The efficacy of training based on the family-centered empowerment model on the mental health of aged women: a stratified randomized controlled trial.

Abstract

Background: Mental health among older women is substantial due to their longer life expectancy. They are more susceptible to mental disorders like depression and anxiety compared to older men. Additionally, older women fulfill essential family roles and depend on social support for age-related health issues. Family-centered education provides a platform to assist families and foster a collaborative relationship between the patient, family members, and health care providers in end-of-life care. The study aimed to explore how education based on family‑centered empowerment model affects mental health in aged women.

Methods: This randomized controlled trial involved a group of 60 elderly women aged 60 years and older, specifically selected from elderly-friendly health centers in Tabriz-East Azerbaijan, who were randomly assigned to either an intervention or control group with an equal ratio. The intervention group received a family-centered healthy lifestyle intervention weekly for 10 sessions, while the control group received standard care from elderly-friendly centers. The mean score of mental health using a three-part questionnaire of demographic-anthropometric characteristics and a mental health questionnaire (GHQ) were assessed before the intervention, 4 and 8 weeks after the intervention through SPSS/version 13 using, ANCOVA, independent t‑test, and repeated measure analysis at a significant level of p < 0.05.

Results: The average age (standard deviation: SD) was 64.0 (3.8) years. The literacy level of the more than half of the participants was primary school. Regarding occupation and marital status, the majority of them were married and housekeeper. Two months after the intervention (end of the intervention), a significant decrease was detected in terms of overall mental health score in the intervention group compared to the control (the adjusted difference was - 5.7 with a 95% CI from - 10.3 to -1.1, and the p-value was 0.015). In the intragroup analysis, two months after the intervention, there was a significant decrease in overall mental health score compared to baseline in the intervention group (the mean change was - 5.4, with a 95% CI from - 9.9 to -0.9, and a p-value of 0.015). Moreover, a significant decrease was indicated in the physical subscale score in the intervention group compared to the control group (the adjusted difference was - 5.7, with a 95% CI from - 10.2 to -1.2, and a p-value of 0.015). There was no significant difference between the two groups in other subscales (p > 0.05). In the intragroup analysis, there was a significant decrease in the physical subscale score (the mean change was - 1.7, with a 95% CI from - 2.9 to -0.2, and a p-value of 0.038) and anxiety symptoms (the mean change was - 1.8, with a 95% CI from - 3.4 to -1.0, and a p-value of 0.033) compared to the baseline in the intervention group.

Conclusion: An education based on family-centered empowerment model could improve the overall mental health score in elderly women. Hence, it may be recommended to regard this approach as a practicable educational strategy for improving the well-being of the elderly.

Trial registration: Iranian Registry of Clinical Trials; https://irct.behdasht.gov.ir/trial/30535 (IRCT20161126031087N2), registered (03/08/2018).