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促进养老院居民健康和主观幸福感的(数字化)身心干预:一项整群随机对照试验性研究

(Digital) Mind-Body Intervention to Promote Health and Subjective Well-Being of Residents in Nursing Homes: A Cluster-Randomized Controlled Pilot Study.

作者信息

Uhl Jule, Schönfeld Simone, Meyer Laura, Reus Annika, Neumann Claudia, Langer Lena, Michaelsen Maren M, Esch Tobias

机构信息

Institute for Integrative Health Care and Health Promotion, Witten/Herdecke University, Witten, Germany.

出版信息

Gesundheitswesen. 2025 Mar 3. doi: 10.1055/a-2517-8263.

Abstract

Nursing care insurance companies in Germany have the legal mandate to develop measures to strengthen the health resources of residents of nursing homes. The present study aimed to examine a mindfulness-informed mind-body intervention (on-site and app) adapted for residents in nursing homes regarding their effect on health-related parameters.A pilot study (DRKS00030409) was carried out with three groups in twelve nursing homes (RCT). There was an on-site intervention in a group (O), an individual app application with technical support (A) and a passive control group (C). The participating residents (n=28; n=29; n=19) were cluster-randomized. Before, after, and three months after the intervention period (December 2022 - January 2023), among other things, subjective well-being (WHO-5, primary outcome) and mindfulness (KIMS-D, including four subscales) were assessed. Differences within and between study groups and participants with different participation intensity were tested. In addition, a sensitivity analysis was carried out with people who did not have severe cognitive impairments at all three survey times.Indications of differences were found in subjective well-being during the intervention period between the study groups of medium size. While a decrease was observed in the control group, there was no change in the intervention groups. When the intensity of participation was taken into account, the difference between the groups became clearer. In addition, the app group showed an increase in mindfulness (subscale ) immediately after the intervention compared to the control group.Although further studies with larger samples are needed, the results already indicate that the intervention improves the well-being and mindfulness of the target group. Individual support could explain the higher effectiveness in the app group. The influence of the Covid-19 pandemic and the season (winter) on effectiveness must also be examined.

摘要

德国的护理保险公司有法定任务制定措施,以增强养老院居民的健康资源。本研究旨在检验一种为养老院居民量身定制的正念身心干预措施(现场干预和应用程序干预)对健康相关参数的影响。在12家养老院对三组对象进行了一项试点研究(DRKS00030409,随机对照试验)。一组进行现场干预(O组),一组进行有技术支持的个人应用程序干预(A组),还有一个被动对照组(C组)。参与的居民(分别为28人、29人、19人)进行整群随机分组。在干预期(2022年12月至2023年1月)之前、之后以及干预后三个月,评估了主观幸福感(WHO-5,主要结局)和正念(KIMS-D,包括四个子量表)等指标。对研究组内部和之间以及参与强度不同的参与者之间的差异进行了检验。此外,对在所有三次调查时均无严重认知障碍的人群进行了敏感性分析。在中等规模的研究组之间,发现干预期主观幸福感存在差异迹象。对照组观察到下降,而干预组没有变化。考虑到参与强度后,组间差异更加明显。此外,与对照组相比,应用程序组在干预后立即显示出正念(子量表)增加。尽管需要进行更大样本的进一步研究,但结果已经表明该干预措施改善了目标群体的幸福感和正念。个人支持可能解释了应用程序组更高的有效性。还必须研究新冠疫情和季节(冬季)对有效性的影响。

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