Expressive Art Therapy for Elder Adults With Chronic Low Back Pain

The proportion of eligible participants who agree to enrol in the study.

The proportion of participants who complete the full study protocol.

Intervention adherence will be assessed by the proportion of participants who attended at least 80% of the scheduled group sessions out of the total number randomized. Reasons for non-adherence will be explored through qualitative interviews with participants who did not meet the attendance threshold or discontinued the program prematurely.

Participants will rate their satisfaction with the program on a scale from 0 (not satisfied) to 10 (very satisfied).

Participants will rate the perceived burden of the intervention on a scale from 0 (not demanding) to 10 (very demanding).

Participants will rate their willingness to continue with the program on a scale from 0 (not willing to continue) to 10 (very willing to continue).

This outcome measure will evaluate the feasibility and acceptability of the data collection methods used in the study, including completion rates for outcome assessments.

Feasibility Metrics:

Completion Rates for Outcome Assessments: The number of completed assessments will be divided by the total number of scheduled assessments to calculate the completion rate.

This outcome measure will document any adverse events or safety concerns that arise during the study, including:

Undesirable medical occurrences or problems that a participant experiences during or after the intervention, lasting more than 2 days and/or causing the participant to seek additional treatment.

These adverse events will be categorized into:

Serious Related Adverse Events Non-Serious Adverse Events

Safety Metrics:

Number and type of adverse events Proportion of participants who report serious related adverse events Proportion of participants who report non-serious adverse events

This is a complementary measure allows patients to self-report their impression of the overall change in their condition from the beginning of a study or intervention to the current time point. This provides a global, subjective evaluation of the patient's perceived improvement or worsening of their symptoms or health status. This item has a 7-point rating, with the following response options: very much improved, much improved, minimally improved, no change, minimally worse, much worse, and very much worse.

An 11-point scale measuring low back pain intensity, where 0 indicates no pain and 10 indicates the worst imaginable pain. Participants need to report their back pain in the current moment, in the last 24 hours and the last 3 months.

This 7-item Chinese version measures participants' psychological flexibility, rated on a 7-point scale, where higher scores indicate less flexibility.

AAQ-II has been cross-culturally adapted and validated among local adolescents and has demonstrated satisfactory internal consistency and test-retest reliability

The Chinese version of this instrument measures HRQoL across five domains, providing insight into participants' overall well-being.It comprises 5 items related to mobility, self-care, daily activities, pain/discomfort, and anxiety/depression. Each item has 5 response options (no problem', 'slight problems', 'moderate problems', 'severe problems', and 'extreme problems/unable to').

It has been found to useful in monitoring treatments' effects on HRQoL.

The 24-item Chinese version of the Roland-Morris Disability Questionnaire assesses disability related to low back pain (LBP) in individuals with chronic low back pain (CLBP). Scores range from 0 to 24, with higher scores indicating greater functional limitation and worse disability.

The 21-item Chinese version evaluates mental health across three domains, with higher scores indicating greater issues. It has been cross-culturally adapted to Hong Kong settings,demonstrating excellent internal consistency for depression, anxiety, and stress subscales.