The effects of reminiscence in promoting mental health of Taiwanese elderly

Non-pharmacological depression therapies for older Chinese adults: A systematic review & meta-analysis

PURPOSE

To conduct a systematic review of randomized controlled trials to evaluate the evidence for the use of non-pharmacological depression therapies in older Chinese adults.

MATERIALS AND METHODS

The population was individuals of Chinese extraction over the age of 60 who meet the criteria for depression. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). Six healthcare databases were systematically searched for publications to the end date July 2018. Included study variables were extracted and methodological quality assessments were performed. Ten studies reported sufficient data for meta-analysis.

RESULTS

Fifteen experimental and quasi-experimental studies fulfilled the selection criteria (N = 904 participants). Twelve studies provided sufficient data to evaluate the therapies using Effect Size (ES) (Cohen'sd); ranged from low to high. In the Qigong studies ES varied d = 0.31-0.81, Reminiscence d = 0.20-2.37, and for single studies of Tai Chi d = 1.7 and for Life Story d = 1.46. From the meta-analyses, Qigong was the only treatment that had a significant effect on the severity of depression (Z = -4.47, p < 0.01) with acceptable statistical heterogeneity between studies (I² = 52 %).

CONCLUSION

Overall, there was a large methodological heterogeneity between studies attributed to differing treatments, duration and designs. Reminiscence and Life Story showed an overall effect from a range of measures, as did the exercise therapies Qigong and Tai Chi. Qigong was the only therapy having a significant effect on depression. This therapy may be useful to alleviate depression due to the group and social interaction.

The effects of a Socially Supportive Activities Program (SSAP) on mood in long term care: A pilot study

This study examined the effects of a facilitated 10-week Socially Supportive Activities Program (SSAP) designed to improve mood in a geriatric institutional setting. A sample of 68 Taiwanese elders in long-term care facilities with depressive symptoms were randomly assigned to either an experimental group (N = 35) or a control group (N = 33). Outcomes were measured before the intervention, week 1, and at week 12, one-week post intervention. In the experimental group, pre-post measurement results demonstrated significant reductions in depressive symptoms, measured by Geriatric Depression Scale, and significantly higher levels of self-transcendence, measured by the Self-Transcendence Scale. An additional post-intervention measure of mood was collected with the Apparent Emotional Rating Scale. The AERS also demonstrated a significantly higher score (better mood) in the experimental group than in the control group. This study supports the use of a structured, facilitated, well-designed social activities program like the SSAP, to enhance and improve mood in elders who live in long-term care facilities.

Benchmarks for Evaluating Life Review and Reminiscence Therapy in Alleviating Depression among Older Adults

The efficacy of reminiscence and life review (LR) therapy in alleviating depression among older adults is well established. However, providers in nonresearch settings might implement these interventions inadequately, and such settings rarely can evaluate their outcomes using control groups. Alternatively, evaluators in such settings can calculate a within-group effect size and then compare it with average within-group effect size benchmarks derived from the randomized clinical trials (RCTs) supporting the intervention's effectiveness. This study developed these within-group effect size benchmarks. A search of RCTs from five systematic reviews and meta-analyses, and more recent RCTs published through 2016, yielded 25 studies that met inclusion criteria. Hedge's g for LR recipients and waitlist controls were .598 and -.20, respectively, and .568 and -.012 for reminiscence theory. These benchmarks offer an approach for evaluating the implementation of LR and reminiscence therapy when control groups are infeasible.

Verbal responses, depressive symptoms, reminiscence functions and cognitive emotion regulation in older women receiving individual reminiscence therapy

AIMS AND OBJECTIVES

To examine the effectiveness of individual reminiscence therapy in community-dwelling older women with depressive symptoms and to explore the characteristics of participants' verbalisation in the process.

BACKGROUND

Previous studies have found reminiscence was related to depression and anxiety. Although reminiscence therapy is widely used to reduce depression, little is known about how it works, and the content of verbalisations might provide one explanation.

DESIGN

The study employed a one-group pretest-post-test design.

METHODS

Twenty-seven participants underwent 6-week interventions of individual reminiscence therapy at home that were conducted by one nurse and induced through seeing old photographs. The Geriatric Depression Scale, Zung Self-rating Anxiety Scale, Reminiscence Functions Scale and Cognitive Emotion Regulation Questionnaire were used to measure the emotional states, reminiscence functions and cognitive emotion regulation strategies. Participants' verbalisations were categorised using the Client Behavior System.

RESULTS

Reminiscence therapy relieved depression and anxiety. Both the reminiscence function and cognitive emotion regulation became more favourable after interventions. Furthermore, higher frequencies of recounting, cognitive-behavioural exploration and affective exploration were noted in the process. Participants with more severe depressive symptoms tended to display a higher frequency of affective exploration. The reduction in depression, self-negative reminiscence and negative-focused emotion regulation were respectively associated with verbalisations.

CONCLUSIONS

Individual reminiscence therapy might relieve negative emotion and improve reminiscence function and cognitive emotion regulation. The participants' verbalisation is worthy of our attention, due to its correlation with the severity of depression and its mitigating effects on the depression, anxiety, self-negative reminiscence and negative-focused regulation in older women. The results contribute to our understanding of the therapeutic procedure and suggest a need for more research on the therapeutic processes.

RELEVANCE TO CLINICAL PRACTICE

Study on processes could help training novice clinical interveners so that reminiscence therapy can work better on emotional disorders in clinical practice.

The relationships between activity and quality of life for older men and women at different ages in Taiwan

This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women.

Effects of reminiscence interventions on psychosocial outcomes: a meta-analysis

OBJECTIVES

This study integrated results from controlled trials of reminiscence interventions.

METHODS

Meta-analysis was used to aggregate results from 128 studies on 9 outcome VARIABLES.

RESULTS

Compared to non-specific changes in control-group members, moderate improvements were observed at posttest with regard to ego-integrity (g=0.64) and depression (g=0.57 standard deviation units). Small effects were found on purpose in life (g=0.48), death preparation (g=0.40), mastery (g=0.40), mental health symptoms (g=0.33), positive well-being (g=0.33), social integration (g=0.31), and cognitive performance (g=0.24). Most effects were maintained at follow-up. We observed larger improvements of depressive symptoms in depressed individuals (g=1.09) and persons with chronic physical disease (g=0.94) than in other individuals, and in those receiving life-review therapy (g=1.28) rather than life-review or simple reminiscence. Moderating effects of the control condition were also detected.

CONCLUSIONS

Reminiscence interventions affect a broad range of outcomes, and therapeutic as well as preventive effects are similar to those observed in other frequently used interventions.

Gender differences in the relationship of social activity and quality of life in community-dwelling Taiwanese elders

This study explores the gender differences in the relationship between social activity and quality of life (QOL). A cross-sectional survey of 220 community-dwelling elderly people was conducted in southern Taiwan. Social activity was classified into six categories. The brief version of the World Health Organization QOL (WHOQOL-BREF) was used to measure QOL. Findings revealed that the associations of six types of social activities with QOL were weaker among women than men. The regression analyses further showed that for women, only religious activity was positively related to total QOL, while for men only involvement in formal group activity was positively related to total QOL.

Arousing Curiosity: When Hospital Art Transcends

Evolutionary and emotional congruence theoretical perspectives support the use of certain types of artwork to reduce stress and promote improved outcomes in healthcare settings. This paper explores the artwork of three artists whose work falls outside the traditional representational art supported by these theoretical perspectives. The concept of curiosity as a common thread is proposed as the underlying theory in an effort to explain the success of such work in achieving positive outcomes for patients, families, and staff. Other concepts are explored as contributing theoretical frameworks. Research is needed to determine the impact of this emerging type of artwork and the implications of findings for individuals who create—as well as for those who select—art for healthcare settings.

A comparison of physical health status, self-esteem, family support and health-promoting behaviours between aged living alone and living with family in Korea

AIMS

This study examined and compared the physical health status, self-esteem, family support and health-promoting behaviours between aged living alone and the aged living with family.

BACKGROUND

As the Korean population ages, the number of older people living alone is steadily rising. Previous studies have been conducted to define the factors affecting the health of older people. However, research studies focused on the impact of family support, which potentially affects the overall health of older people, have been rarely conducted.

DESIGN

This was a comparative descriptive design.

METHODS

The survey included a set of four questionnaires. All measures were self-administered. In the data analysis, descriptive statistics were used to analyse the demographic characteristics. The Chi-square test and independent t-test were used to examine the differences between the aged living alone and the aged living with family.

RESULTS

The physical health status (t=-40·85, p<0·001), self-esteem (t=-26·75, p<0·001), family support (t=-16·46, p<0·001) and health-promoting behaviours, specifically exercise (t=-15·86, p<0·001) and nutrition (t=-17·29, p<0·001), of the aged living with family were higher than that of the aged living alone.

CONCLUSIONS

This study shows that the aged living with family exhibited better physical health status, self-esteem and health-promoting behaviours than the aged living alone.

RELEVANCE TO CLINICAL PRACTICE

Clinical practice should be focused on emotional support with family or society for Korean aged, especially the aged living alone. Also, the practice should be adjusted to encourage the health-promoting behaviour for them as well.

Cognitive behavioural therapy and reminiscence techniques for the treatment of depression in the elderly: a systematic review

Psychotherapy, including cognitive behavioural therapy (CBT), reminiscence and general psychotherapy (GPT), is viewed as effective treatment for depression, but its efficacy in older people is not well defined. This systematic review included 14 randomized controlled trials that assessed the efficacy of psychotherapy for treating depression in elderly people (> or = 55 years). The results of this meta-analysis showed that, compared with placebo, psychotherapy was more effective in reducing depression scores (standardized mean difference -0.92; 95% confidence interval -1.21, -0.36). Subgroup analysis showed that CBT, reminiscence and GPT were all more effective than placebo; psychotherapy as an adjunct to antidepressant medication did not increase effectiveness. There was no significant difference between CBT and reminiscence in improving depression. A higher drop-out rate was observed in studies that did not include psychotherapy versus those that did, although this difference was not statistically significant. Thus, various general formats of psychotherapy are effective for treating depression in older people, although psychotherapy does not significantly increase the effectiveness of anti-depressant medication.

Group reminiscence therapy for cognitive and affective function of demented elderly in Taiwan

BACKGROUND

Elderly people with cognitive impairments are often associated with depressed mood and are heavy consumers in both medical services and need in caregivers. Reminiscence is believed to be effective in improving the cognition and mood of demented people.

OBJECTIVES

This study tested the hypothesis that structured group reminiscence therapy can prevent the progression of cognitive impairment and enhance affective function in the cognitively impaired elderly.

METHODS

A randomized controlled trial (RCT) based on a two group pre- and post-test design was used. The experimental subjects underwent eight group sessions, one session per week. The measurements were performed using Mini-Mental State Examination (MMSE), Geriatric Depression Scale short form (GDS-SF), and Cornell Scale for Depression in Dementia (CSDD).

RESULTS

The sample consisted of 102 subjects, with 51 in the experimental group and 51 in the control group. Results demonstrated that the intervention significantly affected cognitive function and affective function as measured by MMSE and CSDD (p = 0.015 and 0.026), indicating that the cognitive function of the experimental subjects increased and their depressive symptoms diminished following intervention.

CONCLUSION

Participation in reminiscence activities can be a positive and valuable experience for demented older persons. Consequently, the development of a structured care program for elderly persons with cognitive impairment and the need for long-term care is essential. Thus, health providers in long-term care facilities should be trained in reminiscence group therapy, and to be able to deliver such a program to the targeted group.

Depressive symptoms among older residents at nursing homes in Taiwan

AIMS AND OBJECTIVES

To examine the depressive symptoms of older residents at nursing homes and the relationship between their depressive symptoms and certain selected variables.

BACKGROUND

Depression has become a major healthcare concern among the older people, but nursing home-based studies on risk factors of depression have still hardly been well performed in Taiwan.

DESIGN

A cross-sectional design was developed and implemented.

METHODS

A research sample of 138 older residents was recruited from eight nursing homes located in southern Taiwan. During face-to-face interviews, the Center for Epidemiological Studies Depression Scale, Social Support Scale, Chronic Condition Checklist and Socio-demographic Inventory were used for data collection.

RESULTS

The results showed that 81.8% of those residents were identified as being depressed. It was further discovered that the length of residency, number of chronic conditions, perceived health status and the amount of social support from their family and relatives could explain 38.8% of the total variances in depressive symptoms.

CONCLUSIONS

Our study suggests that, in Taiwan, older people who live in nursing homes suffer from more depressive symptoms than those in community dwellings. To maintain and improve the health status for the elderly as much as possible, it is suggested that healthcare providers at nursing homes should develop an effective health promotion program for these older peoples.

RELEVANCE TO CLINICAL PRACTICE

There exists a high rate of depressive symptoms among older residents at nursing homes. It is imperative that a proper identification and its correspondent treatment for this health problem on the older residents are required. In late life, to maintain a higher level of quality of life, it is important to suggest that the health providers should regularly screen older people to increase the likelihood of diagnosis and improved treatment of late-life depressive symptoms.

Autobiographical Recall Training in Elderly Adults with Subjective Memory Complaint: A Pilot Study

Subjective memory complaint is a self-reported memory impairment which affects elderly people. This problem does not interfere with daily living activities but could decrease quality of life. This study's purpose was to verify whether a specific, newly developed, autobiographical recall training could modify self-perception of memory of subjects with subjective memory complaint. Seven elderly subjects (4 women and 3 men; mean age 65.5 yr., SD = 11) with such complaint, evidenced through a specific questionnaire, attended the training course and were prospectively assessed on standard neuropsychological tests, depressive symptomatology, and self-perception of memory. Self-perception of memory, as assessed by scores on a formalized questionnaire, improved significantly after the training, while depressive symptoms did not change. Neuropsychological performances were normal before and after the training, but a statistically significant improvement was observed only on the phonological fluency test. Thus the present pilot study suggested that the training may be effective in improving self-perception of memory and metamnestic capacity in elderly people with subjective memory complaints but not in changing subjects' depressive symptoms. This requires replication of this work with a much larger sample so statistical power is adequate.