Internet-based cognitive behavioral therapy for psychological distress in older adults without cognitive impairment living in nursing homes during the COVID-19 pandemic: A feasibility study

• Main Authors: Yuchen Ying, Yunxin Ji, Fanqian Kong, Qiqi Chen, Yueer Lv, Yanbin Hou, Lijie Zhu, Pingping Miao, Libo Yu, Laiyou Li, Wei Kuang, Lingli Jiang, Xiaozhuo Zhu, Xiaozhuang Liu, Le Xu, Yuwei Mi, Zhongze Lou, Liemin Ruan
• Format: Article
• Language: English
• Published: Elsevier 2021-12-01
• Series: Internet Interventions
• Subjects: COVID-19; Internet-based cognitive behavioral therapy; Older adults; Psychological distress; Mental health; Feasibility study
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214782921001019

Background: The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. Methods: Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. Results: Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. Conclusion: ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.