Authors (including presenting author) :
PANG YCV(1), Hui SC(1), O WN(2), Wai CFF(2), Man TS(3), Choi CL(3), Shun KW(4), Lui SF(4)
Affiliation :
Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital
Introduction :
The COVID-19 pandemic has tremendously reshaped our social landscape. Social distancing policies are enforced in many countries due to concerns of infection control. For patients with chronic schizophrenia, whose negative symptoms are notoriously burdensome, the strike of COVID-19 has posed challenges to the combat against social and emotional withdrawal. It is therefore timely to look into interventions that promote self-efficacy and interpersonal effectiveness. The focus of this paper is the i-ExAM program, which seeks to enhance one-to-one in-depth interactions with self and others.
Objectives :
This study was conducted to identify the effect of the individual Expressive Art with Mindfulness program (i-ExAM) on the improvement of psychogeriatric client’s mood and psychotic symptoms. It is pivotal to Positive Behavioural Intervention Support(PBIS) values. This person-centred and strength-based model comprises of multi-component interventions, including arts, music, dance movement, horticulture therapy and more, to bring creative mindfulness into the client’s personal life.
Methodology :
Convenience sampling from 6 male & 4 female psychogeriatric patients were referred by ward nurse. The mean age was 68.6. Each individual session was conducted twice a week, 45 minutes per session. iExAM program included 8 sessions, and was run on the ratio of one nurse/patient care assistance to one patient. The scores of Cognitive Performance Scale (CPS), Geriatric Depression Scale (GDS), Brief Psychiatric Rating Scale (BPRS) were measured before and after the iExAM. Feedback by nurse in charge was collected at the end of each session. Patient satisfaction survey was conducted at the end of the eighth session. A paired t-test was used to compare CPS, GDS and BPRS scores pre- and post-intervention.
Result & Outcome :
It was found that the i-ExAM had a significant effect on improving mood functions (t 7.61 , p < 0.01 ) and BPRS (t 22.09 , P< 0.01). Regarding the sub-domains, moderate effect was demonstrated in anxiety and emotional withdrawal. No significant effect was noted in cognitive performance, which was not a focus of the program. Patient feedback was categorised into five areas: (i) being encouraged and motivated in self expression and exploration, (ii) being inspired to enhance relationship with other, (iii) boost in positive emotion, (iv) relieve negative emotion, and (v) improve concentration.
Conclusion: The i-ExAM program was associated with improvements in the mood and negative psychotic symptoms of the aged people with schizophrenia. Preliminary findings from this study suggest that the use of expressive arts and mindfulness intervention is beneficial to enhancing emotional regulation, and initiating relationships with self and others. However the sample size of the study is small, further research should consider recruit more participants to examine the effectiveness of i-ExAM program. Future research direction may explore its application in different age groups and disease-specific populations.
