Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study

Ning Qin; Jie Li; Xiaoqi Wu; Chun Zhang; Yating Luo; Xiaoqian Dong; Huan Cao; Sha Wang; Min Liu; Jianfei Xie; Andy Sk Cheng

doi:10.1186/s12912-023-01449-9

Effects of rational emotive behavior therapy on alexithymia, anxiety, depression and sleep quality of older people in nursing homes: a quasi-experimental study

BMC Nurs. 2023 Aug 24;22(1):280. doi: 10.1186/s12912-023-01449-9.

Authors

Ning Qin^#^{1

2}, Jie Li^#^{1

2}, Xiaoqi Wu², Chun Zhang², Yating Luo², Xiaoqian Dong², Huan Cao², Sha Wang¹, Min Liu¹, Jianfei Xie³, Andy Sk Cheng⁴

Affiliations

¹ Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
² Xiang Ya Nursing School, Central South University, Changsha, Hunan, 410013, China.
³ Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China. xiejianfei@csu.edu.cn.
⁴ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, 999077, China.

^# Contributed equally.

Abstract

Background: Alexithymia, a subclinical cognitive-affective impairment, is prevalent in older people and increases the risk of mental disorders. There is a vast alexithymia treatment gap, with majority of older people in nursing homes lacking access to adequate mental health care. The study aimed to evaluate the effects of rational emotive behavior therapy (REBT) on alexithymia, anxiety, depression and sleep quality of older people in nursing homes.

Methods: This quasi-experimental study was conducted with two groups (the control group and intervention) from March to November 2021. This study enrolled 86 participants, two of whom were lost to follow-up; 42 received usual care (control group) and 42 received REBT based on usual care (intervention group) in nursing homes. The older people in both groups were evaluated at baseline (T0), within one-week post-intervention (T1), and at 3-month follow-up (T3). Generalized estimating equations were used by SPSS version 26 to assess the differential change in the outcomes between the two groups.

Results: The intervention group shows significantly greater improvement in alexithymia than the control group at both T1 (β = -8.167, 95%CI= -10.965, -5.368, P < 0.001) and T2 (β=-4.119, 95%CI= -7.171, -1.067, P = 0.008). The two groups showed significant differences at both T1 and T2 in both difficulty identifying feelings and difficulty describing feelings. Compared to the control group, the intervention group shows a significant improvement in sleep quality at T2 (β = -2.048, 95%CI=-4.004, -0.091, P = 0.040). The two groups showed significant differences at both T1 and T2 in both sleep disturbance and daytime dysfunction. For depression and anxiety, no significant differences were found between the intervention and control groups.

Conclusions: REBT showed to be an effective method for improving alexithymia and sleep quality of older people in nursing homes. However, it failed to significantly alleviate anxiety and depression at least in a short-term trial. Refining this intervention may have a broader, more substantial impact on future research.

Keywords: Alexithymia; Anxiety; Depression; Nursing home; Older people; Rational emotive behavior therapy; Sleep quality.

Abstract

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