Achieving self-management goals among low income older adults with functional limitations.
Janiece L Taylor, Laken Roberts, Melissa D Hladek and 4 others
PMID 30799154WHAT IT FOUND
Older adults who set self-management goals with nurses often reported fully or partially meeting them, especially fall prevention.
Because nurses worked as part of a program that also included occupational therapy and home repair, this does not show nurse visits alone caused improvement.
Key findings
01Pain goals were chosen by 50% of participants; 39% fully achieved them, 39% partially achieved them, 17% did not achieve them, and 5% were not assessed.
02Fall prevention goals were chosen by 51% of participants; 46% achieved them, 40% partially achieved them, 10% did not achieve them, and 4% were not assessed.
03Mood goals were chosen by 19% of participants; 32% fully achieved them, 45% partially achieved them, 17% did not achieve them, and 6% were not assessed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The paper analyzed only participants who received the CAPABLE treatment and did not compare them with a control group, so it cannot show that the program or nurse visits caused goal achievement. Goal achievement was self-reported by participants to nurses with whom they had built rapport, so responses may have been influenced by wanting to please the nurse. The analysis pooled two trials with different income eligibility definitions, although demographics were reported as equivalent. Some goals were not assessed for 4% to 11% of participants because of a transition from paper to electronic documentation. The nurse visits occurred as part of a five-month interdisciplinary program that also included occupational therapy and home repair, so the nurse contribution cannot be separated. Participants had to be able to stand with or without assistance and were excluded if cognitively impaired, so the findings may not apply to people who could not stand even with assistance or who had cognitive impairment.
Declared interests
The underlying trials were funded by the National Institute on Aging and the Centers for Medicare and Medicaid Services. The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not conclude that nurse visits alone caused goal achievement. Participants received a five-month interdisciplinary program that also included occupational therapy and home repair, and the outcome was self-reported without a comparison group.