教育干预对具有虚弱表型的社区居住老年人功能能力的益处：随机对照试验

IF 7.5 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2024-11-09 DOI:10.1016/j.ijnurstu.2024.104955

Andrea González-Mariscal , Juan Corral-Pérez , María Ángeles Vázquez-Sánchez , Laura Ávila-Cabeza-de-Vaca , Manuel Costilla , Cristina Casals

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引用次数: 0

摘要

背景：对护士在初级保健中管理虚弱方面的知识和技能的需求十分迫切。虚弱是一种多方面的疾病，在老年人中普遍存在，通常会导致功能减退。目前，人们对旨在提高社区体弱老年人在初级护理环境中的功能能力的教育干预措施的效果了解有限：本研究旨在评估一项教育计划对居住在社区的前期体弱和体弱老年人功能能力的影响：设计：为期 12 个月的多中心随机对照试验：FRAGSALUD研究在西班牙加的斯和马拉加地区的14家医疗中心进行：共有 199 名居住在社区的虚弱/预虚弱老年人（74.2 ± 6.4 岁）：方法：符合弗里德标准中至少一项标准的参与者被分配到对照组（90 人）或干预组（109 人），对照组接受常规医疗保健援助。为期 6 个月的干预包括四次小组会议和六次电话会议，由专业护士、体育科学家和营养学家主持。这项教育计划的重点是体育锻炼指南、营养习惯、认知和社会心理健康。使用日常生活基本活动（巴特尔指数）和工具性活动（劳顿和布罗迪量表）的调查问卷对功能能力进行评估。所有结果均在基线、干预结束后（6 个月）和干预结束后 6 个月（12 个月）进行评估。采用弗里德曼方差分析和 Wilcoxon 符号秩检验对三个时间点的功能能力差异（巴特尔指数和劳顿与布罗迪量表得分）进行分析：结果：在 6 个月和 12 个月的评估中，对照组与干预组相比，在基本日常生活活动和工具性日常生活活动方面都出现了统计学意义上的显著下降，而干预组则保持了相似的水平，避免了这种与年龄相关的下降：教育干预的设计便于在医疗系统内实施，特别是对护士而言，它成功地维持了基本日常生活和工具性日常生活的功能能力水平，而对照组在 12 个月的随访中功能能力有所下降。因此，我们鼓励采取教育干预措施，以保持生活在社区中的体弱/先天性体弱老年人的功能独立性：该试验已在 ClinicalTrials.gov 注册（标识符：NCT05610605），第一名参与者已于 2022 年 3 月注册。Tweetable 摘要：FRAGSALUD 教育干预可在 12 个月内防止体弱老年人与年龄相关的功能独立性下降。

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Benefits of an educational intervention on functional capacity in community-dwelling older adults with frailty phenotype: A randomized controlled trial

Background

There is an urgent demand for nurses to expand their knowledge and skills in managing frailty in primary care. Frailty is a multifaceted condition that is prevalent among older adults and often leads to reduced functional capacity. Currently, there is a limited understanding of the effectiveness of educational interventions aimed at improving functional capacity among community-dwelling frail older adults in a primary care setting.

Objective

This study aimed to evaluate the impact of an educational program on functional capacity among pre-frail and frail older adults living in the community.

Design

A 12-month, multicenter, randomized controlled trial.

Settings

The FRAGSALUD study was conducted across 14 healthcare centers situated within the regions of Cadiz and Malaga, Spain.

Participants

A total of 199 frail/pre-frail community-dwelling older adults (74.2 ± 6.4 years).

Methods

Participants who met at least one Fried's criteria were assigned to either the control group (n = 90), which received usual healthcare assistance, or the intervention group (n = 109). The 6-month intervention comprised four group sessions and six telephone calls conducted by professional nurses, sport scientists, and nutritionists. This educational program focused on guidelines for physical activity, nutritional habits, cognition, and psychosocial well-being. Functional capacity was assessed using questionnaires for basic (Barthel Index) and instrumental (Lawton and Brody Scale) activities of daily living. All outcome measures were evaluated at baseline, immediately after the intervention (6-month), and six months after the intervention as a follow-up (12-month). Differences in functional capacity (Barthel Index and Lawton and Brody Scale scores) across the three time points were analyzed using Friedman's ANOVA, with Wilcoxon signed-rank test for pairwise comparisons.

Results

At both 6-month and 12-month assessments, the control group showed a statistically significant decline in basic and instrumental activities of daily living compared to the intervention group, which maintained similar levels, preventing this age-related decline.

Conclusions

The educational intervention, designed for easy implementation within healthcare systems, especially for nurses, successfully maintained levels of functional capacity in basic and instrumental activities of daily living, while the control group experienced a decline in functional capacity during the 12-month follow-up. Thus, educational interventions are encouraged for preserving the functional independence of frail/pre-frail older adults living in the community.

Registration

This trial was registered at ClinicalTrials.gov (Identifier: NCT05610605) and the first participant was registered in March 2022.

Tweetable abstract: The FRAGSALUD educational intervention prevents the age-related decline in functional independence over 12 months in frail older adults.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).