Effectiveness of Reminiscence Therapy on Reduction of Stress among Elderly Residing in old age Home

 

Poonam Devi¹, Jeen Mexina S²

¹Lecturer, Kailash Institute of Health and Medical Science, Haryana

²Principal, Kailash Institute of Health and Medical Science, Haryana

 

ABSTRACT:

Reminiscence has been defined as the “vocal or silent recall of events in a person’s life, either alone or group of people”. Reminiscence therapy is a process in which individual attempt to accept negative event in the past, resolve past conflicts, reconcile the discrepancy between ideals and reality, identify continuity between past and present, and find meaning and worth in life. It helps the elderly recollect past coping activity and strategies, including memories of plans as developed to solve difficult situation, goal directed activities and the achievement of one’s own goal or goals one helped other meet.Pre-experimental approach was adopted to determine the effectiveness of reminiscence therapy among elderly residing in Red Cross society old age home sector-15 Panchkula. One group pre-test post-test research design was used where 30 old age people were included in pre-experimental one group respectively. Convenient sampling technique was used to select 30 elderly people residing in old age home. Protocol for Reminiscence therapy was developed and content validity was determined by experts internal consistency (r=0.7) and stability (r=0.98) of tool was tested by using split half reliability test- re test method respectively. Pilot study was conducted found to be feasible. Base line stress level was assessed and reminiscence therapy was introduced where seven sessions were delivered for subject in experimental group. It is evident from the result that pretest mean score was founded to be 20.06 as compared to the post test mean score 11.1.Hence the study concluded that the reduction of stress level among elderly people after the administration of reminiscence therapy. This indicate that the reminiscence therapy was effective therefore the null hypothesis is rejected.

 

 

 

INTRODUCTION:

Stress is more common among elderly. It affects activity and work performance. American Psychological Association (APA) as "the use of life histories–written, oral, or both–to improve psychological well-being. The therapy is often used with older people."¹ This form of therapeutic intervention respects the life and experiences of the individual with the aim to help the patient maintain good mental health. The majority of research on reminiscence therapy has been done with the elderly community, especially those suffering from depression, although a few studies have looked at other elderly samples².

 

Reminiscence serves different psychological functions, including the taxonomy presented by Webster³. Webster's Reminiscence Functions Scale (RFS) includes eight reasons why people reminisce: boredom reduction, bitterness revival, prepare for death, conversation, identity, intimacy maintenance, problem solving, and teach/inform. Psychologists have looked at using reminiscence therapeutically to improve affect and coping skills, although the effectiveness of this therapy has been debated.⁴ From more recent data, as outlined below, the therapy appears to have positive and even lasting results within the elderly community Many studies have examined the effects of reminiscence therapy on overall affect⁵. One group of researchers implemented reminiscence therapy into a community in response to a rash of suicides⁶. The researchers administered the therapy to older adults (predominantly women) at a local community center for the elderly. A questionnaire administered after the group reminiscence therapy session revealed that 97.3% of participants enjoyed the experience of talking, 98.7% enjoyed listening to others, 89.2% felt that the group work with reminiscence therapy would help in their daily life, and 92.6% wished to continue in the program. The researchers suggest their results support the previously reported effects of increased life satisfaction and self-esteem.⁷ Another study showed that after one session a week for 12 weeks of integrative reminiscence therapy, institutionalized older veterans in Taiwan experienced significant increases in self-esteem and life satisfaction as compared to the control group.⁸The twentieth century has seen a triumphant increase in life expectancy60. years is usually considered has the dividing line between middle and old ages. It is a period of rest from physical stress and mental strain. Currently, elderly people represent around 20% of the total population and will represent 25% by 2020. The aging population has a looming public health challenges, as currently 355/380 million people, aged 60 years and older live in developing countries. ⁹In 2020,the number of old age people is projected to reach more than 1000 million, with 70% living in developing countries, especially in India, China, Brazil, Indonesia and Pakistan¹⁰.

 

OBJECTIVE:

1.      To assess the pre test level of stress among elderly residing in Red-cross society old age home in sector-15 Panchkula (Haryana) by using Sheldon Cohen ‘s perceived stress scale.

2.      To develop and administer the reminiscence therapy on reduction of stress among elderly residing in Red-cross society old age home in sector-15 Panchkula (Haryana).

3.      To evaluate the post test level of stress among elderly residing in Red-cross society old age home in sector-15 Panchkula (Haryana) by using Sheldon Cohen ‘s perceived stress scale.

^4.   To find out the association between pre test and post test level of stress among elderly residing in Red-cross society old age home and their selected demographic variables.

 

MATERIALS AND METHODS:

Pre-experimental approach was adopted to determine the effectiveness of reminiscence therapy among elderly residing in red cross society old age home sector-15 Panchkula. One group pre-test post-test research design was used where 30 old age people were included in pre-experimental one group respectively. Reminiscence therapy was developed and content validity was determined by experts from the field of psychiatric nursing, OBG, Pediatrics, Community internal consistency (r=0.7) and stability (r=0.98) of tool was tested by using split half reliability test- re test method respectively.It took around 20 min on an average to complete interview from each study participant. The respondents clearly and easily understood the language and study found to be feasible. Ethical clearance to conduct the study was obtained from institutional committee of, kailash Institute of Health and Medical Science, panchkula, Haryana, India. The permission for data collection was obtained from the concerned authority; the investigator assured the anonymity to the study participants, and their consent was obtained. Data were collected from the study participants with the help of semi structured interview schedule from 16^th March to 10^th April 2017 using shelden cohen;s perceived stress scale. Descriptive mean and standard deviation and inferential statistics was used for data analysis.

 

RESULTS:

Section 1

Socio demographic characteristics of participates

Tables 1 Represent that data regarding socio demographic characteristics of elderly residing in old age home. Most of the elder people 63.3% were in age group 60-70 years, Religion wise majority of elder people 86% were Hindu, 80% were married, 33.3% elder people were educated (up to 8^th class) and only 16.7% elder people were graduate, 56.7% elder people were depend on pension (source of income), duration of stay (50.0%). 36.7% elder people bonoafide state was Himachal Pardesh.

 

Table-1; Frequency and percentage distribution of study participants according to socio-demographic variable [N=30]

Demographic Variable	Frequency (f)	Percentage (%)
Age in years 60-70 71-80 81-90	19 7 4	63.33% 23.33% 13.3%
Gender Male Female	18 12	60.0% 40.0%
Marital status Married Unmarried	24 6	80.0% 20.0%
Religion Hindu Sikh Muslim	26 3 1	86.7% 10.0% 3.3%
Educational status Illiterate Primary Secondary Graduation	8 10 7 5	26.6% 33.3% 23.3% 16.6%
Source of income Pension Deposit Family members Institution	17 2 5 6	56.6% 6.6% 16.6% 20.0%
Duration of stay < 2 years 2-4 years 4-6 years >6 years	15 8 5 2	50.0% 26.6% 16.6% 6.6%
Frequency of visit by family members Once in a month Twice in a three months Thrice in a 6 months Never	11 6 8 5	36.6% 20.0% 26.6% 16.6%
Bonafide State Himachal Pardesh Haryana Punjab Other	15 7 3 5	50.0% 23.3% 10.0% 16.6%

 

ASSESSMENT OF EFFECTIVENESS OF REMINISCENCE THERAPY ON REDUCTION OF STRESS LEVEL:

Part BFrequency and percentage distribution of study participants according to stress:

Frequency and percentage distribution of study participants shows that 9 (30.0%) old age people were low stress than moderate 13 (43.3%),were moderate and 8 (26.7%) were severe. Post intervention frequency distribution of study participants shows that 20 (66.7%) were much lower than moderate, 9 (30.0%) were slightly lower than moderate and 1 (3.3%) were slightly higher than moderate.

 

Table-2 Frequency and percentage distribution of study participants according to level of stress, before and after Reminiscence therapy (N=30)

S. No	Level of stress	Score	Pre-test		Post-test
			Frequency	Percentage	Frequency	Percentage
1.	Low stress	0-13	9	30.3%	20	66.7%
2.	Moderate stress	14-26	13	43.3%	9	30.0%
3.	Severe stress	27-40	8	26.7%	1	3.3%

 

Table-3 Mean, SD $ standard error of study participants.

	N	Mean	Std. Deviation	Mean difference	Std. error Mean	Sig.
Pre-test	30	20.06	6.79	8.96	1.24	.000
Post-test	30	11.10	4.59		.8392

 

 

Part B: TESTING OF HYPOTHESIS:

H1-there will be statistical significant difference in pre-test $ post-test stress score after reminiscence therapy among older people.

Table-3 Show that mean pre-test score and SD of participant were 20.06±6.79. Post intervention mean ±SD at stress score for participant were 11.10±4.59. Finding revealed that mean of pretest scores of students were significantly higher than the post test score of the students. Therefore concluded that Reminiscence Therapy was effective in term of decreasing post test score of elder people.

 

 

Mean of Study Participantsof Pre-Test and Post-Test (N=30)

 

Table 3: Association of socio-demographic variables of with post test score (N=30)

Demographic data		Perceived Stress Level Post Test			Association with post test
Variable	options	Mild	Moderate	Severe	Chi test		P value	D .f.	Result
Age in years	60-70years	10	8	1	5.410		.248	4	Not sig.
	71-80years	7	0	0
	81-90years	3	1	0
Gender	Male	14	3	1	4.167		.125	2	Not sig.
	Female	6	6	0
Marital status	Married	16	7	1	.278		.870	2	Not sig.
	Unmarried	4	2	0
	Divorced Widowed
Religion	Hindu	16	9	1	2.308		.679	4	Not sig.
	Christian	3	0	0
	Sikh	1	0	0
	Muslim
	Others
Educational status	Illiterate	6	2	0	4.733		.578	6	Not sig.
	Primary	7	3	0
				1
	Graduation	4	1	0
	Post-graduation	20	9	1
Source of income	Pension	10	6	1	2.819	.831		6		Not sig.
	Deposit	2	0	0
	Family-members	3	2	0
	Institutional	5	1	0
Duration of stay	<2 years	11	4	0	3.343	.738		6		Not sig.
	2-4 years	5	2	1
	4-6 years	3	2	0
	>6 years	5	1	0
Frequency of visit by family	Once in a week	6	5	0	7.924	.244		6		Not sig.
	Twice in a week	4	2	0
	Thrice in a week	6	2	0
	Never	4	0	1
Bonafied state	Himachal	9	5	1	5.362	.498		6		Not sig.
	Haryana	5	2	0
	Punjab	1	2	0
	Others	5	0	0

 

DISCUSSION:

It present study pre-intervention level 9 (30.0%) old age people were low stress than moderate, 13 (43.3%) were moderate and 8 (26.7%) were severe.

 

Post intervention frequency distribution of study participants shows that 20 (66.7%) were much lower than moderate, 9 (30.0%) were slightly lower than moderate and 1 (3.3%) were slightly higher than moderate.

 

Findings of present study shows effectiveness of reminiscence therapy in terms improvement of mean post test scores. These finding supported by study conducted by B. Suresh et.al (2015) conducted a pre-experimental study to assess the effectiveness of reminiscence therapy on stress among elderly in selected old age home, Chennai. A modified Sheldon Cohen’s perceived stress scale was used for the study.The result revealed that there was a significant improvement in mean post test score of stress, it is also supported bu Colleagues, et.al (2015) conducted where somewhat similar findings revealed. In addition to the above studies.

 

J. Elizabeth et.al (2014) conducted a study to evaluate the effectiveness of reminiscence therapy on stress and coping strategies among elderly in selected old age home, Tamil Nadu.

 

And the study was effective in reducing the stress among elderly residing in old age home.

 

In conclusion of discussion, the above studies strongly consistent with previous findings that indicated the reminiscence therapy at significant effect on the students , which is supported by the studies of M. Sanish et.al (2009), J. Wang et.al (2004), B. Azam, (2016).

 

LIMITATIONS OF THE STUDY:

The present study has its own limitations like any other study. Following are the limitations of the study:

1.      Elderly male and female subjects residing in selected old age home.

2.      Old age home in sector 15 Panchkula.

 

ACKNOWLEDGEMENT:

I would like to acknowledge the study participants for providing me their keen responses. My sincere thanks to all those who assisted me, directly or indirectly, especially the Institutional Ethical Committee of kailash Institute of Health and Medical Science, Haryana, India in the successful completion of this study.

 

CONFLICT OF INTEREST:

The study entitled “Effectiveness of reminiscence therapy on reduction of stress among elderly residing in old age home” is a bonafide research work of Mrs.Poonam Devi lecturer, kailash Institute of Health and Medical Science, Haryana, India. Authors do not have any relationships/condition/circumstances that present a potential conflict of interest.

 

SOURCE OF FUNDING:

The study entitled “Effectiveness of reminiscence therapy on reduction of stress among elderly residing in old age home” is a self funded research work of Mrs. Poonam Devi.

 

REFFRENCES:

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3.       Webster, J.D. (1993). "Construction and Validation of the Reminiscence Functions Scale". Journals of Gerontology. 48: 256–262.

4.       Watt, L. M.; Cappeliez, P. (1 May 2000). "Integrative and instrumental reminiscence therapies for depression in older adults: Intervention strategies and treatment effectiveness". Aging & Mental Health. 4 (2): 166–177.

5.       Hill, Andrew; Brettle, Alison (1 December 2005). "The effectiveness of counselling with older people: Results of a systematic review". Counselling and Psychotherapy Research. 5 (4): 265–272.

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8.       Wu, Li-Fen (1 August 2011). "Group integrative reminiscence therapy on self-esteem, life satisfaction and depressive symptoms in institutionalised older veterans". Journal of Clinical Nursing. 20 (15-16): 2195–2203.

9.       Allen Butler., (1985),. Ageing. (1^sted.).U.S.A: British cataloguing publishers.

10.     Baltimore., (1989) ,. Comprehensive textbook of psychiatry. (12^th ed.).U.S.A: Williams and Wilkins publications.

 

 

 

 

 

Received on 14.04.2018        Modified on 14.07.2018

Accepted on 10.08.2018      ©A&V Publications All right reserved