Enhancing quality of life for activity-limited older adults in Sri Lanka: a need-based caregiver education intervention study

Abstract

Introduction: The increasing ageing population in the world is a public health concern that affects older adults, families, caregivers, the community, and the country. This study explored the impact of the developed need-based educational intervention on improving the quality of life (QoL) of activity-limited older adults. Methods: This pre- and post-interventional study was conducted in two selected divisional secretariat divisions in the Colombo District in the Western province of Sri Lanka. The sample of older adults (N = 72) was selected based on their highest level of activity limitations. The intervention was provided to caregivers, and the outcome was evaluated by older adults. The developed educational intervention and handbook were delivered to the intervention group (n = 36) while the other group of older adults (n = 36) was recruited as controls. The pre- and post-QoL levels of older adults in both intervention and control groups were assessed using the validated Sinhala World Health Organization-Quality of Life-Brief (WHOQOL-BREF) questionnaire. The intervention consisted of two to four educational sessions with practical demonstrations, two weeks apart, for the caregivers. Participants were followed up for six months. Data were analyzed by SPSS 20 using the Mann-Whitney U test and the paired Wilcoxon signed-rank test to compare the mean scores between and within groups. Results: The mean age was 78.63±8.36 (n = 72) and there was no statistically significant difference in the sociodemographic characteristics, activity level, and morbidity status of older adults in the two groups (p > 0.05). Older adults presented with age-related walking difficulties (38.8%, n = 28), disabling strokes (29.2%, n = 21), and post-hip fractures (6.9%, n = 5). Mean scores after six months of intervention between two groups (intervention vs. control) of physical health (30.67±13.19 vs. 21.73±16.62) and psychological domains (32.84±12.59 vs. 25.93±16.84) were significantly better (p < 0.05). Mean pre- vs. post-intervention scores of the control groups of older adults significantly declined (p < 0.001) in overall QoL (28.41±13.16 vs. 25.01±13.47) and domains of physical health (26.79±17.17 vs. 21.73±16.62), psychological (30.67±17.34 vs. 25.93±16.84), and environmental (43.23±12.82 vs. 40.36±13.16), while no significant change was observed in the social relationships domain (12.96±16.38 vs. 12.04±16.48; p > 0.05). Conclusions: The need-based educational intervention, along with the educational handbook, has a positive impact on the QoL of older adults. We recommend formal educational sessions with country-specific guidelines for caregivers of activity-limited older adults in the community to improve their QoL.