Effects of an Updated Preventive Home Visit Program Based on a Systematic Structured Assessment of Care Needs for Ambulatory Frail Older Adults in Japan: A Randomized Controlled Trial

Abstract Background Older adults with multiple chronic somatic diseases are challenged by mental comorbidities and social environmental changes resulting in complex bio-psychosocial healthcare needs. Comparatively few studies have addressed the coping strategies and resources of this highly vulnerable group. This study used the INTERMED interview method as a basis to investigate the resources of home-dwelling older adults with complex health care needs. Methods Following a randomized controlled trial this qualitative study analyzed detailed notes taken by a trained psychosomatic doctor during 24 interventional supportive counseling home visits. The randomized controlled trial participants were recruited from the ESTHER cohort study, a population-based study of older adults conducted in the state of Saarland, Southwest Germany. Patients with complex health care needs identified with the INTERMED interview received the supportive counseling home visit intervention, which followed the principles of narrative-based medicine and explored the personal resources of the participants. Notes from 24 supportive counseling home visits were analyzed using thematic content analysis. Results The qualitative analysis from 24 home visits identified 387 single codes, from which two main categories and 14 subcategories were derived. Participants with complex health care needs named currently available present resources and personal/long-lasting resources representing the main categories. Eight main categories were derived within the field of currently available resources that were deemed helpful to cope with the actual situation. Personal/long-lasting resources comprise statements that reflect personal experiential and attitudinal resources gained through socialization and internalization of interpersonal experiences. Conclusion The highly vulnerable group of complex patients reported many social, personal and structural resources that play significant roles in helping them to deal with their current situation. Home care professionals need skills to recognize and use the many different potential resources each client is able to access, which could enhance their well-being.

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Effects of Exercise Programs on Falls and Mobility in Frail and Pre-Frail Older Adults: A Multicenter Randomized Controlled Trial

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2006.04.005 ◽

2006 ◽

Vol 87 (7) ◽

pp. 885-896 ◽

Cited By ~ 285

Author(s):

Marjan J. Faber ◽

Ruud J. Bosscher ◽

Marijke J. Chin A Paw ◽

Piet C. van Wieringen

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Exercise Programs ◽

Frail Older Adults ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial

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Effects of a Preventive Home Visit Program in Ambulatory Frail Older People: A Randomized Controlled Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glr176 ◽

2011 ◽

Vol 67A (3) ◽

pp. 302-309 ◽

Cited By ~ 31

Author(s):

A. Kono ◽

Y. Kanaya ◽

T. Fujita ◽

C. Tsumura ◽

T. Kondo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Older People ◽

Home Visit ◽

Controlled Trial ◽

Frail Older People ◽

Preventive Home Visit ◽

Randomized Controlled

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Chronic Care Clinics: A Randomized Controlled Trial of a New Model of Primary Care for Frail Older Adults

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.1999.tb03832.x ◽

1999 ◽

Vol 47 (7) ◽

pp. 775-783 ◽

Cited By ~ 126

Author(s):

E. A. Coleman ◽

L. C. Grothaus ◽

N. Sandhu ◽

E. H. Wagner

Keyword(s):

Older Adults ◽

Primary Care ◽

Randomized Controlled Trial ◽

Chronic Care ◽

Controlled Trial ◽

New Model ◽

Frail Older Adults ◽

Randomized Controlled

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Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-019-0855-9 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 6

Author(s):

Tsung-Jen Hsieh ◽

Shin-Chang Su ◽

Chun-Wei Chen ◽

Yaw-Wen Kang ◽

Ming-Hsia Hu ◽

...

Keyword(s):

Older Adults ◽

Randomized Controlled Trial ◽

Physical Performance ◽

Controlled Trial ◽

Control Group ◽

Nutrition Interventions ◽

Frail Older Adults ◽

Randomized Controlled ◽

Home Based ◽

Frailty Score

Abstract Background Frail older adults are predisposed to multiple comorbidities and adverse events. Recent interventional studies have shown that frailty can be improved and managed. In this study, effective individualized home-based exercise and nutrition interventions were developed for reducing frailty in older adults. Methods This study was a four-arm, single-blind, randomized controlled trial conducted between October 2015 and June 2017 at Miaoli General Hospital in Taiwan. Overall, 319 pre-frail or frail older adults were randomly assigned into one of the four study groups (control, exercise, nutrition, and exercise plus nutrition [combination]) and followed up during a 3-month intervention period and 3-month self-maintenance period. Improvement in frailty scores was the primary outcome. Secondary outcomes included improvements in physical performance and mental health. The measurements were performed at baseline, 1 month, 3 months, and 6 months. Results At the 6-month measurement, the exercise (difference in frailty score change from baseline: − 0.23; 95% confidence interval [CI]: − 0.41, − 0.05; p = 0.012), nutrition (− 0.28; 95% CI: − 0.46, − 0.11; p = 0.002), and combination (− 0.34; 95% CI: − 0.52, − 0.16; p < 0.001) groups exhibited significantly greater improvements in the frailty scores than the control group. Significant improvements were also observed in several physical performance parameters in the exercise, nutrition, and combination groups, as well as in the 12-Item Short Form Health Survey mental component summary score for the nutrition group. Conclusions The designated home-based exercise and nutrition interventions can help pre-frail or frail older adults to improve their frailty score and physical performance. Trial registration Retrospectively registered at ClinicalTrials.gov (identifier: NCT03477097); registration date: March 26, 2018.

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