Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study

Abstract Background Alexithymia, a subclinical cognitive-affective impairment, is prevalent in older people and increases the risk of mental disorders. There is a vast alexithymia treatment gap, with majority of older people in nursing homes lacking access to adequate mental health care. The study a...

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Main Authors: Ning Qin, Jie Li, Xiaoqi Wu, Chun Zhang, Yating Luo, Xiaoqian Dong, Huan Cao, Sha Wang, Min Liu, Jianfei Xie, Andy SK Cheng
Format: Article
Language:English
Published: BMC 2023-08-01
Series:BMC Nursing
Subjects:
Online Access:https://doi.org/10.1186/s12912-023-01449-9
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author Ning Qin
Jie Li
Xiaoqi Wu
Chun Zhang
Yating Luo
Xiaoqian Dong
Huan Cao
Sha Wang
Min Liu
Jianfei Xie
Andy SK Cheng
author_facet Ning Qin
Jie Li
Xiaoqi Wu
Chun Zhang
Yating Luo
Xiaoqian Dong
Huan Cao
Sha Wang
Min Liu
Jianfei Xie
Andy SK Cheng
author_sort Ning Qin
collection DOAJ
description Abstract Background Alexithymia, a subclinical cognitive-affective impairment, is prevalent in older people and increases the risk of mental disorders. There is a vast alexithymia treatment gap, with majority of older people in nursing homes lacking access to adequate mental health care. The study aimed to evaluate the effects of rational emotive behavior therapy (REBT) on alexithymia, anxiety, depression and sleep quality of older people in nursing homes. Methods This quasi-experimental study was conducted with two groups (the control group and intervention) from March to November 2021. This study enrolled 86 participants, two of whom were lost to follow-up; 42 received usual care (control group) and 42 received REBT based on usual care (intervention group) in nursing homes. The older people in both groups were evaluated at baseline (T0), within one-week post-intervention (T1), and at 3-month follow-up (T3). Generalized estimating equations were used by SPSS version 26 to assess the differential change in the outcomes between the two groups. Results The intervention group shows significantly greater improvement in alexithymia than the control group at both T1 (β = -8.167, 95%CI= -10.965, -5.368, P < 0.001) and T2 (β=-4.119, 95%CI= -7.171, -1.067, P = 0.008). The two groups showed significant differences at both T1 and T2 in both difficulty identifying feelings and difficulty describing feelings. Compared to the control group, the intervention group shows a significant improvement in sleep quality at T2 (β = -2.048, 95%CI=-4.004, -0.091, P = 0.040). The two groups showed significant differences at both T1 and T2 in both sleep disturbance and daytime dysfunction. For depression and anxiety, no significant differences were found between the intervention and control groups. Conclusions REBT showed to be an effective method for improving alexithymia and sleep quality of older people in nursing homes. However, it failed to significantly alleviate anxiety and depression at least in a short-term trial. Refining this intervention may have a broader, more substantial impact on future research.
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spelling doaj.art-71b46ec55442477b8f4f112a37175a092023-11-19T12:51:05ZengBMCBMC Nursing1472-69552023-08-0122111110.1186/s12912-023-01449-9Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental studyNing Qin0Jie Li1Xiaoqi Wu2Chun Zhang3Yating Luo4Xiaoqian Dong5Huan Cao6Sha Wang7Min Liu8Jianfei Xie9Andy SK Cheng10Nursing Department, The Third Xiangya Hospital, Central South UniversityNursing Department, The Third Xiangya Hospital, Central South UniversityXiang Ya Nursing School, Central South UniversityXiang Ya Nursing School, Central South UniversityXiang Ya Nursing School, Central South UniversityXiang Ya Nursing School, Central South UniversityXiang Ya Nursing School, Central South UniversityNursing Department, The Third Xiangya Hospital, Central South UniversityNursing Department, The Third Xiangya Hospital, Central South UniversityNursing Department, The Third Xiangya Hospital, Central South UniversityDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityAbstract Background Alexithymia, a subclinical cognitive-affective impairment, is prevalent in older people and increases the risk of mental disorders. There is a vast alexithymia treatment gap, with majority of older people in nursing homes lacking access to adequate mental health care. The study aimed to evaluate the effects of rational emotive behavior therapy (REBT) on alexithymia, anxiety, depression and sleep quality of older people in nursing homes. Methods This quasi-experimental study was conducted with two groups (the control group and intervention) from March to November 2021. This study enrolled 86 participants, two of whom were lost to follow-up; 42 received usual care (control group) and 42 received REBT based on usual care (intervention group) in nursing homes. The older people in both groups were evaluated at baseline (T0), within one-week post-intervention (T1), and at 3-month follow-up (T3). Generalized estimating equations were used by SPSS version 26 to assess the differential change in the outcomes between the two groups. Results The intervention group shows significantly greater improvement in alexithymia than the control group at both T1 (β = -8.167, 95%CI= -10.965, -5.368, P < 0.001) and T2 (β=-4.119, 95%CI= -7.171, -1.067, P = 0.008). The two groups showed significant differences at both T1 and T2 in both difficulty identifying feelings and difficulty describing feelings. Compared to the control group, the intervention group shows a significant improvement in sleep quality at T2 (β = -2.048, 95%CI=-4.004, -0.091, P = 0.040). The two groups showed significant differences at both T1 and T2 in both sleep disturbance and daytime dysfunction. For depression and anxiety, no significant differences were found between the intervention and control groups. Conclusions REBT showed to be an effective method for improving alexithymia and sleep quality of older people in nursing homes. However, it failed to significantly alleviate anxiety and depression at least in a short-term trial. Refining this intervention may have a broader, more substantial impact on future research.https://doi.org/10.1186/s12912-023-01449-9Rational emotive behavior therapyNursing homeOlder peopleAlexithymiaAnxietyDepression
spellingShingle Ning Qin
Jie Li
Xiaoqi Wu
Chun Zhang
Yating Luo
Xiaoqian Dong
Huan Cao
Sha Wang
Min Liu
Jianfei Xie
Andy SK Cheng
Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study
BMC Nursing
Rational emotive behavior therapy
Nursing home
Older people
Alexithymia
Anxiety
Depression
title Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study
title_full Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study
title_fullStr Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study
title_full_unstemmed Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study
title_short Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study
title_sort effects of rational emotive behavior therapy on alexithymia anxiety depression and sleep quality of older people in nursing homes a quasi experimental study
topic Rational emotive behavior therapy
Nursing home
Older people
Alexithymia
Anxiety
Depression
url https://doi.org/10.1186/s12912-023-01449-9
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