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

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

doi:10.1136/bmjopen-2017-016674

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

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

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective To 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. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-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. Intervention Nurse-supported self-management programme. Measurements Effectiveness 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. Results Self-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. Conclusions A 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.

Original language	English
Article number	e016674
Number of pages	11
Journal	BMJ Open
Volume	8
Issue number	1
DOIs	https://doi.org/10.1136/bmjopen-2017-016674
Publication status	Published - 1 Jan 2018

Keywords

MACULAR DEGENERATION
HOME RESIDENTS
HEARING-LOSS
HEALTH-CARE
INTERVENTION
VISION
EDUCATION
OUTCOMES
VERSION
REHABILITATION

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Roets-Merken, L. M., Zuidema, S. U., Vernooij-Dassen, M. J. F. J., Teerenstra, S., Hermsen, P. G. J. M., Kempen, G. I. J. M., & Graff, M. J. L. (2018). Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial. BMJ Open, 8(1), Article e016674. https://doi.org/10.1136/bmjopen-2017-016674

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

abstract = "Objective To 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. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-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. Intervention Nurse-supported self-management programme. Measurements Effectiveness 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. Results Self-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. Conclusions A 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.",

keywords = "MACULAR DEGENERATION, HOME RESIDENTS, HEARING-LOSS, HEALTH-CARE, INTERVENTION, VISION, EDUCATION, OUTCOMES, VERSION, REHABILITATION",

author = "Roets-Merken, {Lieve M.} and Zuidema, {Sytse U.} and Vernooij-Dassen, {Myrra J. F. J.} and Steven Teerenstra and Hermsen, {Pieter G. J. M.} and Kempen, {Gertrudis I. J. M.} and Graff, {Maud J. L.}",

year = "2018",

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doi = "10.1136/bmjopen-2017-016674",

language = "English",

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Effectiveness of a nurse-supported self-management programme for dual sensory impaired older adults in long-term care: a cluster randomised controlled trial. / Roets-Merken, Lieve M.; Zuidema, Sytse U.; Vernooij-Dassen, Myrra J. F. J. et al.
In: BMJ Open, Vol. 8, No. 1, e016674, 01.01.2018.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

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AU - Roets-Merken, Lieve M.

AU - Zuidema, Sytse U.

AU - Vernooij-Dassen, Myrra J. F. J.

AU - Teerenstra, Steven

AU - Hermsen, Pieter G. J. M.

AU - Kempen, Gertrudis I. J. M.

AU - Graff, Maud J. L.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective To 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. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-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. Intervention Nurse-supported self-management programme. Measurements Effectiveness 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. Results Self-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. Conclusions A 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.

AB - Objective To 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. Design Cluster randomised controlled trial. Setting Thirty long-term care homes across the Netherlands. Participants Long-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. Intervention Nurse-supported self-management programme. Measurements Effectiveness 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. Results Self-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. Conclusions A 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.

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KW - VISION

KW - EDUCATION

KW - OUTCOMES

KW - VERSION

KW - REHABILITATION

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DO - 10.1136/bmjopen-2017-016674

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SN - 2044-6055

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