Department of Psychology, University of Southern California, Los Angeles.
School of Psychology and Counseling, University of Southern Queensland, Toowoomba, Australia.
Gerontologist. 2018 Mar 19;58(2):353-361. doi: 10.1093/geront/gnw152.
This study investigated the mechanisms of change underlying an activity-based lifestyle intervention, an occupational therapy program aimed at promoting healthy habits, and routines in older adults. We examined two activity-relevant factors as potential mediators linking the intervention to reduced symptoms of depression: activity frequency and global perceptions of activity significance. Social connections and perceived control were assessed to understand how activity-related factors relate to reduced symptoms of depression.
The sample consisted of 460 multiethnic community-dwelling older adults aged 60-95 years. Participants were randomly assigned to a 6-month lifestyle redesign intervention (n = 232) or a no-treatment control (n = 228) condition. After the 6-month period, 360 individuals completed post-testing. Latent change score models were used to represent changes from baseline over the experimental interval. Structural equation models were applied to examine the indirect effects of the intervention on reduced depressive symptoms.
The results demonstrated significant indirect effects from intervention receipt to decreased depressive symptoms via increased activity frequency and activity significance. Higher activity frequency was linked to fewer depressive symptoms via heightened social connections, whereas increased activity significance was associated with fewer depressive symptoms via enhanced perceived control.
The results support basic principles of occupational therapy by highlighting important mediating roles of activity frequency and activity significance in reducing depressive symptoms. Understanding of these change mechanisms can help optimize activity-centered interventions to reduce depressive symptoms.
本研究旨在探讨基于活动的生活方式干预的变化机制，这是一种职业治疗计划，旨在促进老年人的健康习惯和日常生活规律。我们研究了两个与活动相关的因素，作为潜在的中介因素，将干预与抑郁症状的减轻联系起来：活动频率和对活动意义的整体感知。评估社会联系和感知控制，以了解与活动相关的因素与抑郁症状减轻之间的关系。
样本由 460 名多民族社区居住的 60-95 岁老年人组成。参与者被随机分配到 6 个月的生活方式重新设计干预组（n = 232）或无治疗对照组（n = 228）。6 个月后，360 人完成了测试。潜在变化分数模型用于表示从基线到实验间隔的变化。结构方程模型用于检验干预对减少抑郁症状的间接影响。
结果表明，干预对减少抑郁症状有显著的间接影响，这是通过增加活动频率和活动意义来实现的。更高的活动频率通过增强社会联系与更少的抑郁症状相关，而更高的活动意义则通过增强感知控制与更少的抑郁症状相关。
结果支持职业治疗的基本原则，强调了活动频率和活动意义在减少抑郁症状方面的重要中介作用。对这些变化机制的理解可以帮助优化以活动为中心的干预措施，以减少抑郁症状。
