Life Balance: A pilot study evaluating the efficacy of a group education program on self-management in older adults with multiple conditions.

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New Zealand is experiencing an ageing population and the social, economic, medical and political implications and challenges that accompany demographic change. Overall, New Zealanders are living more independently and for longer, resulting in an ageing population with an increased prevalence of long-term conditions and often multiple conditions (multi-morbidity). It is increasingly acknowledged that ‘successful aging’ relies in part on the individual’s ability to self-manage his or her life. The concept of self-management or self-regulation has usually been associated with the physical aspects of aging but other factors are just as important for aging successfully including maintaining social networks and resources, and acquiring or maintaining skills to cope with potential and future stressors. Given the increased recognition of those factors and of the prevalence of multi-morbidity, current interventions are increasingly targeting overall wellbeing and utilising strategies that are useful for trans-diagnostic (across multiplie diseases) symptoms rather than a symptom /disease specific approach. Mindfulness strategies offer potential to enhance self-management and quality of life across physical conditions. The Life Balance Self-management Programme being evaluated here combines cognitive behavioural and mindfulness strategies, applying them across chronic diseases (trans-diagnostically) to help manage negative thoughts and emotions and to enhance the uptake of the education and self-management strategies. This randomised pilot study aims to test that participant recruitment and randomisation to groups, education sessions and data gathering via questionnaires run smoothly and to produce data from the outcomes of the education sessions to support undertaking a larger randomised controlled trial. The study design is a randomised open-label controlled trial with a wait listed control group. A convenience sample will be recruited of 60 older adults (non-Maori aged 65+ or Maori aged 55+) living independently in the community diagnosed with one or more long-term conditions and able to attend and participate in the intervention sessions and to understand/speak English. The Life Balance Self-management Programme entails attendance at 2 hour group education sessions for four consecutive weeks (8hrs in total). Manualised education sessions include the following topics: Healthy living, Symptom management, medication management and Self-management, form the first hour each day and four sessions on Mindful coping skills (cognitive behavioural and mindfulness strategies) are presented in the second hour. Participants receive a 130 page resource book containing a synopsis of the content, further resources and self-directed exercises. Outcomes measures assessed at baseline, 6 weeks and 12 weeks include the primary outcome (quality of life) as well as measures assessing disability, medication adherence, mindfulness awareness, beliefs about medication, illness perception, health distress, depression and satisfaction with education sessions at end treatment.

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