Effects of a Biopsychosocial-Spiritual Group Intervention on Quality of Life of Institutionalized Seniors

Study Overview
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Brief Summary
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This study aimed to evaluate the effects of a biopsychosocial-spiritual (BPS-S) Group intervention on quality of life among seniors with disabilities in long-term care residential settings.

Detailed Description
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Background: Traditionally, biomedical care approach has been insufficient to meet the complex needs of older people living with multi-morbidity. Promoting whole-person wellness and better quality of life becomes a key goal of care in residential long-term care facilities. The integrative approaches composed of physio-psycho-social and spiritual components might be a viable strategy to assist older adults accept uncontrollable life changes and enhance holistic wellness. Purpose: The study purpose was to develop and evaluate the effects of 8-week biopsychosocial-spiritual (BPS-S) group intervention versus usual care on self-perception of quality of life (QoL) and meaning in life among seniors with disability in residential care home at mid- and post-intervention, and at a 1-month follow up. Methods: This single-blind randomized controlled trail with repeated measures design was conducted in residential long-term care facilities. Both the experimental groups (EG) and the control group (CG) received routing group activities based on their institution's schedule. Additionally, the EG received 8 sessions of weekly BPS-S group therapy for 80 minutes each. The baseline characteristics of residents with disabilities (including demographic information, length of stay in the institution and medical conditions) were collected using a data sheet, and activities of daily living of these residents were measured using the Barthel Index. To evaluate the effectiveness of the BPS-S group therapy, the primary outcomes including participants' overall QOL and the secondary outcome meaning in life were assessed at four time points: before, mid- and post- intervention and at a 1-month follow up. Quality of Life Index (QLI)-Part I and Purpose in Life (PIL) test were used to measure these outcome variables, respectively.

Official Title
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Effects of a Biopsychosocial-Spiritual Group Intervention on Quality of Life of Institutionalized Seniors With Disabilities: A Randomized Controlled Trial

Conditions
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Quality of Life

Intervention / Treatment
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* Behavioral: the Biopsychosocial-Spiritual Group Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: being 65 years of age or older; living in the institution for at least 1 month; Barthel Index scores under 90; no hearing, visual impairment and infectious diseases; being able to follow instructions and participate in group activities. Exclusion Criteria: have the diagnosis of major depression.

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: the Biopsychosocial-Spiritual Group Intervention<br>The experimental group received 8 sessions of weekly BPS-S group therapy for 80 minutes each. | Behavioral: the Biopsychosocial-Spiritual Group Intervention<br>* The Experimental group received 8 sessions of weekly BPS-S group therapy for 80 minutes each.<br>|
| No Intervention: weekly general chatting activities<br>The Control group received weekly general chatting activities for 30 minutes. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in quality of life summary scores before intervention to 4-week post intervention. | Quality of life was measured using the Chinese version of the Quality of Life Index (QLI)-Part I. It contains 33 items measuring satisfaction regarding the four domains (health and functioning, social and economic domain, psychological/spiritual wellness, and family). The QLI-Part I is a six-point satisfaction rating scale from very unsatisfied (1) to very satisfied (6). To determine the scores, each satisfaction item is recoded from -0.25 to 0.25, and both the overall and subscale scores of the QLI-Part I calculated by following step by step scoring instructions ranges from 0 to 30; highest values represent better quality of life | The data were collected before the intervention to week 12: baseline, in the middle of the intervention (the fourth week), at the end of the intervention (the eighth week), and the follow-up four weeks after the intervention (the twelfth week). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Meaning in life summary scores before intervention to 4-week post intervention. | Meaning in life was measured using the Purpose in Life Test (PIL). It is a 20-item scale designed to measure the degree of perceived meaning and purpose in individual life. Each item of the original scale is rated on a seven-point scale along a continuum from one extreme feeling (0) to the opposite feeling (7). However, too many options may be difficult for older adults to make ratings, so the original seven-point scale was modified to a five-point scale in this study, with 3 representing a neutral response. Possible scores range from 20 to 100, where higher scores indicate stronger sense of meaning in life. | The data were collected before the intervention to week 12: baseline, in the middle of the intervention (the fourth week), at the end of the intervention (the eighth week), and the follow-up four weeks after the intervention (the twelfth week). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Quality of Life, Institutionalized seniors, Disabilities, Meaning in life, Biopsychosocial-Spiritual group intervention