The influence of group Tai Chi practice on loneliness among older adults living alone in Wuhan: the mediating role of social self-efficacy

BACKGROUND: Loneliness and a decline in physical activity in older age are associated with adverse effects on physical and mental health. The objective of this study was to investigate the impact of group Tai Chi sessions on loneliness and social self-efficacy among older adults in Wuhan, China. METHODS: A randomized controlled study was conducted using linear mixed-effects modeling (LMM), incorporating fixed effects for the factors "group" and "time," their interaction, as well as random intercepts at the participant level. The sample consisted of 140 participants aged between 65 and 85 years (M = 70.03, SD = 8.46), all of whom lived alone and had no cognitive impairments that could interfere with study participation. RESULTS: The experimental group engaged in Tai Chi practices for six months, meeting twice weekly, while the control group received no intervention. Surveys were administered both before and after the six-month experimental period. The DeJong Gierveld Loneliness Scale and the Community Self-Efficacy Scale were utilized. The results of the linear mixed-effects model indicated a significant reduction in loneliness in the experimental group, with the group × time interaction reaching statistical significance (β = -1.837, p < 0.001, CI = [-2.098; -1.576]). Additionally, a significant increase in social self-efficacy was observed (β = 2.248, p < 0.001, CI = [1.663; 2.801]). Mediation analysis demonstrated that the indirect effect of the intervention on loneliness through social self-efficacy was statistically significant (B = - 0.035, 95% bootstrap CI [-0.061; -0.014]). CONCLUSIONS: These findings provide empirical support that participation in the Tai Chi program effectively reduces loneliness and enhances self-efficacy among older adults living alone. The findings may be utilized in developing social and medical assistance projects aimed at reducing loneliness and enhancing social self-efficacy among older adults. It is anticipated that the implementation of such programs could improve the quality of life for older adults and enhance their degree of social integration.