Effects of tai chi qigong on psychosocial well-being among hidden elderly, using elderly neighborhood volunteer approach: a pilot randomized controlled trial

Aileen Wk Chan, Doris Sf Yu, K C Choi, Aileen Wk Chan, Doris Sf Yu, K C Choi

Abstract

Purpose: To test the feasibility and preliminary effectiveness of a tai chi qigong program with the assistance of elderly neighborhood volunteers in strengthening social networks and enhancing the psychosocial well-being of hidden elderly.

Patients and methods: "Hidden elderly" is a term used to describe older adults who are socially isolated and refuse social participation. This pilot randomized controlled trial recruited 48 older adults aged 60 or above who did not engage in any social activity. They were randomized into tai chi qigong (n=24) and standard care control (n=24) groups. The former group underwent a three-month program of two 60-minute sessions each week, with the socially active volunteers paired up with them during practice. Standard care included regular home visits by social workers. Primary outcomes were assessed by means of the Lubben social network and De Jong Gieveld loneliness scales, and by a revised social support questionnaire. Secondary outcomes were covered by a mental health inventory and the Rosenberg self-esteem scale, and quality of life by using the 12-Item Short Form Health Survey. Data was collected at baseline, and at three and six months thereafter.

Results: The generalized estimating equations model revealed general improvement in outcomes among participants on the tai chi qigong program. In particular, participants reported a significantly greater improvement on the loneliness scale (B=-1.32, 95% confidence interval [CI] -2.54 to -0.11, P=0.033) and the satisfaction component of the social support questionnaire (B=3.43, 95% CI 0.10-6.76, P=0.044) than the control group.

Conclusion: The pilot study confirmed that tai chi qigong with elderly neighborhood volunteers is a safe and feasible social intervention for hidden elderly. Its potential benefits in improving social and psychological health suggest the need for a full-scale randomized controlled trial to reveal its empirical effects.

Keywords: group-based activity; social isolation; social network; social support.

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart tracking participants through randomized controlled trial.
Figure 2
Figure 2
De Jong Gieveld loneliness scale across time between control and tai chi qigong groups. Abbreviation: CI, confidence interval.
Figure 3
Figure 3
RSSQ sum of satisfaction across time between control and tai chi qigong groups. Abbreviations: RSSQ, revised social support questionnaire; CI confidence interval.
Figure 4
Figure 4
Physical component scales across time between control and tai chi qigong groups. Abbreviations: SF-12, 12-Item Short Form Health Survey; CI confidence interval.

References

    1. World Health Organization 10 facts on ageing and health. 2015. [Accessed September 2, 2016]. [updated September 2015]. Available from:
    1. Steering Committee on Population Policy . Population policy: strategies and initiatives. Hong Kong SAR: Chief Secretary for Administration’s Office; 2015.
    1. Cornwell B, Laumann EO, Schumm LP. The social connectedness of older adults: a national profile. Am Sociol Rev. 2008;73(2):185–203.
    1. Hong Kong Special Administrative Region Government News Press releases. Assistance to the unidentified elderly [updated 2007] [Accessed August 31, 2016]. Available from: .
    1. Asia-Pacific Institute of Ageing Studies, Lingnan University Hidden elderly service research [updated 2009] [Accessed August 31, 2016]. Available from: .
    1. The Chinese University of Hong Kong . A Qualitative Study on ‘Hidden Elderly’ in Hong Kong. Hong Kong Special Administrative Region: Central Policy Unit; 2008.
    1. Chau PH, Gusmano MK, Cheng JO, Cheung SH, Woo J. Social vulnerability index for the older People-Hong Kong and New York city as examples. J Urban Health. 2014;91(6):1048–1064.
    1. Eng PM, Rimm EB, Fitzmaurice G, Kawachi I. Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men. Am J Epidemiol. 2002;155(8):700–709.
    1. Cattan M, White M, Bond J, Learmouth A. Preventing social isolation and loneliness among older people: a systematic review of health promotion interventions. Ageing Soc. 2005;25(1):41–67.
    1. Greaves CJ, Farbus L. Effects of creative and social activity on the health and well-being of socially isolated older people: outcomes from a multi-method observational study. J R Soc Promot Health. 2006;126(3):134–142.
    1. Dickens AP, Richards SH, Greaves CJ, Campbell JL. Interventions targeting social isolation in older people: a systematic review. BMC Public Health. 2011;11:647.
    1. Saito T, Kai I, Takizawa A. Effects of a program to prevent social isolation on loneliness, depression, and subjective well-being of older adults: a randomized trial among older migrants in Japan. Arch Gerontol Geriatr. 2012;55(3):539–547.
    1. Chan AW, Lee A, Lee DT, Sit JW, Chair SY. Evaluation of the sustaining effects of Tai Chi Qigong in the sixth month in promoting psychosocial health in COPD patients: a single-blind, randomized controlled trial. Scientific World J. 2013;2013:425082.
    1. Lee LY, Lee DT, Woo J. The psychosocial effect of Tai Chi on nursing home residents. J Clin Nurs. 2010;19(7–8):927–938.
    1. Lu X, Hui-Chan CW, Tsang WW. Tai Chi, arterial compliance, and muscle strength in older adults. Eur J Prev Cardiol. 2013;20(4):613–619.
    1. Ni GX, Song L, Yu B, Huang CH, Lin JH. Tai Chi improves physical function in older Chinese women with knee osteoarthritis. J Clin Rheumatol. 2010;16(2):64–67.
    1. Wayne PM, Walsh JN, Taylor-Piliae RE, et al. Effect of tai chi on cognitive performance in older adults: systematic review and meta-analysis. J Am Geriatr Soc. 2014;62(1):25–39.
    1. DiGiacomo M, Lam P, Roberts BL, Lau TC, Song R, Davidson PM. Exploring the reasons for adherence to t’ai chi practice. J Altern Complement Med. 2010;16(12):1245–1246.
    1. Chan AW, Lee A, Lee DT, et al. The sustaining effects of Tai chi Qigong on physiological health for COPD patients: a randomized controlled trial. Complement Ther Med. 2013;21(6):585–594.
    1. Ng SM, Wang CW, Ho RT, et al. Tai chi exercise for patients with heart disease: a systematic review of controlled clinical trials. Altern Ther Health Med. 2012;18(3):16–22.
    1. Sun J, Buys N, Jayasinghe R. Effects of community-based meditative Tai Chi programme on improving quality of life, physical and mental health in chronic heart-failure participants. Aging Ment Health. 2014;18(3):289–295.
    1. Zhang Y, Fu FH. Effects of 14-week Tai Ji Quan exercise on metabolic control in women with type 2 diabetes. Am J Chin Med. 2008;36(4):647–654.
    1. Wolf SL, O’Grady M, Easley KA, Guo Y, Kressig RW, Kutner M. The influence of intense Tai Chi training on physical performance and hemodynamic outcomes in transitionally frail, older adults. J Gerontol A Biol Sci Med Sci. 2006;61(2):184–189.
    1. Field T. Tai chi research review. Complement Ther Clin Pract. 2011;17(3):141–146.
    1. Chan AW, Yu DS, Choi KC, Lee DT, Sit JW, Chan HY. Tai chi qigong as a means to improve night-time sleep quality among older adults with cognitive impairment: a pilot randomized controlled trial. Clin Interv Aging. 2016;11:1277–1286.
    1. Haski-Leventhal D, Bargal D. The volunteer stages and transitions model: organizational socialization of volunteers. Hum Relat. 2008;61(1):67–102.
    1. Haski-Leventhal D, Ben-Arieh A, Melton GB. Between neighborliness and volunteerism: participants in the strong communities initiative. Fam Community Health. 2008;31(2):150–161.
    1. Browne RH. On the use of a pilot sample for sample size determination. Stat Med. 1995;14(7):1933–1940.
    1. Lubben JE. Assessing social networks among elderly populations. Fam Community Health. 1988;11(3):42–52.
    1. Rubinstein RL, Lubben JE, Mintzer JE. Social isolation and social support: an applied perspective. J Appl Gerontol. 1994;13(1):58–72.
    1. Yunong H. Family relations and life satisfaction of older people: a comparative study between two different hukous in China. Ageing Soc. 2012;32(1):19–40.
    1. Leung GT, de Jong Gierveld J, Lam LC. Validation of the Chinese translation of the 6-item De Jong Gierveld Loneliness Scale in elderly Chinese. Int Psychogeriatr. 2008;20(6):1262–1272.
    1. Sarason IG, Sarason BR, Shearin EN, Pierce GR. A brief measure of social support: practical and theoretical implications. J Soc Pers Relat. 1987;4(4):497–510.
    1. Veit CT, Ware JE., Jr The structure of psychological distress and well-being in general populations. J Consult Clin Psychol. 1983;51(5):730–742.
    1. Schmitt DP, Allik J. Simultaneous administration of the Rosenberg Self-Esteem Scale in 53 nations: exploring the universal and culture-specific features of global self-esteem. J Pers Soc Psychol. 2005;89(4):623–642.
    1. Lam ET, Lam CL, Fong DY, Huang WW. Is the SF-12 version 2 health survey a valid and equivalent substitute for the SF-36 version 2 health survey for the Chinese? J Eval Clin Pract. 2013;19(1):200–208.
    1. Hardin JW. Generalized estimating equations (GEE) In: Everitt BS, Howell DC, editors. Encyclopedia of Statistics in Behavioral Science. Vol. 2. Wiley Online Library; 2005. pp. 721–729.
    1. Park YJ, Park IH. Effect of tai chi exercise on loneliness, sleep pattern, and instrumental activities of daily living in elderly women. J Muscle Jt Health. 2010;17(2):151–161.
    1. Chen S, Conwell Y, Chiu HF. Loneliness and aging in China – a public health problem in need of solutions. Int Psychogeriatr. 2014;26(11):1771–1772.
    1. Grenade L, Boldy D. Social isolation and loneliness among older people: issues and future challenges in community and residential settings. Aust Health Rev. 2008;32(3):468–478.
    1. Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A. 2013;110(15):5797–5801.
    1. Pettigrew S. Reducing the experience of loneliness among older consumers. J Res Consum. 2007;12:1–4.
    1. Toepoel V. Ageing, leisure, and social connectedness: how could leisure help reduce social isolation of older people? Soc Indic Res. 2013;113(1):355–372.
    1. Giummarra MJ, Haralambous B, Moore K, Nankervis J. The concept of health in older age: views of older people and health professionals. Aust Health Rev. 2007;31(4):642–650.
    1. Orsega-Smith EM, Payne LL, Mowen AJ, Ho C, Godbey GC. The role of social support and self-efficacy in shaping the leisure time physical activity of older adults. J Leis Res. 2007;39(4):705.
    1. Cheung CK, Ngan MH. Contributions of volunteer networking to isolated seniors in Hong Kong. J Gerontol Soc Work. 2000;33(2):79–100.
    1. McDonald TW, Chown EL, Tabb JE, Schaeffer AK, Howard EK. The impact of volunteering on seniors’ health and quality of life: an assessment of the retired and senior volunteer program. Psychology. 2013;4(3):283.
    1. Anukul C. Depression and Social Cohesion: Is There a Connection? [master’s thesis] Long Beach, CA: California State University; 2014.
    1. Ohmer ML. Citizen participation in neighborhood organizations and its relationship to volunteers’ self- and collective efficacy and sense of community. Soc Work Res. 2007;31(2):109–120.
    1. Coyle CE, Dugan E. Social isolation, loneliness and health among older adults. J Aging Health. 2012;24(8):1346–1363.
    1. Chan AWK, Yu DSF, Choi KC, Chan HYL, Wong EML. Effects of a peer-assisted tai chi qigong program on social isolation and psychological well-being in Chinese hidden elders: a pilot randomised controlled trial. The Lancet. 2016;388(Suppl 1):S23.

Source: PubMed

3
订阅