“BRASH Therapy” on Quality of Life Among Nursing Home Residents: A Pre-Experimental Study
Abstract
Introduction: Elderly residing in nursing homes are susceptible to health issues, which can significantly impact their quality of life. This study aims to evaluate the effect of “BRASH Therapy” (Benson Relaxation, Affirmation, Butterfly Hug, and Self-Healing Touch Therapy) on the quality of life of the elderly.
Methods: A quantitative approach employing a pre-experimental pre and post-test design was utilized in this study. The sample consisted of 65 participants selected through purposive sampling technique. The inclusion criteria are able to communicate in Indonesian, able to stand, and had no injuries to the upper and lower extremities. Meanwhile, the exclusion criteria set were elderly people with mental and cognitive disorders, as well as chronic mobility disorders. The intervention provided was “BRASH Therapy” administered over five sessions, each lasting fifteen minutes. The quality of life of the elderly was measured pre an post the completion of all intervention sessions. The instrument used for this measurement was the WHOQOL-BRIEF, which has been validated and is reliable. Due to the data not being normally distributed, the Wilcoxon test was used for processing. This research has been declared ethically receivable with evidence of passing ethical review with Ethical Approval Number 283/EA/KEPK-BUB-2024.
Results: The majority of the respondents in this study were female (78,5%), with an average age of 74,3 years. The findings revealed median quality-of-life scores increased from 48,5 (IQR = 20,25-76,75) at baseline to 70,5 (IQR =20,25-80,50) post-intervention. The bivariate test indicated a statistically significant result (Z = ?6,758, p < 0,001). The calculated effect size was very large (r = 0,84, 95% CI: 0,74–0,90), indicating substantial practical significance. Thus, participation in “BRASH Therapy” showed statistically significant improvement of quality of life among elderly residing in nursing homes.
Conclusion: The findings can serve as a basis for considerating complementary interventions aimed at improving the quality of life of elderly residing in nursing homes.
References
Central Statistics Agency of Indonesia. Elderly Population Statistics 2023 [Internet]. Jakarta: Directorate of People’s Welfare Statistics; 2023. Available from: https://www.bps.go.id/id/publication/2023/12/29/5d308763ac29278dd5860fad/statistics-of-aging-population-2023.html
Chen Y, Li X, Ge L, Pan B, Bing Z, Ying X, et al. Comparison of life quality in older adults living in traditional family versus nursing home: a systematic review and meta-analysis. Psychol Health Med [Internet]. 2022 May 28;27(5):1072–83. Available from: https://doi.org/10.1080/13548506.2020.1847303
Juanita J, Nurhasanah N, Jufrizal J, Febriana D. Health related quality of life of Indonesian older adults living in community. Enfermería Clínica [Internet]. 2022;32:S71–5. Available from: https://doi.org/10.1016/j.enfcli.2022.03.022
Šare S, Ljubi?i? M, Gusar I, ?anovi? S, Konjevoda S. Self-esteem, anxiety, and depression in older people in nursing homes. Healthc [Internet]. 2021;9(8). Available from: https://doi.org/10.3390/healthcare9081035
Daely Susisusanti, Nuraini Tuti, Gayatri Dewi, Pujasari Hening. Impacts of Age and Marital Status on the Elderly’s Quality of Life in An Elderly Social Institution. J Public health Res [Internet]. 2022 Feb 1;11(2):jphr.2021.2731. Available from: https://doi.org/10.4081/jphr.2021.2731
Setiyani R, Iskandar A. Cognitive impairment among older adults living in the community and in nursing home in Indonesia: a pilot study. Dement e Neuropsychol [Internet]. 2022;16(3):347–53. Available from: https://doi.org/10.1590/1980-5764-DN-2022-0012
Ministry of Health of The Republic of Indonesia. Indonesian Health Survey 2023 [Internet]. Indonesian Health Survey 2023. Jakarta: Ministry of Health of The Republic of Indonesia; 2023. Available from: https://www.badankebijakan.kemkes.go.id/ski-2023-dalam-angka/
Lutzman M, Sommerfeld E, Ben-David S. Loneliness and social integration as mediators between physical pain and suicidal ideation among elderly men. Int Psychogeriatrics [Internet]. 2021;33(5):453–9. Available from: https://doi.org/10.1017/S104161022000112X
Obuobi-Donkor G, Nkire N, Agyapong VIO. Prevalence of major depressive disorder and correlates of thoughts of death, suicidal behaviour, and death by suicide in the geriatric population—a general review of literature. Behav Sci (Basel) [Internet]. 2021;11(11). Available from: https://doi.org/10.3390/bs11110142
Waryati SY, Andika. Optimisasi Pemeriksaan Kesehatan Lansia: Pendampingan Terintegrasi Di “Posyandu Lansia Nusa Indah.” J Pengabdi Masy Berkemajuan Selaparang [Internet]. 2023;7(4):2431–6. Available from: https://doi.org/10.31764/jpmb.v7i4.19778
Taufik T, Prihartanti N, Daliman D, Karyani U, Purwandari E. Be alone without being lonely: strategies to improve quality of life for an elderly living in nursing homes. Curr Psychol [Internet]. 2024;43(7):6044–50. Available from: https://doi.org/10.1007/s12144-023-04804-w
Jasour A, Afrasiabifar A, Zoladl M, Hosseini N. A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study. BMC Geriatr [Internet]. 2023;23(1):1–9. Available from: https://doi.org/10.1186/s12877-023-04378-z
Merwanda Y, Tambun YM, Nurhaeni H. Pengaruh Terapi Afirmasi Positif dengan Media Flash Card Terhadap Ketidakberdayaan Pasien Rehabilitasi Pasca Stroke. Qual J Kesehat [Internet]. 2024;18(2):153–62. Available from: https://doi.org/10.36082/qjk.v18i2.1798%0A
Cagaoan MSF, Dayrit ACD, Vega ACR Dela, Flores MJ V. Effectiveness of the Butterfly Hug Method to the Level of Mental Health Status of Senior Citizens Living in a Selected Healthcare Facility: Basis for Adjunct Therapy. J Rural Community Nurs Pract [Internet]. 2023;1(2):185–209. Available from: https://doi.org/10.58545/jrcnp.v1i2.119
Ba?c? H, Ç?nar Yücel ?. Effect of Therapeutic Touch on Sleep Quality in Elders Living at Nursing Homes. J Relig Health [Internet]. 2020;59(3):1304–18. Available from: https://doi.org/10.1007/s10943-019-00831-9
Caetano R. Standards for reporting non-randomized evaluations of behavioral and public health interventions: The TREND statement. Addiction [Internet]. 2004;99(9):1075–80. Available from: https://doi.org/10.1111/j.1360-0443.2004.00785.x
Hadning I, Ainii NQ. An Analysis of Health Workers’ Quality of Life in Indonesia During COVID-19 Pandemic. In: Proceedings of the 4th International Conference on Sustainable Innovation 2020–Health Science and Nursing (ICoSIHSN 2020) [Internet]. 2021. p. 425–30. Available from: https://doi.org/10.2991/ahsr.k.210115.085
Molazem Z, Alizadeh M, Rambod M. The effect of benson’s relaxation technique on pain intensity, belief, perception, and acceptance in adult hemophilia patients: A randomized controlled trial. Int J Community Based Nurs Midwifery [Internet]. 2021;9(3):187–98. Available from: https://doi.org/10.30476/ijcbnm.2021.87937.1471
Osman Ali SA, Kamel N, Holmes SL, Abdelfatah Arafat AE. Effect of Benson’s Relaxation Technique on Psychological Distress and Sleep Quality among Elderly. Heal Educ Heal Promot [Internet]. 2022;10(1):1–12. Available from: https://www.sid.ir/en/VEWSSID/J_pdf/5067620220124.pdf
Ebrahimloee S, Masoumpoor A, Nasiri M, Babaie M, Farahani AV, Yousefiasl S, et al. The effect of Benson relaxation technique on the severity of symptoms and quality of life in children with irritable bowel syndrome (IBS): a quasi-experimental study. BMC Gastroenterol [Internet]. 2022;22(1):1–7. Available from: https://doi.org/10.1186/s12876-022-02631-0
Aliwu LS, Firmawati, Pakaya AW. Pengaruh Terapi Afirmasi Positif Terhadap Quality Of Life (Kualitas Hidup) Pasien Harga Diri Rendah di Wilayah Kerja Puskesmas Limboto. J Ilm Ilmu Kesehat dan Kedokt [Internet]. 2023;1(1):193–207. Available from: https://doi.org/10.55606/termometer.v1i1.1207
Jessop DC, Harris PR, Gibbons T. Individual differences in spontaneous self-affirmation predict well-being. Self Identity [Internet]. 2023;22(2):247–75. Available from: https://doi.org/10.1080/15298868.2022.2079711
Sitepu ASN br, Nasution AP, Zebua DR. Audio Afirmasi Untuk Membentuk Harga Diri Positif Individu. J Consulen J Bimbing Konseling dan Psikol [Internet]. 2022;5(2):127–36. Available from: https://doi.org/10.56013/jcbkp.v5i2.1466
Safitri ND, Caturini E, Sugiyarto. The Effectiveness of Butterfly Hug in Reducing Anxiety Long-Distance Relationship (LDR) with Parents in Nursing Students. Basic Appl Nurs Res J [Internet]. 2023;4(1):9–19. Available from: http://dx.doi.org/10.11594/banrj.04.01.02
Ramadhani A, Sofia L, Nisa R, Putri HA. Butterfly Hug Therapy in Leaving Self-Acceptance to Generation Z. J Aisyah J Ilmu Kesehat [Internet]. 2023;8(2):743–8. Available from: https://doi.org/10.30604/jika.v8i2.2020
Aslan KSÜ, Çetinkaya F. The effects of therapeutic touch on spiritual care and sleep quality in patients receiving palliative care. Perspect Psychiatr Care [Internet]. 2022;58(1):374–82. Available from: https://doi.org/10.1111/ppc.12801
Senderovich H, Gardner S, Berall A, Shultz R, Grant B, Santaguida V. Therapeutic Touch in the Management of Responsive Behaviors in Patients with Dementia. Dement Geriatr Cogn Disord [Internet]. 2022;51(2):142–9. Available from: https://doi.org/10.1159/000523752
Alp FY, Yucel SC. The Effect of Therapeutic Touch on the Comfort and Anxiety of Nursing Home Residents. J Relig Health [Internet]. 2021;60(3):2037–50. Available from: https://doi.org/10.1007/s10943-020-01025-4
Yu AL, Lo SF, Chen PY, Lu SF. Effects of Group Music Intervention on Depression for Elderly People in Nursing Homes [Internet]. Vol. 19, International Journal of Environmental Research and Public Health. 2022. Available from: https://doi.org/10.3390/ijerph19159291
Tanaka S, Yamagami T, Yamaguchi H. Effects of a group-based physical and cognitive intervention on social activity and quality of life for elderly people with dementia in a geriatric health service facility: a quasi-randomised controlled trial. Psychogeriatrics [Internet]. 2021 Jan 1;21(1):71–9. Available from: https://doi.org/10.1111/psyg.12627
Ngabonziza S, Murekatete MC, Nyiringango G, Marie Grace Musabwasoni S. Peaceful End of Life Theory: A Critical Analysis of Its Use to Improve Nursing Practice. Rwanda J Med Heal Sci [Internet]. 2021 Dec 30;4(3 SE-Articles):412–7. Available from: https://doi.org/10.4314/rjmhs.v4i3.11
Alves M, Silva V, Almeida A, Pereira R, Coelho Barbosa L, Silva R. Care For The Institutionalized Elderly in The Perspective of A Peaceful End of Life. Ciência, Cuid e Saúde [Internet]. 2023 Jun 6;22(1). Available from: https://doi.org/10.4025/ciencuidsaude.v22i0.65964
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