The Effectiveness of Applying Art Therapy on Social Interaction, Self-esteem and Well-Being for Elderly Residents in Long-Term Care Institutions

Study Overview
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Brief Summary
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When aging, older people migrate to long-term care institutions. The elderly residents lack autonomy due to the characteristics of group life. The decline of health function or the occurrence of diseases can easily lead to reduced physical activity, decreased interpersonal interaction, social withdrawal, low self-esteem, and decreased well-being. In current that emphasizes the elderly in health promotion and disease prevention activities, art therapy can be applied for the elderly to achieve the purpose of health promotion. Art therapy could effectively improve social interaction, self-esteem, and well-being; but many researchers still suggest that it is necessary to investigate the effectiveness of art therapy for elderly residents in long-term care institutions. The purpose of this study is to explore the effectiveness of art therapy in improving social interaction, self-esteem, and well-being for elderly residents in long-term care institutions.

Official Title
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The Effectiveness of Applying Art Therapy on Social Interaction, Self-esteem and Well-Being for Elderly Residents in Long-Term Care Institutions

Conditions
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Long-Term Care, Aged

Intervention / Treatment
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* Other: Art therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 65 years or older and lived in the same long-term care institution for more than three months. Communicate in Mandarin or Taiwanese. With glasses or hearing aids and other assistive devices can have good vision and hearing functions. Both upper limb muscle power ≥ 4 points, can autonomous movement against moderate resistance. Under supervision, can safely use scissors for artistic creation and sit continuously for 90 minutes. Score > 20 points on Barthel Index. Score > 16 points on Mini-Mental Status Examination. Score ≤ 9 points on Geriatric Depression Scale. After the researcher's explanation, the participant is willing and able to give informed consent for participation in the study. Exclusion Criteria: Under 65 years of age, and lived in the same long-term care institution less than three months. Severe hearing and vision impaired, making it impossible to communicate. Receiving antidepressant drugs or related treatments. Completely dependent on activities of daily living. Severe depression or severe dementia. The elderly are participating in artistic creation-related activities.

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Art therapy group<br>Experimental group received 8-week art therapy. Art therapy uses different themes and materials to art-making. | Other: Art therapy<br>* The art therapy in this study is once a week, 90 minutes each section for a total of 8-week, and using theme-oriented group art therapy. Each section has one theme, and the researcher guides the elderly to make artistic creations. Each section includes a warm-up phase is 15 minutes, the creative phase is 60 minutes, and sharing phase is 15 minutes.<br>|
| No Intervention: No intervention group<br>No intervention group maintain the institution's original daily routine and participation in activities. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Socially Supportive Activity Inventory | An index-type instrument allows evaluating the quantity and quality of elders' participation in social activity in long-term care settings (Hsu, 2011). All organized into nine subcategories, including (1) all social contacts with family members and friends, (2) chatting with acquaintances, (3) holiday-related activities, (4) cognitive games, (5) involvement by outside organizations, (6) entertainment, (7) pleasure trips, (8) arts/crafts classes, and (9) religious activities (Hsu, 2011). Each subcategory contained three components: frequency, meaningfulness, and enjoyment (Hsu, 2011). The frequency ranged from 1 to 9, and meaningful-ness and enjoyment rated on a 4-point Likert rating ranged from 1 to 4 (Hsu, 2011). Higher scores represented more frequent participation in the activity, more significant meaning to one's life, and greater enjoyment in activity participation (Hsu, 2011). | After 8-week art therapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rosenberg Self-Esteem Scale(Chinese version) | A 10-item scale measured the self-esteem of the respondent (Yeung, 1998). All items answered on a 4-point Likert rating, the minimum and maximum scores on the scale are 10 and 40, with lower scores suggesting better self-esteem (Yeung, 1998). | After 8-week art therapy | 
| Well-Being Scale for Elders | A 9-item scale measured the well-being of the elderly (Lien & Chen, 2015). All items answered on a 5-point Likert rating, the minimum and maximum scores on the scale are 9 and 45, with higher scores suggesting better well-being (Lien & Chen, 2015). | After 8-week art therapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Elderly Residents, Long-Term Care Institutions, Social Interaction, Self-esteem, Well- Being, Art Therapy