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Integration of Social Art Activities and Qigong for Older People in Nursing Home in Indonesia

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ClinicalTrials.gov Identifier: NCT02957773
Recruitment Status : Completed
First Posted : November 8, 2016
Last Update Posted : March 23, 2018
Universitas Tarumanagara
Information provided by (Responsible Party):
Radboud University Medical Center

Brief Summary:

This project will be a randomised controlled trial to investigate the effectiveness of an integrated programme by using social art activity (SA) and exercise, for instance, Qigong (QG, a traditional Chinese exercise) as a therapeutic medium.

This integrated programme aims to increase the well-being and reduce the depressive symptoms that are frequently ascertained in older people who live in nursing homes. The combination of SA and QG might be more beneficial to older people than either individual activity on its own, given that they are addressing different areas of functioning. The art activity focuses on self-expression in non-verbal activity using fine motor movement, whereas physical exercise like Qigong focuses on awareness of breathing and a calm state of mind. This is to help the older person achieve mental and physical relaxation by using gross motor movement. When the interventions are combined by utilising Qigong ahead of the art activities (thus, including both fine and gross motor movements) older people will reach a state of mental and physical relaxation, and moreover, will be able to express their feelings more simply in the social art activities.

Condition or disease Intervention/treatment Phase
Well-being Depressive Symptoms Behavioral: Qigong and art activities Behavioral: Art activities Behavioral: Qigong Behavioral: Daily activities Not Applicable

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 299 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Integration of Social Art Activities and Qigong Exercises to Increase the Well-Being of Older People in Nursing Homes in Indonesia
Study Start Date : January 2017
Actual Primary Completion Date : November 2017
Actual Study Completion Date : December 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Nursing Homes

Arm Intervention/treatment
Experimental: Qigong and art activities
An integrated group of Qigong and art activities for 90 minutes.
Behavioral: Qigong and art activities
Participants join a 90-minute session of integrated Qigong and art activity consisting of 30 minutes Qigong followed by 60 minutes art activity.

Experimental: Art activities
Art activities and daily activities group for 90 minutes.
Behavioral: Art activities
Participants join a 90-minute session that consists of 60-minute art activities followed by 30 minutes daily activities.

Experimental: Qigong
A Qigong and daily activities group for 90 minutes
Behavioral: Qigong
Participants join a 90-minute session that consists of 30-minutes Qigong exercise followed by 60 minutes daily activities (watching television, reading or sitting together).

Daily activities
A daily activities group for 90-minutes.
Behavioral: Daily activities
Participants do their daily activities routine for 90-minutes, such as watching television, reading and sitting together or participants can do free individual activities on their own.

Primary Outcome Measures :
  1. WHOQOL-BREF [ Time Frame: Change from Baseline to 8 weeks, 3 and 6 months ]
    The brief version of the World Health Organization Quality of Life (WHOQOL-BREF) (The WHO Group, 1998) was developed to assess the quality of life. It contains a total of 26 questions. All items are rated on a five-point Likert scale using response categories such as 1 represents very poor, and 5 represents very well with the statement. The instrument consists of four domains: psychological health, physiological health, social relationships, and environmental health. The test - re-test reliability for WHOQOL-BREF lies within 0.81 to 0.90.

Secondary Outcome Measures :
  1. SWLS [ Time Frame: Change from Baseline to 8 weeks, 3 and 6 months ]
    The satisfaction with life scale (SWLS) (Diener, 1984) was developed to assess satisfaction with the respondent's life as a whole. It consists of five statements that the client could either agree or disagree with on a scale of 1 - 7, where 1 represents strongly disagree, and 7 represents strongly agree with the statement. Diener (1985) reported a Cronbach's alpha of 0.87 for the scale and a test - retest stability coefficient of 0.82.

  2. The Indo BDI-II [ Time Frame: Change from Baseline to 8 weeks, 3 and 6 months ]
    Beck Depression Inventory-II for Indonesian general population (Beck, Steer, & Brown, 1996; Ginting, Näring, van der Veld, Srisayekti & Becker, 2013), contains 21-item self-report inventory measuring the severity of depression in adolescents and adults. All items are rated on a 4-point Likert-type scale ranging from 0 to 3, based on the severity of each item. Cronbach's alpha of the Indo BDI-II per group was .90 for healthy participants, and .91 for depressed patients. The test-retest correlation of the Indo BDI-II was significant (r = .55, p < .01).

  3. GDS-15 [ Time Frame: Change from Baseline to 8 weeks, 3 and 6 months ]
    Geriatric Depression Scale 15-item (GDS 15-item) adapted from the Sheikh and Yesavage (1986). The GDS was designed as a screening tool for depression in elderly populations. It consists of 15 questions with YES or NO answer; where YES was treated as 0 and NO-treated as 1. A score > 5 point is suggestive of depression. The Cronbach's α coefficient was 0,71.

  4. MMSE [ Time Frame: Change from Baseline to 8 weeks, 3 and 6 months ]
    Mini-Mental State Exam (MMSE; Folstein, Folstein, & McHugh, 1975) used as a brief indicator of cognitive status. It is an 11-question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. The maximum score is 30. A score of 23 or lower is indicative of cognitive impairment.

  5. SF-36 [ Time Frame: Change from Baseline to 8 weeks, 3 and 6 months ]
    A 36-item short-form (SF-36; Ware Jr, 1993; Perwitasari, 2012) is a widely used questionnaire for measuring self-reported physical and mental health status. It is a short-form health survey with only 36 questions. Estimates of reliability in the physical and mental sections are typically above 0.90.

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Aged 50 years or older
  • Deemed to be cognitively capable of participating in an in-depth interview
  • Admitted to the nursing home at least 3 months ago
  • Healthy physical condition (able to walk and to do daily activity without assistance)
  • Consent to randomization and follow-up.

Exclusion Criteria:

  • Severe cognitive impairment or dementia based on MMSE
  • Blind and have severe hearing or speech impairment that might interfere with participation in the interview
  • Psychotic disorders based on MINI Neuropsychiatric Interview (Sheehan et al., 1998)
  • Severe physical disorder
  • Severe communication problem
  • Alcohol/drug misuse.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02957773

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Panti wredha
Jakarta, Indonesia
Sponsors and Collaborators
Radboud University Medical Center
Universitas Tarumanagara
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Principal Investigator: Roswiyani Roswiyani, M.Psi Behavioural Science Institute, Radboud University, The Netherlands; and Tarumanagara University, Jakarta, Indonesia
Study Director: Jan Spijker, Prof. dr. Behavioural Science Institute, Radboud University, The Netherlands, and Pro Persona Mental Health Care, Depression Expertise Centre, Nijmegen, the Netherlands
Study Director: Cilia Witteman, Prof. dr. Behavioural Science Institute, Radboud University, The Netherlands
Thyme, K. E., Sundin, E. C., Stahlberg, G., Lindstrom, B., Eklof, H., & Wiberg, B. (2007). The outcome of short-term psychodynamic art therapy compared to short-term psychodynamic verbal therapy for depressed women. Psychoanalytic Psychotherapy, 21, 250-264.
Ginting, H., Näring, G., van der Veld, W.M., Srisayekti, W., & Becker, E. S. (2013). Validating the Beck Depression Inventory-II in Indonesia's general population and coronary heart disease patients. International Journal of Clinical and Health Psychology, 13, 235-242. DOI: 10.1016/S1697-2600(13)70028-0.
Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. In: Brink TL, editor. Clinical Gerontology : A Guide to Assessment and Intervention. New York: The Haworth Press, pp. 165-173.
Ali, U. & Hasan, S. (2010). The effectiveness of relaxation therapy in the reduction of anxiety related symptoms (a case study). International Journal of Psychological Studies, 2, 2; 202-208. www.ccsenet.org/ijps
Blomdahl, Gunnarsson, Guregård, S., & Björklund, A. (2013). A realist review of art therapy for clients with depression. The Arts in Psychotherapy, 40, 322- 330. DOI:10.1016/j.aip.2013.05.009
Cloosterman, N.H.M., Laan, A. J., & Alphen, B.P.J.V. (2013). Characteristics of psychotherapeutic integration for depression in older adults: A delphi study. Clinical Gerontologist, 36:5, 395-410. DOI: 10.1080/07317115.2013.816815.
Etemadi, A., & Ahmadi, K. (2009). Psychological disorders of elderly home residents. Journal of Applied Sciences, 9:3, 549-554. DOI: 10.3923/jas.2009.549.554
Hass-Cohen, N.,&Carr, R. (Eds.). (2008). Art therapy and clinical neuroscience. London, England: Jessica Kingsley.
Isaksson, C., Norlén, A.-K., Englund, B., & Lindqvist, R. (2009). Changes in self-imagesas seen in tree paintings. The Arts in Psychotherapy, 36, 304-312. Doi:10.1016/j.aip.2009.07.004.
Neufeld, E., Freeman, S., Joling, K., & Hirdes, J.P. (2014) "When the golden years are blue": Changes in depressive symptoms over time among older adults newly admitted to long-term care facilities. Clinical Gerontologist, 37:3, 298-315. DOI:10.1080/07317115.2014.885919.
Segal, Z.V.,Williams,J.M.G.,&Teasdale,J.D.(2002). Mindfulness-based cognitive therapy for depression. New York: The Guilford Press.
Vinson, L.D., MA , Crowther, M.R., Austin, A.D., & Guin, S.M. (2014). African Americans, mental health, and aging. Clinical Gerontologist, 37:1, 4-17. DOI: 10.1080/07317115.2013.847515.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-ii. San Antonio, 78(2), 490-498.
Perwitasari, D. A. (2012). Development the validation of indonesian version of sf-36 questionnaire in cancer disease. Indonesian Journal of Pharmacy, 248-253.
Ware, J. E. (1993). Sf-36 health survey: Manual and interpretation guide. Boston, MA: Nimrod Press.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Radboud University Medical Center
ClinicalTrials.gov Identifier: NCT02957773    
Other Study ID Numbers: SAAQE-R053
First Posted: November 8, 2016    Key Record Dates
Last Update Posted: March 23, 2018
Last Verified: September 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Additional relevant MeSH terms:
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Behavioral Symptoms