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. 2021 Dec:26:100461.
doi: 10.1016/j.invent.2021.100461. Epub 2021 Oct 1.

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

Yuchen Ying  1   2   3 , Yunxin Ji  1 , Fanqian Kong  4 , Qiqi Chen  2 , Yueer Lv  2 , Yanbin Hou  1 , Lijie Zhu  5 , Pingping Miao  1 , Libo Yu  2 , Laiyou Li  2 , Wei Kuang  2 , Lingli Jiang  2 , Xiaozhuo Zhu  2 , Xiaozhuang Liu  2 , Le Xu  3 , Yuwei Mi  3 , Zhongze Lou  1   6 , Liemin Ruan  1
Affiliations

Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

Yuchen Ying et al. Internet Interv. 2021 Dec.

Abstract

Background: The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020.

Methods: Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT.

Results: Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated.

Conclusion: ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.

Keywords: CBT, cognitive behavioral therapy; CIs, confidence intervals; COVID-19; DSM-IV, The Diagnostic and Statistical Manual of Mental Disorders-4th edition; Feasibility study; GAD-7, Generalized Anxiety Disorder 7-item; GDS, Geriatric Depression Scale; ICBT, Internet-based cognitive behavioral therapy; ITT, intention-to-treat; Internet-based cognitive behavioral therapy; K-10, 10-item Kessler Psychological Distress Scale; LOCF, last observation carried forward; MMRM, mixed-effects model for repeated measure; Mental health; Older adults; PHQ-9, Patient Health Questionnaire 9-item; Psychological distress; RCT, randomized controlled trials; REML, restricted maximum likelihood; SD, standard deviation; SDS, Sheehan Disability Scales; UN, unstructured.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flowchart of participants.
Fig. 2
Fig. 2
A screen shot of an Internet-based cognitive behavioral therapy (ICBT) program called “Healthy Psychological Station”.
See this image and copyright information in PMC

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