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Intervenciones de apoyo a la autogestión para adultos mayores con enfermedades crónicas en desventaja socioeconómica:
Michael T Lawless1, Candice Oster1, Heather Block1
1Flinders University, College of Nursing and Health Sciences, Caring Futures Institute, Bedford Park, SA, Australia.
Patient education and counseling
|August 22, 2025
Resumen
Las intervenciones de apoyo a la autogestión son prometedoras para los adultos mayores con enfermedades crónicas. Los programas multicomponentes adaptados pueden mejorar la calidad de vida y reducir el uso de la atención médica para las poblaciones desfavorecidas.
Área de la Ciencia:
- Gerontología
- Salud pública
- Investigación en servicios de salud
Sus antecedentes:
- Los adultos mayores socialmente desfavorecidos a menudo se enfrentan a desafíos significativos para controlar las enfermedades crónicas y la multimorbilidad.
- El apoyo efectivo a la autogestión es crucial para mejorar los resultados en materia de salud y reducir las disparidades de salud en esta población.
Objetivo del estudio:
- Identificar y describir las teorías, componentes y eficacia de las intervenciones de apoyo a la autogestión.
- Centrarse en los adultos mayores socialmente desfavorecidos (≥ 60 años) con enfermedades crónicas y multimorbilidad.
Principales métodos:
- Revisión sistemática de ensayos controlados aleatorios (ECA) identificados a través de seis bases de datos electrónicas (búsqueda en noviembre de 2023).
- La extracción de datos utilizó la taxonomía Practical Reviews in Self-Management Support; la evaluación del estudio empleó la herramienta Revised Cochrane Risk of Bias.
- La síntesis narrativa crítica guió el análisis de 18 ensayos incluidos (N=6269).
Principales resultados:
- Las intervenciones variaron en teoría, componentes y entrega, lo que demuestra el potencial para mejorar la calidad de vida, la salud mental, los comportamientos de autogestión y la autoeficacia.
- La evidencia sugiere que las intervenciones personalizadas y de múltiples componentes pueden ser particularmente efectivas para los adultos mayores con desventajas socioeconómicas.
- Los impactos positivos observados incluyen una reducción en la utilización de la asistencia sanitaria.
Conclusiones:
- La investigación futura debe centrarse en el desarrollo de intervenciones de apoyo a la autogestión accesibles, culturalmente apropiadas y adaptadas para las poblaciones desfavorecidas.
- Las intervenciones requieren evaluación en la atención primaria y en entornos comunitarios para su eficacia, escalabilidad y sostenibilidad.
- Los proveedores de atención sanitaria deben integrar el apoyo multicomponente basado en la teoría en la atención de rutina, respaldado por políticas flexibles y financiación para abordar las disparidades de salud.
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