Effects of a nurse-led multicomponent intervention for frail older adults living alone in a community: a quasi-experimental study

Abstract

Background Given the rapid aging of the population in Korea, efforts to slow down or prevent frailty, to support the health of older adults, should be an important public health priority. This may allow them to continue living within the community by keeping their functional independence for as long as possible. This study aimed to evaluate the nurse-led multicomponent intervention for community-dwelling pre-frail or frail elderly on physical and psychosocial outcomes. Method A non-equivalent control pre-, post-, and follow-up test design was used with a sample of 126 prefrail or frail older adults (62 in the experimental and 64 in the control group). The 12-week multicomponent intervention for the experimental group comprised physical exercise, cognitive training, and nutrition and disease management education. Outcome variables (Timed Up and Go Test results and measures of frailty, handgrip strength, depression, social activity, and social support) were measured both pre- and post-intervention, and after the 12-week follow-up period. Results For each group, we assessed the significant interaction of time with frailty, depression, social activity, and social support, as well as Timed Up and Go Test results. In the experimental group, levels of depression decreased while levels of social support and social activity increased from each measurement period to the next, within the 12-month study period; those in the control group were relatively stable over time. Conclusions The results indicate that nurse-led multicomponent intervention was effective for improving physical and psychosocial function of the (pre)frail older adults living alone in Korea, suggesting that older adults can take proactive roles in conducting their daily life and managing their health. A strategy for disseminating widely sustainable nurse-led multicomponent interventions should be developed for community-dwelling frail elderly who live alone.

Measuring the effects of nurse-led frailty intervention on community-dwelling older people in Ethiopia: a quasi-experimental study

“…The success of the intervention was evident by a reduction in average frailty scores from the initial assessment to six months and 12 weeks after the intervention, from 2.93 to 1.60 and 1.47, respectively. These findings align with a previous studies that which have reported a consistent decrease in average frailty scores from the baseline to the follow-up period [ 48 , 55 , 56 ]. Additionally, our study corroborates other research indicating that exercise interventions, encompassing endurance, strength, coordination, balance, and flexibility exercises, have successfully reversed frailty in older people with such conditions [ 57 – 59 ].…”

“…Frailty encompasses impairments in physical, psychological, and social functions [ 8 , 9 ], and the results of our study demonstrate that it is possible to enhance physical and psychosocial functioning through a multidimensional intervention that targets these contributing factors [ 48 ]. Prior studies investigating multicomponent interventions, which address multiple underlying causes of frailty such as muscle weakness, malnutrition, and psychosocial symptoms, have been shown to be significantly more effective in reversing frailty in older people compared to single interventions [ 61 ].…”

“…Additionally, it was intended to serve as an extra resource for community health workers involved in carrying out the intervention. The content of the training handbook was based on the multi-dimensional concept of frailty [ 48 – 50 ] and customised to the local setting. The training handbook was reviewed by Ethiopian community nurses with experience in community healthcare services, and it was accompanied by illustrative pictures.…”

Effectiveness of Community-Based Rehabilitation (CBR) Centers for Improving Physical Fitness for Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

“…The characteristics of the included studies are presented in Table 1 . One study was conducted in Israel [ 67 ], four in Korea [ 60 , 62 , 70 , 78 ], four in Japan [ 31 , 61 , 66 , 69 ], and 20 in China [ 34 - 36 , 59 , 63 - 65 , 68 , 72 , 73 , 75 - 77 , 79 - 81 , 83 - 86 ]. There were 16 RCTs [ 34 - 36 , 62 , 67 - 70 , 74 , 76 - 81 , 86 ], and 13 quasi-experimental studies [ 31 , 59 - 61 , 63 - 66 , 72 , 73 , 75 , 82 , 83 ].…”

“…Physical fitness was measured by 31 different assessment tools. Seventeen assessments tools were used by more than two studies, and five of these assessment tools: TUG [ 31 , 59 - 61 , 66 , 76 ], gait speed [ 31 , 59 , 61 , 62 ], handgrip strength [ 31 , 60 , 61 , 87 ], FRT [ 31 , 59 , 61 ], and one-leg standing time [ 31 , 59 , 61 ] were pooled in meta-analysis. Findings from five studies that assessed motor function of older adults with stroke, using the Fugl-Meyer motor function assessment [ 34 - 36 , 81 , 82 ] were presented as an un-pooled forest plot.…”