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The use of case management for community-dwelling older people: the effects on loneliness, symptoms of depression and life satisfaction in a randomised controlled trial
Department of Health Sciences, Faculty of Medicine, Lund University, Lund Sweden.ORCID iD: 0000-0002-1384-4291
Department of Health Sciences, Faculty of Medicine, Lund University, Lund Sweden.
Department of Clinical Sciences in Malmö, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö Sweden.
Department of Clinical Sciences in Malmö, Faculty of Medicine, Center for Primary Health Care Research, Lund University, Malmö Sweden.
2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 889-901Article in journal (Refereed) Published
Abstract [en]

AimTo investigate the effects of a case management intervention for community-dwelling frail older people, with functional dependency and repeated contacts with the healthcare services, focusing on loneliness, depressive symptoms and life satisfaction.DesignA two-armed, nonblinded, randomised control trial with repeated follow-ups, of N = 153 participants at baseline allocated to an intervention (n = 80) and control (n = 73) group.MethodInclusion criteria were the following: ≥65 years of age, living in ordinary housing, in need of assistance in two or more self-reported activities of daily living, having at least two hospital admissions or at least four visits in outpatient care 12 months prior to enrolment. Case managers (nurses and physiotherapists) provided an intervention of general case management, general information, specific information and continuity and safety. The intervention ranged over 12 months with one or more home visit(s) being conducted per month. An intention-to-treat analysis was applied for the primary outcomes of loneliness, depressive symptoms and life satisfaction, along with complete case and sensitivity analyses.ResultsDuring the trial period n = 12 died and n = 33 dropped out. No significant difference was found between the groups at baseline regarding sociodemographic characteristics, subjective health or primary outcomes. The intention-to-treat analysis did not result in any significant effects for the primary outcomes at any of the follow-ups (6 and 12 months). The complete case analysis resulted in a significant difference in favour of the intervention regarding loneliness (RR = 0.49, p = 0.028) and life satisfaction (ES = 0.41, p = 0.028) at 6 months and for depressive symptoms (ES = 0.47, p = 0.035) at 12 months.ConclusionsThe use of case management for frail older people did not result in clear favourable effects for the primary outcomes. However, the study indicates that case management may be beneficial in terms of these outcomes. Due to the complexity of the outcomes, an elaboration of the components and assessments is suggested.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017. Vol. 32, no 2, p. 889-901
National Category
Nursing
Research subject
Care science
Identifiers
URN: urn:nbn:se:mau:diva-56536DOI: 10.1111/scs.12520ISI: 000436254800046PubMedID: 28895175Scopus ID: 2-s2.0-85054146309OAI: oai:DiVA.org:mau-56536DiVA, id: diva2:1718031
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Region SkåneAvailable from: 2022-12-12 Created: 2022-12-12 Last updated: 2024-06-05Bibliographically approved

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