title: Educational interventions to empower nursing home residents: a systematic literature review.
abstract: OBJECTIVE
  Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents.
  
  
  METHODS
  A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents. An additional, manual search of the reference lists and searches with SIGLE and Google Scholar were conducted to identify gray literature. Two authors independently appraised the quality of the studies found and assigned levels to the evidence reported. The results of the studies were grouped according to their main empowering outcomes and described narratively.
  
  
  RESULTS
  Out of 427 identified articles, ten intervention studies that addressed the research question were identified. The main educational interventions used were group education sessions, motivational and encouragement strategies, goal setting with residents, and the development of plans to meet defined goals. Significant effects on self-efficacy and self-care behavior were reported as a result of the interventions, which included group education and individual counseling based on resident needs and preferences. In addition, self-care behavior was observed to significantly increase in response to function-focused care and reasoning exercises. Perceptions and expectations were not improved by using educational interventions with older nursing home residents.
  
  
  CONCLUSIONS
  Individually tailored, interactive, continuously applied, and structured educational strategies, including motivational and encouraging techniques, are promising interventions that can help nursing home residents become more empowered. Empowering strategies used by nurses can support residents in their growth and facilitate their self-determination. Further research on the empowerment of residents using empowerment scales is needed.
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Graz, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Schoberer
authors.affiliation: Turku University Hospital, University of Turku, Turku, Finland.
authors.forename: Helena
authors.initials: H
authors.lastname: Leino-Kilpi
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Graz, Austria.
authors.forename: Helga E
authors.initials: HE
authors.lastname: Breimaier
authors.affiliation: Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands.
authors.forename: Ruud Jg
authors.initials: RJ
authors.lastname: Halfens
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Graz, Austria.
authors.forename: Christa
authors.initials: C
authors.lastname: Lohrmann
mesh_terms: D000073496:Frailty / Q000523:psychology*; D006040:Goals; D006266:Health Education / Q000458:organization & administration*; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D009042:Motivation; D009735:Nursing Homes / Q000458:organization & administration*; D011209:Power, Psychological; D012648:Self Care / Q000523:psychology
keywords: empowerment; health education; older people; self-care activities; self-determination; self-efficacy