title: Effects on leisure activities and social participation of a case management intervention for frail older people living at home: a randomised controlled trial.
abstract: Frailty causes disability and restrictions on older people's ability to engage in leisure activities and for social participation. The objective of this study was to evaluate the effects of a 1-year case management intervention for frail older people living at home in Sweden in terms of social participation and leisure activities. The study was a randomised controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to intervention (n = 80) or control groups (n = 73). The intervention group received monthly home visits over the course of a year by nurses and physiotherapists working as case managers, using a multifactorial preventive approach. Data collections on social participation, leisure activities and rating of important leisure activities were performed at baseline, 3, 6, 9 and 12 months, with recruitment between October 2006 and April 2011. The results did not show any differences in favour of the intervention on social participation. However, the intervention group performed leisure activities in general, and important physical leisure activities, to a greater extent than the control group at the 3-month follow-up (median 13 vs. 11, P = 0.034 and median 3 vs. 3, P = 0.031 respectively). A statistically significantly greater proportion of participants from the intervention group had an increased or unchanged number of important social leisure activities that they performed for the periods from baseline to 3 months (93.2% vs. 75.4%, OR = 4.48, 95% CI: 1.37-14.58). Even though statistically significant findings in favour of the intervention were found, more research on activity-focused case management interventions is needed to achieve clear effects on social participation and leisure activities.
authors.affiliation: Center for Innovative Care in Aging, Department of Community-Public Health, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.|Research Group Active and Healthy Ageing, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Marianne
authors.identifier: 0000-0001-7456-2039
authors.initials: M
authors.lastname: Granbom
authors.affiliation: Research Group Active and Healthy Ageing, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.|Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
authors.forename: Jimmie
authors.initials: J
authors.lastname: Kristensson
authors.affiliation: Research Group Older People's Health and Person-Centred Care, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Sandberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000458:organization & administration*; D015444:Exercise; D005260:Female; D016330:Frail Elderly; D006792:House Calls; D006801:Humans; D007899:Leisure Activities; D008297:Male; D058992:Social Participation; D012959:Socioeconomic Factors; D013548:Sweden
keywords: aged; case management; community living; frailty; health promotion