Effects of self-management support programmes on activities of daily living of older adults.
2016
Background: The ability of older adults to carry out activities of daily living (ADL) and to adapt and to manage their own life decreases due to deterioration of their physical
and cognitive condition. Nurses and other health care professionals should support the
self-management ability of older adults to prevent ADL dependence and increase the ability
to adapt and to self-manage the consequences of living with a chronic condition.
Objective: To gain insight into the evidence of the effects of self-management support programmes on the activities of daily living of older adults living at home.
Method: A systematic literature review of original research publication. Searches were
performed in December 2014 in PubMed, CINAHL and PsycINFO. No limitations were
applied regarding date of publication, language or country.
Publications were eligible for this review on condition that they described a self-management
support programme directed at adults of on average 65 years or older, and living in the
community; used a randomised or non-randomised control group or before and after design; and presented information about the effects on activities of daily living. A threestage inclusion process was applied and the authors independently assessed the methodological
quality of the included studies. A best evidence synthesis was performed using guidelines
provided by the Cochrane Collaboration Back Review Group.
Results: A total of 3671 potentially relevant references were found. After screening the references, sixteen studies, both studies with a randomised controlled design (n = 13) and
before and after design (n = 3), were included.
The methodological assessment of the sixteen studies indicated variations in the risk of bias
from low (n = 12) to moderate (n = 3) and high (n = 1). Although there was considerable variation in study population, intervention characteristics and measurement instruments
used, most studies (n = 15) showed effects of self-management support programmes on the
activities of daily living of older adults.
Conclusions: There is a moderate level of evidence that self-management support programmes with a multi-component structure, containing disease-specific information, education of knowledge and skills and, in particular, individually tailored coaching, improve the activities of daily living of older adults. Further research is required to gain insight
into the most appropriate context and approach of self-management support interventions
targeting activities of daily living of older adults living in the community.
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