JMIR Publications

ABSTRACT

Background:

Increasing life expectancy has led to a rise in nursing home admissions, a context in which older adults often experience chronic physical and mental health conditions, chronic pain, and reduced well-being. Non-pharmacological approaches are especially important for managing older adult health, including sensory stimulation (SS), and therapist support (TS). However, the synergistic effects of SS and TS have not been investigated.

Objective:

This randomized controlled trial examined the specific and combined effects of brief SS and TS interventions on older adults' physical and mental health and pain levels, among individuals living in nursing homes.

Methods:

Ninety-six patients aged 65-99 from a nursing home in northern Israel were randomly assigned to three groups: SS, TS, and combined SS+TS interventions, each delivered as four 20-minute sessions. SS was implemented using a multi-sensory Snoezelen room. Pain levels, blood pressure, heart rate, blood oxygen saturation, and hand grip strength were measured before and after each of the four weekly 20-minute therapeutic sessions. In addition, life satisfaction and anxiety were evaluated before and after the whole intervention. Mixed model analyses tested the relative efficacy of the three interventions, applying simple slope analysis with Tukey correction. Study rationale and analytical plans were preregistered.

Results:

The combined intervention of sensory stimulation and therapist support (SS+TS) resulted in reduced pain levels compared to SS (B=0.209, P=.006)) and TS (B=0.23, P=.002) alone over four sessions (F(6,266)=2.62, P=.017, Rns2=0.23). Also, combined SS+TS intervention resulted in reduced systolic blood pressure vs. SS (B=0.09, P=.01) and TS alone (B=0.016, P<.001) over the intervention (F(6,272)=5.42, P<.001, Rns2=0.29). In addition, synergic SS+TS intervention resulted in an increased grip strength vs. SS. (B=-0.35, P=.003) and TS (B=-.032, P=.008) alone, over the intervention (F(6,273)=2.25, P=.04, Rns2=0.19). Moreover, combined SS+TS resulted in an improvement in life satisfaction (B=-4.29, P<.0001) compared to SS (B=-2.38, P=.0042) and TS alone (B=-1.20, P=.13) groups (F(2,39)=3.47, P=.04). Finally, SS+TS demonstrated greater improvement in symptoms of general anxiety disorder (B=10.64, P<.0001), compared to SS (B=3.30 P=.0154) and TS (B=1.13, P=.375) alone (F(2,38)=13.5, p<.001). No differences between the interventions were shown for blood oxygen saturation (F(6,273)=2.06, P=.06), diastolic blood pressure (F(6,272)=1.12, P=.35), and heart pulse (F(6,273)=1.33, P=.23).

Conclusions:

The combined intervention of SS and TS showed therapeutic benefits for pain management and physical and mental health of older adults living in nursing homes, relative to each therapeutic component in isolation. This brief intervention can be readily implemented to improve well-being and optimize therapeutic resources in nursing home settings.