Occupational therapist-led mindfulness-based stress reduction for older adults living with subjective cognitive decline or mild cognitive impairment in primary care: a feasibility randomized controlled trial
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Authors
Tran, Todd
Date
Type
thesis
Language
eng
Keyword
mindfulness , primary care , mixed methods , older adults , subjective cognitive decline , mild cognitive impairment , technology , computer tablets , randomized controlled trial , Aging and Health
Alternative Title
Abstract
Community-dwelling older adults with subjective cognitive decline or mild cognitive impairment experience functional performance issues, resulting in a decreased satisfaction with their overall everyday performance. Additionally, cognitive decline has been associated with anxiety and depression among older adults. These psychological issues may further exacerbate cognitive decline.
Consequently, exploring and evaluating non-pharmacologic interventions such as behavioural strategies on its own or in parallel with pharmacological interventions to mitigate concomitant psychological factors or support self-perceived functional performance and satisfaction with performance would be critical. Occupational therapists are well-positioned to address both the psychological and functional needs of older adults experiencing cognitive decline in a primary care setting.
This dissertation evaluated an occupational therapy-led Mindfulness-Based Stress Reduction (MBSR) program among older adults with early cognitive deficits, and has two AIMS:
AIM 1: To explore the feasibility of conducting a full-scale randomized control trial (RCT) of an MBSR program, in an interprofessional primary care setting, with the objective to: 1a. Assess rates of recruitment, adherence, and retention, 1b. Explore the acceptability of using computer tablets for intervention and data collection and 1c. Explore the participants’ and healthcare providers’ perspectives and acceptability of technology in the MBSR program.
AIM 2: To evaluate the impact of MBSR on self-perceived functional performance and satisfaction and psychological outcomes to: 2a. Determine the effect sizes of these clinical outcomes.
A convergent mixed-methods, feasibility RCT was used. Participants were randomized into an MBSR or wait-list control group and were compared at three different time points (week-0, week-9 and week-13) on primary and secondary clinical outcomes. Data analysis examined the quantitative and qualitative data separately and were then merged for comparative analysis to best understand the feasibility of a larger clinical trial and to explore clinical outcomes.
Our pilot RCT investigation found a significant reduction in anxiety but did not show improvements in other outcomes. Additionally, our feasibility rates had lower-than-expected outcomes, but with minor modifications to our current design, it is well suited for a full RCT. Last, based on the qualitative findings, we found that MBSR is feasible for practice in an interprofessional primary care setting.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.