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The effect of complex interventions on supporting self-care among community-dwelling older adults: a systematic review and meta-analysis
- Source :
- Age and Ageing. 47:185-193
- Publication Year :
- 2017
- Publisher :
- Oxford University Press (OUP), 2017.
-
Abstract
- Background self-care is critical to enable community-dwelling older adults to live independently. Complex interventions have emerged as a strategy to support self-care, but their effectiveness is unknown. Our objective was to review systematically their effectiveness on both positive (increased scores in self-rated health, Activities of Daily Living, Instrumental Activities of Daily Living, quality of life) and negative aspects (increased incidence of falls, fear of falling, hospital and nursing home admission, increased depression score), and to determine which intervention components explain the observed effects. Methods CINAHL, MEDLINE, British Nursing Index, PsycInfo and Cochrane CENTRAL were searched from January 2006 to October 2016. Randomised controlled trials providing at least two of these components: individual assessment, care planning or provision of information were reviewed. Outcomes were pooled by random-effects meta-analysis. Results twenty-two trials with 14,364 participants were included with a low risk of bias. Pooled effects showed significant benefits on positive aspects including self-rated health [standardised mean difference (SMD) 0.09, 95% confidence interval (CI) 0.01-0.17] and the mental subscale of quality of life (SMD 0.44, 95% CI 0.09-0.80) as well as on the negative aspect of incidence of falls [odds ratio (OR) 0.60, 95% CI 0.46-0.79]. There was no significant improvement in ADL, IADL, overall quality of life, fear of falling, reduction in health service utilisation or depression levels. Meta-regression and subgroup analysis did not identify any specific component or characteristic in complex interventions which explained these effects. Conclusion based on current evidence, supporting self-care in community-dwelling older adults using complex interventions effectively increases self-rated health, reduces the occurrence of falls and improves the mental subscale of quality of life.
- Subjects :
- Male
Gerontology
Health Knowledge, Attitudes, Practice
Aging
Activities of daily living
Poison control
Subgroup analysis
CINAHL
Fear of falling
03 medical and health sciences
0302 clinical medicine
Quality of life (healthcare)
Risk Factors
Activities of Daily Living
medicine
Humans
030212 general & internal medicine
Geriatric Assessment
Aged
Aged, 80 and over
business.industry
030503 health policy & services
Age Factors
Fear
General Medicine
Odds ratio
Hospitalization
Self Care
Treatment Outcome
Meta-analysis
Quality of Life
Accidental Falls
Female
Independent Living
Geriatrics and Gerontology
medicine.symptom
0305 other medical science
business
Subjects
Details
- ISSN :
- 14682834 and 00020729
- Volume :
- 47
- Database :
- OpenAIRE
- Journal :
- Age and Ageing
- Accession number :
- edsair.doi.dedup.....14cc42a97b444b50cebe6f6b45a3741a
- Full Text :
- https://doi.org/10.1093/ageing/afx151