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Publication date

Effects of self-management support programmes on activities of daily living of older adults.

Bolscher-Niehuis, M.J.T. van het, Bergsma, A., Vocht, H.M. de, Ouden, M.E.M. den, Francke, A.L. Effects of self-management support programmes on activities of daily living of older adults. Journal of Advanced Nursing: 2016, 72(suppl. 1) 73. Abstract. 5th European Nursing Congress: 'Caring for older people: how can we do the right things right?' 4-7 oktober 2016, Rotterdam.
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.