The psychological impact of a nurse-led proactive self-care program on independent, non-frail community-dwelling older adults: A randomized controlled trial

Arkers Kwan Ching Wong, Frances Kam Yuet Wong

Research output: Journal article publicationJournal articleAcademic researchpeer-review

Abstract

Background: Poor mental health is common later in life and is a crucial factor in determining older adults’ ability to live independently in the community. Existing nurse-led proactive self-care programs for older adults focus on physical health, since many are living with chronic diseases. Little is known about their effectiveness on the psychological outcomes of independent, non-frail community-dwelling older adults. Aim: The aim of this study was to examine the impact of a nurse-led proactive self-care program with a health-social partnership model for community-dwelling older adults on depressive symptoms, life satisfaction, and the mental component of health-related quality of life. Design and Methods: This was a single-blinded, randomized controlled trial. Adults aged 60 or over who lived within the service areas and scored ≥ 18 in the Mini-Mental Status Examination were included. Data were collected using questionnaires pre- (T1), post- (T2), and three month after the intervention (T3). The program provided a comprehensive assessment, health and self-management information, and empowerment, and promoted the accessibility of community services by building a health-social partnership network in the community. Generalized Estimating Equation was used to calculate the group, time, and interaction effects. Intention-to-treat was employed as the primary analysis in this study. Results: Of the 843 potential community-dwelling older adults who were assessed for eligibility, 457 eligible participants were randomized into the intervention (n = 230) or control group (n = 227). Among them, 175 (76.0%) participants in the intervention group and 190 (83.7%) participants in the control group completed data collection at T3, 6 months after T2 at the completion of the program. The results showed a significant time effect between T1 and T2 (Wald χ2 = 25.7, p <.001) and T1 and T3 (Wald χ2 = 7.40, p =.007) in terms of the presence of depressive symptoms. Conclusions: Interprofessional care addressing health and social needs improves the depressive symptoms among older adults dwelling in the community.

Original languageEnglish
Article number103724
JournalInternational Journal of Nursing Studies
Volume110
DOIs
Publication statusPublished - Oct 2020

Keywords

  • Community-dwelling older adults
  • Depressive symptoms
  • Health-social partnership
  • Psychological outcomes

ASJC Scopus subject areas

  • Nursing(all)

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