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*Dagens forskningsoversigt fra Scias Update:*
The effect of complex interventions on supporting self-care among
community-dwelling older adults: a systematic review and meta-analysis.
Age Ageing. 2018 Mar 01;47(2):185-193
Authors: Wong KC, Wong FKY, Yeung WF, Chang K
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.
PMID: 28927235
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Dette abstract er hentet via PubMed fra National Library of Medicine, USA
<https://www.ncbi.nlm.nih.gov/home/about/policies>.
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