviewing and physical exercise programme (all p < 0.05) for experimental group, while no significant improvement in control group except on the happiness scale. Regarding group differences in the outcome measures, the change scores on pain intensity, state anxiety and depression were significantly better in the experimental group. Motivational interviewing and physical exercise programme is effective in improving pain, physical mobility, psychological well-being and self-efficacy for community-dwelling older persons with chronic pain. Motivational interviewing is a feasible counselling technique whose content can be modified based on target group to change maladaptive behaviours, elicit ambivalences and enhance self-efficacy for making changes. Thus, promoting motivational interviewing and physical exercise programme to older persons with pain is effective and important.