Later life often brings mental health challenges, significantly impacting an older adult’s ability to maintain independence within their community. While proactive self-care programs led by nurses have traditionally emphasized physical health, particularly for seniors managing chronic conditions, their influence on the psychological well-being of independent, community-dwelling older adults has been less explored.
This study aimed to investigate the effectiveness of a nurse-led proactive self-care program, incorporating a health-social partnership model, on key mental health indicators for older adults living in their communities. These indicators included depressive symptoms, overall life satisfaction, and the mental component of health-related quality of life.
A single-blinded, randomized controlled trial was conducted to assess the program’s impact. Participants aged 60 and above, residing in designated service areas and scoring at least 18 on the Mini-Mental Status Examination, were recruited. Data was gathered using questionnaires at three intervals: before the intervention (T1), immediately after (T2), and three months post-intervention (T3). The comprehensive program featured thorough assessments, educational resources on health and self-management, empowerment strategies, and improved access to community services via a newly established health-social partnership network. Generalized Estimating Equations were employed to analyze group, time, and interaction effects, with intention-to-treat analysis as the primary statistical method.
Out of 843 potential participants in the community, 457 eligible older adults were randomly assigned to either the intervention group (n = 230) or the control group (n = 227). A substantial majority, 175 (76.0%) from the intervention group and 190 (83.7%) from the control group, completed data collection at T3, six months following the program’s conclusion at T2. The findings revealed a significant time-based improvement between T1 and T2 (Wald χ2 = 25.7, p < .001), indicating positive changes in the measured outcomes during the program.
In conclusion, this research underscores the value of interprofessional care models that address both health and social needs in enhancing the mental health of older adults living in the community. Specifically, Community Self Care Programs utilizing health-social partnerships and led by nurses can effectively reduce depressive symptoms and improve overall mental well-being in this population.
