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Effecten van een integrale wijkaanpak genaamd ‘Even Buurten’ op de (gezondheidsgerelateerde) kwaliteit van leven en welzijn van ouderen

Effects of an integrated neighborhood approach on older people’s (health-related) quality of life and well-being

  • Published:
Tijdschrift voor Gerontologie en Geriatrie

Samenvatting

Een integrale wijkaanpak (IWA) wordt steeds vaker aangeprezen als methode om zelfstandig wonende ouderen te ondersteunen, maar het is onbekend of deze aanpak effectief is. In dit artikel zijn de effecten van een IWA (Even Buurten) op de (gezondheidsgerelateerde) kwaliteit van leven en het welzijn van ouderen (≥70 jaar) onderzocht. Er is gebruik gemaakt van een gematcht quasi-experimenteel onderzoeksdesign waarin interventie-ouderen (n = 186) werden vergeleken met controle-ouderen (n = 186) die de ‘gebruikelijke’ zorg en ondersteuning ontvingen (een nulmeting en een meting na zes en twaalf maanden). De primaire uitkomsten waren (gezondheidsgerelateerde) kwaliteit van leven (HRQol; EQ-5D-3L, SF-20) en welzijn (SPF-IL). De effecten werden geanalyseerd middels generalized lineair mixed modeling met herhaalde metingen, waarbij zowel een intention to treat als as treated analyse werd gedaan. Uit de nulmeting bleek dat de interventiegroep in vergelijking met de controlegroep gemiddeld significant ouder was, vaker alleenstaand, lager opgeleid, een lager inkomen had, een grotere kans had op ≥1 ziekten en een lager welzijn, lichamelijk functioneren, rolvervulling en psychische gezondheid had. Na één jaar was geen substantieel verschil te zien in welzijn of HRQoL tussen de interventie- en controlegroep. Het gebrek aan effecten benadrukt de complexe aard van initiatieven voor integrale zorg en ondersteuning.

Abstract

Integrated neighborhood approaches (INAs) are increasingly advocated to support community-dwelling older people; their effectiveness however remains unknown. We evaluated INA effects on older people’s (health-related) quality of life (HRQoL) and well-being in Rotterdam. We used a matched quasi-experimental design comparing INA with “usual” care and support. Community-dwelling people (aged ≥70) and control subjects (n = 186 each) were followed over a one-year period (measurements at baseline, 6 and 12 months). Primary outcomes were HRQoL (EQ-5D-3L, SF-20) and well-being (SPF-IL). The effect of INA was analysed with generalized linear mixed modeling of repeated measurements, using both an “intention to treat” and “as treated” approach. The results indicated that pre-intervention participants were significantly older, more often single, less educated, had lower incomes and more likely to have ≥1 disease than control subjects; they had lower well-being, physical functioning, role functioning, and mental health. No substantial difference in well-being or HRQoL was observed between the intervention and control group after 1 year. The lack of effects of INA highlights the complexity of integrated care and support initiatives.

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Authors and Affiliations

  1. Erasmus School of Health Policy & Management (ESHPM), Erasmus Universiteit Rotterdam, Burgemeester Oudlaan 50, 3000 DR, Rotterdam, Nederland

    Hanna M. van Dijk, Jane M. Cramm, Erwin Birnie & Anna P. Nieboer

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  1. Hanna M. van Dijk
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  2. Jane M. Cramm
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  3. Erwin Birnie
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  4. Anna P. Nieboer
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Correspondence to Hanna M. van Dijk.

Additional information

Een aangepaste versie van dit paper is verschenen in BMC Research Notes, https://doi.org/10.1186/s13104-016-2254-5.

An adapted version of this paper was published in BMC Research Notes, https://doi.org/10.1186/s13104-016-2254-5.

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van Dijk, H.M., Cramm, J.M., Birnie, E. et al. Effecten van een integrale wijkaanpak genaamd ‘Even Buurten’ op de (gezondheidsgerelateerde) kwaliteit van leven en welzijn van ouderen. Tijdschr Gerontol Geriatr 49, 117–126 (2018). https://doi.org/10.1007/s12439-018-0251-y

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  • DOI: https://doi.org/10.1007/s12439-018-0251-y

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