Community-Based Nursing Interventions for Older Adults with Chronic Diseases: A PRISMA-Guided Systematic Review of Effects on Quality of Life, Depression, and Patient Activation
DOI:
https://doi.org/10.56294/saludcyt20252317Keywords:
Community Nursing, Chronic Disease Management, Older Adults, Quality of Life, Depression, Patient ActivationAbstract
Introduction: The rapid aging of global populations has intensified challenges in managing chronic diseases, especially in low- and middle-income countries (LMICs). Older adults with diabetes, hypertension, COPD, and related conditions face physical and psychological burdens, including reduced quality of life and increased depression. Community-based nurse-led interventions offer a promising framework for enhancing patient-centered care and self-management, though evidence remains fragmented.
Aim: To systematically synthesize global evidence on the effectiveness of community-based nursing interventions for older adults with chronic diseases, focusing on quality of life, depression, and patient activation/self-efficacy.
Method: Following PRISMA 2020 guidelines, five databases (PubMed, Embase, Scopus, CINAHL, and Google Scholar) were searched through September 2025 for studies involving adults aged ≥60 years receiving nurse-led community interventions. Eligible designs included randomized controlled trials, quasi-experimental studies, and economic evaluations. Risk of bias was assessed using Cochrane RoB2 and ROBINS-I.
Results: Ten studies (n≈3,000) from the USA, Europe, Asia, Africa, and Latin America met inclusion. Interventions included chronic disease self-management, health literacy programs, lifestyle education, multicomponent geriatric care, patient-centered medical homes, and behavioural activation. Seven studies showed improved quality of life, six reduced depressive symptoms, and four enhanced patient activation. Effects were observed in both high-income and LMIC settings. Risk of bias was generally low to moderate, with RCTs providing stronger evidence.
Conclusions: Community-based nursing interventions improve quality of life and depression among older adults with chronic diseases, with promising effects on patient activation. Their feasibility in LMICs underscores global applicability. Future research should prioritize standardized outcomes, long-term follow-up, and economic evaluation.
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Copyright (c) 2025 Ateya Megahed Ibrahim, Donia Elsaid Fathi Zaghamir (Author)
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