A randomised clinical trial of a wellness programme for healthy older people

Background: With a growing increase in the population of older people worldwide, there is an undeniable need for efficient and cost-effective service delivery in occupational therapy. Method: This randomised clinical trial employed a parallel design, with an experimental and a control group and a pre-test and post-test, to evaluate the effectiveness of a wellness programme based on the Model of Human Occupation (MOHO). Participants were 65 years of age or older, community-dwelling Japanese older people. Data were analysed for 30 experimental participants who received a 15-session MOHO programme and 33 controls who received a 15-session standard care, crafts programme. Quality of life and psychological wellbeing were compared between groups using the Japanese versions of the Life Satisfaction Index - Z (LSI-Z) and the World Health Organisation Quality of Life-26 (QOL26), respectively. Results: The LSI-Z score for the experimental group improved an average of 3.4 points whereas the control group's mean score improved by 0.1 point. The mean change for the experimental group (m.chg = 3.4, SD = 5.8) was significantly different (p = 0.01) from that of the control group (m.chg = 0.1, SD = 4.8) and the effect size (Cohen's d) was 0.62 (95% confidence interval = 0.13-1.11). The psychological domain score (QOL26) improved slightly for the experimental group whereas it declined slightly for the control group. The mean change was significantly different (p = 0.02) between the experimental (m.chg = 0.1, SD = 0.5) and control (m.chg = -0.1, SD = 0.3) groups; effect size (Cohen's d) was 0.49 (95% confidence interval = 0.02-0.96). Conclusion: The findings support the conclusion that MOHO-based occupational therapy interventions can promote wellness effectively in older people by having an impact on quality of life and sense of wellbeing.