The effects of intervention on the quality of life, sense of coherence and daily activities of frequent attenders

Abstract

Background and objective: When FAs with chronic disease and various needs are able to keep up their psychological and physical wellbeing, perform daily activities and maintain control of their life, they are able to live an active life and take care of themselves longer, and this has an impact on their quality of life. The role of community matron is to assess an individual’s problems and needs for health services and improve the self-care of FAs by providing a needs-based education.  The goal of this study is to evaluate the effectiveness of nurse-led intervention on the quality of life, sense of coherence and daily activities of frequent attenders (FAs).

Methods: This study is an intervention trial, with a two-year follow-up, including intervention and control groups. The intervention group received nurse-led intervention that included the assessment of FAs care needs, an individualized care plan, support for self-management and service coordination. The FAs in the control group received traditional care, including patient education and support. Self-reported instruments were used to collect data from adult frequent attenders, including the Frenchay Activities Index (FAI), Sense of Coherence (SOC) and 15D, to assess the health-related quality of life (HRQoL). Follow-ups measurements were taken after one year and after two years between 2008 and 2011.

Results: The study shows a significant correlation between sense of coherence and quality of life (p < .0005) and quality of life and amount of daily activities performed (p < .0005) in both groups. The intervention group had statistically significantly better sense of coherence at every stage of the study. The activities of daily living statistically significantly weakened in the intervention group (p = .001) from baseline to two years despite intervention, whereas in the control group it remained unchanged. In the control group, a statistically significant correlation was found between sense of coherence and FAs feeling satisfaction with their current life (p = .019). The HRQoL did not differ between the groups during the study.

Conclusions: These results indicate a correlation between sense of coherence and quality of life and also between quality of life and amount of daily activities among FAs. Intervention did not improve the quality of life of FAs or their daily functioning. More research is needed to demonstrate the effects of community matron model on FAs care, the role of ehealth needs to be strongly involved.