Discussion
death, Anxiety, anxiety, depressive, depression, disability, trait-anxiety
Findings of the present study suggest that, compared to usual care, MBEC could potentially improve senior residents' mental health and spiritual well-being. This was clearly demonstrated in the improvement of state- and trait-anxiety and an enhancement of religious and existential well-being. These effects were generally maintained up to four weeks post-intervention, with the exception of state-anxiety. However, no discernible effects on geriatric depression were observed at any post-intervention time points.Psychological and spiritual distress increase along with aging, especially among those living in long-term residential settings [Anxiety is considered to be a risk factor for the development of depression [Although mindfulness has been verified as an effective strategy for improving the extent of discomfort and spiritual distress in the palliative care setting [It is worth mentioning that in the results of within-group comparisons, CG participants’ overall and their religious aspects of spiritual well-being worsened significantly compared to baseline. Spiritual well-being may be seen as a barometer when seniors with disabilities in residential settings face disability and approach death. Spiritual well-being normally declines over time if spiritual care cannot be appropriately and comprehensively provided [Corroborated by our statistical results, participants’ qualitative feedback and PI and RAs’ observations suggest that MBEC was well-received and had positive impacts on mental and spiritual well-being. Participants reported perceived improvement in depressive and anxiety symptoms, with remarks such as “I do feel less anxious in general.” “I realize that being negative is doing nothing to me. I cannot always complain (about the facility). It is what it is now.” They were able to participate more in the long-term care facilities. “After practice (mindfulness), I start to take part in (facility-arranged) activities. Try not to focus on downtime. Have some fun, you know.”Moreover, participants commented on their changes related to spiritual well-being after mindfulness practice, sharing sentiments, such as “I feel peace and tranquility while practicing mindfulness… I used to feel lonely and abandoned.” “Of course, I missed my own bed at home. I don’t belong here (long-term care facility). But now I know I cannot always look back. I need to accept and start appreciating what I have so far.” Participants’ changes were also reflected in their behavior, as one participant shared, “I used to be so bored here. After mindfulness, I now try to look for things to do (in the facility). Not too bad, some of them.” These findings further emphasize the clinical applicability of MBEC.