Effects of a nurse-led self-management intervention on the quality of life among community-dwelling older adults with geriatric syndromes: a randomized controlled trial

Older adults with geriatric syndromes commonly experience reduced quality of life. Although nurse-led self-management interventions are considered a promising home-based care strategy, their effects and sustainability in improving quality of life remain uncertain. A two-arm randomized controlled trial was conducted with 90 participants (82.35 ± 5.73 years), randomly assigned to intervention or control group (1:1 ratio). Intervention group received weekly nurse-led self-management sessions over 12 weeks. Control group received usual care. Quality of life was the primary outcome, while blood pressure, blood oxygen saturation, heart rate, blood glucose, body mass index (BMI), physical activity, and self-efficacy were assessed as secondary outcomes at baseline (T0), immediately after 12 weeks of intervention (T1), and 12 weeks post-intervention (T2). Generalized estimating equation models were applied to assess the effects of the intervention on outcomes over time. The nurse-led self-management intervention showed statistically significant improvements in quality of life (T1: MD = 0.13, p < 0.01) and BMI (T1: MD = 0.58, p = 0.03). At T1, the point estimate for improvement in quality of life also exceeded the minimal clinically important difference threshold of 0.09 (MD = 0.13, 95% CI: 0.04 to 0.20). Compared to T0, the intervention group showed clinically significant changes in systolic blood pressure (T1: 132.40 mmHg; T2: 136.63 mmHg), blood glucose (T1: 7.90 mmol/L), and BMI (T2: 25.01 kg/m²). No significant improvements were found in physical activity (T1: p = 0.74; T2: p = 0.45) or self-efficacy (T1: p = 0.54; T2: p = 0.98). The nurse-led self-management intervention significantly improved quality of life and BMI, while blood pressure and blood glucose showed favourable clinical trends. However, the effects appeared to diminish at 12 weeks post-intervention.