Chronic pain and depression are leading causes of disability for older adults worldwide. There is a need to develop effective, culturally congruent treatments for Chinese older adults who are more likely to be stigmatized in the Chinese community for mental health problems. By taking advantage of traditional Chinese healing practices and combining them with western psychoeducational model and neurophysiological findings, an integrated body-mind-social-spirit (BMSS) intervention was developed and tested in China and the U.S. The objectives of this pilot study are to examine the effects of this intervention in mitigating chronic pain, reducing depression, and increasing social support among Chinese older adults.
Study Design and Samples:
This pilot study utilized a single group pretest and posttest design. Mixed method design was used. Chinese older adults with chronic pain and depression were recruited from two community mental health centers - one in Shanghai and one in New York. The eligible older adults were introduced to an 8-week BMSS model intervention. There were 30 older adults in Shanghai and 22 older adults in New York who participated in the study. The mean age was 72.9 (SD= 8.28). Among them, 38 were female (73.1%).
The intervention uses the BMSS model, which is comprised of the following elements practiced by two experienced clinicians: psycho-educational group, mindfulness meditation, and Eight Brocade practice. This recovery oriented, group practice project was introduced twice a week over eight weeks. In addition to 1.5 hour group activities and embodied mindfulness practice, the participants needed to complete “homework” exercises during the week and record the exercises they did at home including frequencies and duration.
Measures and Data Collection:
Outcome measures included the Medical Outcomes Study Pain Measures (MOSPM), Pain Resilience Scale (PRS), Patient Health Questionnaire (PHQ-9), Geriatric Depression Scale (CTGDS), and Social Support Rating Scale (SSRS). Participants were interviewed by the trained interviewers at baseline and one week after the intervention. Qualitative data was collected to understand the participants’ feedback on the program after the intervention.
Results showed that both groups had significant reductions in the level of chronic pain and depression, and improvement in subjective support and the utilization of social support (p<0.05). During the interviews, every participant reported a decrease in physical pain, especially those with severe symptoms who reported significant pain reduction and reduced impact on daily dysfunction. The participants also reported improvements in quality of sleep and short-term memory, as well as improved outlook on life, better communication skills and interpersonal relationships, and improved subjective perception of social support.
Conclusions and Implications
In conclusion, the integrative body-mind-social-spirit model finds success as a culturally congruent methodology for treating chronic physical pain and depression in Chinese older adults. However, due to the single group pretest-posttest design and the small sample size, the study cannot provide sufficient evidence of the efficacy of the intervention. A randomized controlled trial needs to be conducted in order to examine the efficacy of this intervention program in the future.