The effects of resourcefulness-based instrumental reminiscence therapy on psychological adjustment in nursing home residents: a randomised controlled trial

Abstract

Background: Older adults do not always adapt successfully to nursing homes. Learning resourcefulness and instrumental reminiscence may contribute to the psychological adjustment made by nursing home residents. How both attributes can be combined to enhance residents' adjustment remains unclear.

Objectives: This study examined the effects of resourcefulness-based instrumental reminiscence therapy (RBIRT) on psychological adjustment, learned resourcefulness, self-efficacy, social support and quality of life (QoL) of nursing home residents.

Methods: A randomised, controlled, assessor-blinded, parallel-arm trial was conducted between January 2022 and February 2023 in Fujian, China, with 120 participants (intervention = 60, comparison = 60) from two separate nursing homes. The intervention group participants received a 6-week RBIRT, involving Reminiscence Interview, Emotional Venting, Reconstruction Strategies, Planning for the Future and Strengthening Support. The control group participants received routine institutional care. Participants were assessed using the Nursing Home Adjustment Scale, Resourcefulness Scale, General Self-efficacy Scale, Perceived Social Support Scale and the 12-item Short-Form Health Survey. Outcomes were evaluated at baseline (T0), immediately post intervention (T1) and at 1-month (T2) and 3-months (T3) post-intervention.

Results: Participants in the intervention group showed significant improvement in 'psychological adjustment,' 'learned resourcefulness,' 'self-efficacy,' 'social support' and 'QoL-mental health dimension' compared to the control group (P < 0.001). These effects were sustained at the 1- and 3-month follow-ups.

Conclusions: Innovative RBIRT improved psychological adjustment, learned resourcefulness, self-efficacy, social support and mental health-related QoL among nursing home residents.

Keywords: instrumental reminiscence therapy; learned resourcefulness; older adults; older people; psychological adjustment; randomised controlled trial.