Design, Implementation and evaluation of Home Care Support Intervention Program for lonely older adults: A feasibility study in Gorgan city

Abstract

Introduction: due to an increasing aging population across the world particularly underdeveloped countries, community-based programs should be established to improve the quality of older adults.In this meantime, lonely older adults are more likely to deprive of supportive home care compared to their peers Therefore, the purpose of this study was to design, implementation and evaluation of intervention program of supportive home care program for lonely older adults in Gorgan city. Method and material: This feasibility study is a mixed-method with a concurrent nested design which was conducted in 2021-2022 in Gorgan city. This study was carried out at three phases. Phase one (design): one fast review literature and cross-sectional among 213 lonely older adults study was conducted and an action plan was designed to implement home care supportive care intervention. The questionnaires including feelings of loneliness (UCLA-20), quality of life (CASP-19), general health (GHQ12), social network (LSNS-6), social support (MSPSS-12), and self-care ability (SASE-17) were completed among lonely older adults. Furthermore, three open-ended questions about required supportive home care services were asked in the first phase of the study. In phase two (implementation): one before-after study with control group within three months (12 weeks) among 36 interested lonely older adults from cross-sectional study was carried out. In intervention program, the comparison group was selected from Ali Abad Katul, 51 lonely older adults registered at health care center in Ali Abad-E- Katul were recruited. Phase three (evaluation), after three months intervention program, post-test was conducted at three time points(immediately after intervention, three months and six months after intervention). Moreover, Semi-structured interviews were conducted with 19 lonely older adults in intervention group and one research partner immediately after the intervention using content qualitative approach to identify positive and negative points concerned with the intervention program. To indicate the effect of intervention program over time and comparison with control group repeated measures ANOVA test was applied. Data analysis was done using SPSS software version 20 and MAXQDA version 20 software. Results: the mean age of participants in cross-sectional study was 68.10 ± 6.20, 91.1 percent of participants were women. there was a significant relation among outcome variables including feeling of loneliness (P< 0.001, F= 15.915), quality of life (P< 0.001, F=16.499) and general health (P< 0.001, F= 12.753) in different stages of measurements.. Semi-structured interviews revealed two sub-categories related to positive ponts (improved personal knowledge and skills, constructed social relationship and modified personal behaviors) and one negative (infrastructural and communication challenges).