Reminiscence Therapy to Improve Self-Esteem, Loneliness, and Stress in Rural Thai Older Adults: A Quasi-Experimental Study

Abstract

Background: Loneliness, psychological stress, and low self-esteem are important mental health concerns among community-dwelling older adults and may negatively affect healthy ageing and quality of life. This study examined psychosocial outcomes associated with participation in a 4-week Hybrid Happy Reminiscence Program among community-dwelling older adults. Methods: A quasi-experimental pretest–posttest control group study was conducted between September and November 2025 among community-dwelling older adults in Don Tako Subdistrict, Ratchaburi Province, Thailand. Participants were recruited using purposive sampling based on predefined eligibility criteria and were subsequently assigned to either an experimental group (n = 30), which received the Hybrid Happy Reminiscence Program combining bi-weekly face-to-face group sessions with a digital intervention delivered through the LINE application, or a control group (n = 30), which received routine community care. No statistically significant between-group differences were detected in the measured baseline demographic characteristics (all p > 0.05). Primary outcomes included self-esteem, loneliness, and psychological stress. Results: Within the experimental group, self-esteem increased from baseline to posttest (t(29) = −8.07, p < 0.001), while loneliness (t(29) = 5.11, p < 0.001, Cohen’s d = 0.93) and psychological stress (t(29) = 6.59, p < 0.001, Cohen’s d = 1.20) decreased. At posttest, the experimental group had higher self-esteem than the control group (mean difference = 4.73, 95% CI: 3.23–6.23, t(58) = 6.32, p < 0.001) and lower loneliness scores (mean difference = −2.13, 95% CI: −3.27 to −1.00, t(58) = −3.78, p < 0.001). For psychological stress, the experimental group also had a lower mean score than the control group at posttest, although the confidence interval included zero (mean difference = −0.73, 95% CI: −1.51 to 0.04, t(58) = −1.89, p = 0.063). Conclusions: Participants receiving the Hybrid Happy Reminiscence Program showed greater post-intervention self-esteem and lower loneliness scores than those receiving routine community care. Although psychological stress decreased within the intervention group, the post-intervention between-group difference was not statistically significant. Given the quasi-experimental design and the non-random allocation procedure, these findings should be interpreted as group differences consistent with a possible beneficial effect of the program rather than definitive evidence of causality. Larger randomized controlled studies with longer follow-up periods are needed to confirm these findings and to distinguish intervention-specific effects from non-specific influences.