Holistic Self-Empowerment Care Intervention for Optimized Independent Living and Quality of Life: A Study Protocol

Not Applicable

Recruiting

• Conditions: Long-Term Care; Caregiver Burden

• Registration Number: NCT06736782
• Lead Sponsor: The University of Hong Kong

Brief Summary

This protocol describes a pilot study evaluating the effectiveness of the Self-Empowerment Care Model in promoting independence and quality of life among frail older adults in Hong Kong. Rooted in Nordic re-enablement principles and refined in Japan, the intervention adopts a holistic approach that focuses on hydration, exercise, diet, and defecation care. This 12-week intervention will be tested across three care settings-residential, day care, and home care. The study uses a quasi-experimental design involving 60 participants, aiming to compare outcomes of the intervention group with a control group receiving standard care. The study also assesses its impact on caregivers' burden and job satisfaction.

Detailed Description

Introduction:

As populations age, maintaining independence in activities of daily living (ADLs) becomes essential to enhance quality of life (QOL) and reduce caregiver burden. However, traditional custodial practices often exacerbate functional decline among older adults. The Self-Empowerment Care model emphasizes enhancing independence through tailored interventions addressing physical, social, and cultural needs. Despite its successful implementation in Japan and Taiwan, its application in Hong Kong remains unexplored.

Objectives:

Evaluate the feasibility, acceptability, and effectiveness of the Self-Empowerment Care model in improving ADLs and QOL for frail older adults.

Assess the impact on caregivers, including reduced burden and enhanced job satisfaction.

Identify factors affecting the sustainability of the intervention.

Methods:

Study Design: Quasi-experimental with a 1:1 allocation ratio.

Participants:

Older adults aged ≥65 years with functional decline. Informal and formal caregivers participating voluntarily. Exclusion: severe cognitive or mental illness, terminal illness. Sample Size: 60 older adults (30 per group), plus caregivers.

Intervention: Four components:

* Hydration: Promote daily water intake of 2000 mL.

* Exercise: Sequential activities tailored by physiotherapists.

* Defecation Care: Personalized interventions based on habits.

* Dietary Support: Nutritionally balanced meals and independent eating. Control Group: Standard care without structured interventions.

Data Collection:

Quantitative: ADLs (Barthel Index), QOL (EQ-5D-5L), caregiver burden (Zarit Interview), and caregiver satisfaction (Minnesota Satisfaction Questionnaire).

Qualitative: Focus groups with caregivers to explore their experiences. Timeline: Pre- and post-intervention assessments with a follow-up focus group. Analysis A mixed-method approach will be used. Quantitative data will undergo statistical analyses (e.g., linear mixed-effects models) to compare outcomes between intervention and control groups. Qualitative data will be analyzed thematically.

Ethics and Dissemination:

Approved by the Human Research Ethics Committee of the University of Hong Kong, the study prioritizes participants' dignity and autonomy. Results will be disseminated through academic publications and shared with policymakers to inform eldercare practices.

Significance:

This study is among the first in Hong Kong to implement and evaluate the Self-Empowerment Care model. It aims to provide empirical evidence for integrating holistic eldercare models into routine practices, with the potential to benefit both aging individuals and caregivers.

Study Timeline

• Study Start: 2024-07-01
• Status Verified: 2024-12
• Study First Submitted: 2024-12-12
• Study First Submitted QC: 2024-12-12
• Last Update Submitted: 2024-12-12
• Study First Posted: 2024-12-17
• Last Update Posted: 2024-12-17
• Primary Completion: 2024-12-31
• Study Completion: 2025-03-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 207

Inclusion Criteria

• Age 65 years or older
• Functional decline
• Potential to benefit from reablement.

Exclusion Criteria

• Severe cognitive impairment, those with mild impairment will be considered.
• Severe mental illness
• Terminal illness

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Barthel Index	12 Weeks	Evaluates participants' ability to perform basic activities of daily living (ADLs) independently. Scores range from 0 to 100, with higher scores indicating greater independence.
EQ-5D-5L	12 Weeks	A standardized instrument measuring health-related quality of life across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Adult Social Care Outcomes Toolkit (ASCOT)	12 Weeks	Assesses quality of life in the context of social care, with higher scores indicating better social care outcomes.
Self-Determination Survey	12 Weeks	Measures participants' autonomy and motivation in managing their own care, capturing changes in self-determination over time.
Instrumental Activities of Daily Living (IADL)	12 Weeks	Evaluates participants' ability to perform more complex daily tasks, such as managing finances and medication, with higher scores reflecting better functionality.

Secondary Outcome Measures

Name	Time	Method
Minnesota Satisfaction Questionnaire (MSQ)	12 Weeks	Measures job satisfaction among formal caregivers, with higher scores indicating greater satisfaction in their caregiving roles.
Zarit Caregiver Burden Interview (ZBI)	12 Weeks	Evaluates the emotional, physical, and financial burden experienced by informal caregivers, with higher scores indicating greater burden.

Trial Locations

Locations (1)

Sau Po Centre on Ageing, HKU; 🇭🇰 Hong Kong, Hong Kong