Promoting well-being in frail elderly people: theory and intervention

Schuurmans, J. E. H. M., 2004, [S.l.]: [s.n.]. 216 p.

Research output: ThesisThesis fully internal (DIV)

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  • Johanna Engelberta Hendrika Maria Schuurmans
In this project, it was investigated if well-being in frail elderly patients (hospital and family practitioners patients) can be increased by means of increasing their Self-Management Ability (SMA). Frail elderly people have suffered interacting losses in physical, social, and psychological domains of functioning. These losses lead to a decreased reserve capacity for dealing with these and new losses. As such, frail elderly people have a risk of declining well-being. To counteract or mitigate these negative consequences of frailty, an intervention was proposed to increase frail elderly people’s adaptive abilities (self-management abilities) to realize well-being. The intervention consisted of six home visits by a geriatric nurse. The visits were psycho-educational and contained information and assignments. Effects of the intervention were tested by comparing an experimental and a control group, both about 50 persons. Besides, some theoretical models about the expected relations between frailty, self-management abilities and well-being were tested in several samples. These samples consisted of elderly people with different levels of frailty. Main results and conclusions: - Using frailty to select older people at risk for interventions may, therefore, be a large improvement compared to selecting people using chronological age. - Both self-management abilities and well-being can be increased in frail elderly hospital patients by means of a general intervention that does not focus on the consequences of specific diseases, but on elderly people’s general capacity for realizing well-being. - The intervention increased overall well-being, which includes physical, social, and psychological well-being. - The intervention increased the self-management abilities and via these, well-being. - The increase in self-management abilities and well-being was found in the short term (directly after the intervention) and in the longer term (4 months after the intervention). - We were able to give our intervention a clear theoretical basis that connected the problem, the working mechanism, and the outcomes. Using the theoretical, we were able to design an intervention that increased the theoretical mechanism of self-management abilities and thereby appeared to lead to the expected outcome (increased well-being). - Most of our theoretical propositions predicted positive well-being well. Other theorizing might be required to capture relevant predictors for negative well-being. Well-being must be considered multidimensionally. - Self-management abilities are mostly related to positive aspects of well-being; frailty is mostly related to negative aspects of well-being. - The SMA intervention can be implemented in transmural care for frail elderly hospital patients, but additional criteria for selecting the patients have to be used.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Award date2-Jun-2004
Place of Publication[S.l.]
Print ISBNs903672032X
Publication statusPublished - 2004


  • Proefschriften (vorm), Welzijn, Ouderen, 44.68

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