Journal Article

Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial

Hermsen, Pieter G J M, Teerenstra, Steven, Graff, Maud J L, Roets-Merken, Lieve M, Kempen, Gertrudis I J M, Zuidema, Sytse U, Vernooij-Dassen, Myrra J F J

2018

Overview

ObjectiveTo evaluate the effectiveness of a nurse-supported self-management programme to improve social participation of dual sensory impaired older adults in long-term care homes.DesignCluster randomised controlled trial.SettingThirty long-term care homes across the Netherlands.ParticipantsLong-term care homes were randomised into intervention clusters (n=17) and control clusters (n=13), involving 89 dual sensory impaired older adults and 56 licensed practical nurses.InterventionNurse-supported self-management programme.MeasurementsEffectiveness was evaluated by the primary outcome social participation using a participation scale adapted for visually impaired older adults distinguishing four domains: instrumental activities of daily living, social-cultural activities, high-physical-demand and low-physical-demand leisure activities. A questionnaire assessing hearing-related participation problems was added as supportive outcome. Secondary outcomes were autonomy, control, mood and quality of life and nurses’ job satisfaction. For effectiveness analyses, linear mixed models were used. Sampling and intervention quality were analysed using descriptive statistics.ResultsSelf-management did not affect all four domains of social participation; however. the domain ‘instrumental activities of daily living’ had a significant effect in favour of the intervention group (P=0.04; 95% CI 0.12 to 8.5). Sampling and intervention quality was adequate.ConclusionsA nurse-supported self-management programme was effective in empowering the dual sensory impaired older adults to address the domain ‘instrumental activities of daily living’, but no differences were found in addressing the other three participation domains. Self-management showed to be beneficial for managing practical problems, but not for those problems requiring behavioural adaptations of other persons.Trial registration number NCT01217502; Results.

• Publisher: BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Activities of Daily Living / Aged, 80 and over / Blindness / Chronic illnesses / Cluster Analysis / Deaf-Blind Disorders - psychology / Deaf-Blind Disorders - rehabilitation / Evidence Based Practice / Evidence-based medicine / Female / Humans / Intervention / Job satisfaction / Licenses / Linear Models / Long term health care / Long-Term Care - organization & administration / Male / Netherlands / Nurse's Role / Nurse-Patient Relations / Nurses / Older people / Participation / Quality of Life / Self-Management - methods / Social Participation / Surveillance / Visual impairment