The effects of a cognitive-behavioural model-based social facilitation program on psychosocial well-being amongst Chinese nursing home residents: a randomized controlled trial

BACKGROUND: Nursing home residents often suffer from a reduction in social networks and emotional bonds with family and friends. Innovative social facilitation interventions were developed to assist residents in adapting to a new life, but the effects on psychosocial well-being have not been well documented. OBJECTIVE: To evaluate the effects of a cognitive-behavioural model-based social facilitation program on the psychosocial well-being of Chinese nursing home residents. DESIGN: An assessor-blind, parallel-arm randomized controlled trial. SETTING AND PARTICIPANTS: Older adults residing in Chinese nursing homes were recruited between October 2023 and May 2024. METHODS: A total of 180 nursing home residents were randomly assigned to either a cognitive-behavioural model-based social facilitation program (CBMSFP) group, receiving cognitive restructuring, emotional management, and behavioural change, or to a control group receiving routine institutional care. Primary outcomes included social isolation and subjective well-being, while secondary outcomes encompassed cognitive tendencies, psychological adjustment, self-efficacy and perceived social support. Assessments were conducted at baseline (T0), immediately post-intervention (T1), and at 1-month (T2) and 3-month (T3) follow-ups. Generalized estimating equations (GEEs) were used to analyse the effects of group, time, and their interaction of the intervention, with minimal clinically important difference (MCID) calculated via control group standard error of measurement (SEM × 1.96) to evaluate clinical value. RESULTS: Participants in the intervention group exhibited significant reductions in social isolation and significant improvements in subjective well-being, cognitive tendencies, psychological adjustment, self-efficacy and perceived social support compared to the control group (P < .001) from T0-T3. Effects exceeding MCID thresholds were observed for social isolation, subjective well-being, and cognitive tendencies at different follow-up periods, while the clinical significance of self-efficacy and perceived social support were not being observed. CONCLUSIONS: CBMSFP can reduce social isolation and enhances psychosocial well-being amongst nursing home residents, with clinically meaningful and sustained benefits for key outcomes.