The purpose of the study was to present a trial whose intention was to assess self-care program effectiveness by proactive nurses on psychological results. To achieve the aim of the research, Wong and Wong (2020) established a partnership between the social and health models for the elders who dwelled in community facilities. The researchers examined the relationship between the models and self-care programs on depressive symptoms, health-related life quality mental component, and life satisfaction. From the literature, Wong and Wong show that previous findings have been used in asserting that improvements in psychological health among older adults are achieved using a nurse-led proactive self-care program. Wong and Wong examine the effects of psychological outcomes among older adults by investigating the relationship life satisfaction, quality of life mental components, and depressive symptoms have on older patients within the community.
Regardless of the group, every participant was offered equal care based on their physical history. Wong and Wong established the hypothesis on the need to ensure self-care programs with proactive nurses were responsible for controlling outcomes associated with life satisfaction, depressive symptoms presence, and mental component associated with health-related life quality. By administering the MMSE test to the subjects, the researchers ensured the ≥18 score was an external factor that did not influence the outcome of the investigation. The variables are identified as control and intervention groups.
The research design employed in the article was a quantitative research approach, employed descriptive reasoning, and the study was randomized but followed the single-blinded design. Four hundred fifty-seven subjects were sampled to participate in the research using probability sampling and were all accounted for at the end of the study. The study population was selected from older adults with attention to their physical health in a community setting. The sample size for the research was calculated using power analysis. The subjects chosen for the research were not aware of intervention of control groups’ use. However, 18 participants from the intervention group and six from the control group withdrew from the research. Svedlov (2017) shows that when a researcher(s) modifies the independent variable(s}, the impact encountered by the dependent variable(s) is simultaneously controlled. Moreover, Svedlov (2017) asserts that randomized trials are vital in how the experiment is controlled, and this is significant in research since it helps to strengthen the internal validity associated with the study.
The participants in the control group (n=227) formed the independent variable and received the usual community services. The independent variable was involved usual community services at the study district’s service centers, and all received regular health talk and basic health checks access. Those in the intervention group (n=230) formed the dependent variable, received similar health checks access, and followed a three-month program. Through the program, the dependent variable was involved in an intensive arrangement wherein the subjects received loading dose treatment during their first visit. The treatment included evaluation, intervention, and mental and physical health evaluation promotion led by a registered nurse and supported by social or community workers. The subsequent home visits resulted in a bi-weekly maintenance dose that was administered alternatively either through telephone calls or using home visits.
Svedlov (2017) shows that when a researcher(s) modifies the independent variable(s}, the impact encountered by the dependent variable(s) is simultaneously controlled. Moreover, Svedlov (2017) asserts that randomized trials are vital in how the experiment is controlled, and this is significant in research since it helps to strengthen the internal validity associated with the study. The reliability measure in the research can be attributed to the use of tables that Wong and Wong use in recording their data. Further, they use inclusion criteria in their approach to determining the number of participants for the study. The approach was appropriate as quantitative research based on how all subjects were treated.
Every participant eligible for the study and agreed to contribute to the research signed a consent form. Moreover, in line with the Helsinki declaration, Wong and Wong (2020) performed their research under ethical and standard criteria. The approval by the university’s ethics sub-committee also highlights how the article adhered to research ethics. Based on the approval and with identifier NCT02286375, the study was registered at ClinicalTrials.gov.
Using the Wald Test, Wong and Wong were able to highlight the parameters associated with the certain variables employed in the study. Researchers could only remove the variable from the model if their explanatory values were zero. Based on McCullagh and Nelder (2019), successful data gathering on the same units overtime followed by repeated observations is correlated, defining the parameters associated with the Generalized Estimation Equations model. Using the model, the research showed the differences in time effects between T1 and T3 were p =.001, Wald x2 = 25.7 and p =.007, Wald x2 = 7.40 respectively in depression scores. Further, the model also showed depression levels in the two groups were low at baseline, and over time, the levels improved. For the life satisfaction variable, both groups had values above 3, representing a level that was between fair and satisfactory. Both groups had the same interaction effects on the mental component of life quality. However, between T1 and T2, the average scores rose by 7.0 and 4.8, respectively. The results were tabulated for the reader and then illustrated for better understanding.
Conclusion, Implications, and Recommendations
The limitation associated with the research is that it is focused on a self-care program for the elderly. A better understanding of the outcomes could have been attributed to participants 18 years and above. Another limitation is the study’s attention to one country, and therefore, the outcomes might be biased based on the specific health-related factors that might only impact the older adults in the Chinese population. However, the study’s strength is associated with its ability to empower the older generation to engage in their care plan. Moreover, the findings contribute to an improved self-care program by proactive nurses.
While the study’s outcomes might be applicable in clinical practice, it remains uncertain whether the elderly population within the community is independent, specific to mental illness history. Nonetheless, in communities with large populations, the study’s outcomes might be generalized since Wong and Wong used a calculated sample size that represented an entire population. Wong and Wong highlight the main limitation as insufficient time to establish a steady collaboration between the general practitioners and the nurses, contributing to the failure to obtain differences between the groups.
Based on the limitations, the recommendation for future studies is to include all adults, 18 years and above, in the self-care program for a more informed outcome. Another recommendation for future research is that if researchers should give attention to older adults, they should incorporate all adults 65 years and above instead of focusing on community-dwelling older adults. The third recommendation is to include participants from several countries to minimize the possibilities of region-based bias in the outcomes.
McCullagh, P., & Nelder, J. A. (2019). Generalized linear models.
Monaghan, T. F., Agudelo, C. W., Rahman, S. N., Wein, A. J., Lazar, J. M., Everaert, K., & Dmochowski, R. R. (2021). Blinding in Clinical Trials: Seeing the Big Picture. Medicine (Kaunas, Lithuania), 57, 7.)
Sverdlov, O. (2017). Modern adaptive randomized clinical trials: Statistical and practical aspects. Chapman & Hall/CRC.
Wong, A. K. C., & Wong, F. K. Y. (2020). A randomized controlled trial is the psychological impact of a
nurse-led proactive self-care program on independent, non-frail community-dwelling older adults. International Journal of Nursing Studies, 110.