Methods: A randomized controlled trial was conducted in six long term care facilities. A sample of the total 140 diabetes elderly participants who newly relocated to long term care facilities within one year was recruited. Six long term care facilities were randomly assigned into either the intervention group (3 institutions, n=66) or the control group(3 institutions, n=74). Intervention group received a Mindfulness Based Stress Reduction program intervention. The mindfulness instructor orally guide the elderly with the Taiwanese language to practice mindfulness breathing, meditation, compassion cultivation, wheelchair sitting mindfulness yoga, mindfulness listening, difficulty interpersonal relationships, mindfulness eating and drinking, body parts appreciation and share the group discussion on the final. A group of 10-15 participates per once was implemented once per week for a total 9 weeks of the 90 minutes. Control group received routine diabetes nursing care. The emotional distress (depression, DASS-21; Relocation Stress Scale- Chinese Version, RSS- C) questionnaires and glycemic control (HbA1c) were used to measure outcomes. Assessments were conducted at baseline and at 3, 6 and 9 weeks of follow-up. Generalized Estimating Equation (GEE) was used for adjustments of the effects o f MBSR intervention.
Results: All participants mean age were 78.5 years. An 90% (60/66) MBSR intervention retention rate was achieved. Compared with control, the MBSR intervention was more effective in reducing emotional distress and improving glycemic control. Significantly improved included relocation stress (RSS-C) scores (β=-9.26, SE=1.13, Wald χ2=66.99, P<0.001) , depression (DASS-21) scores (β=-6.79, SE=1.07, Wald χ2= 40.11, P<0.001) and HbA1c levels (β=-1.38, SE=0.29, Wald χ2= 22.90, P<0.001) from baseline to 3, 6 and 9 weeks of follow-up.
Conclusion: In the conclusion, the MBSR intervention significantly improved emotional distress and reduced diabetes risk in HbA1c levels. The results suggest that diabetes educators were proficient in specific intervention program design in long term care.