Effects of Nurse-Led Programs on Psychosocial, Functional, and Clinical Outcomes in Older Adults: A Systematic Review and Meta-Analysis

Abstract

Nurse-led programs for older adults have gained increasing attention as a strategy to address the complex health care needs of ageing populations. This systematic review and meta-analysis evaluated their effects on quality of life, mental health, functional status, and clinical outcomes. Electronic databases were searched for randomized controlled trials and quasi-experimental studies comparing nurse-led programs with usual care or alternative interventions. Intervention purpose, core components, care setting, delivery mode, intensity, and follow-up were classified descriptively. Random-effects meta-analyses were conducted across 41 studies. Nurse-led programs improved several psychosocial, functional, and selected clinical outcomes, including empowerment, social support and role participation, patient satisfaction, compliance and motivation, cardiovascular disease risk, frailty, and metabolic syndrome and glycaemic control. Effects on depression and mental health, metabolic and nutritional health, and mortality were not statistically significant. Substantial heterogeneity was present in most outcome domains and reflected marked variation in program content, care setting, participant characteristics, outcome measurement, and follow-up. Nurse-led designation alone should therefore not be interpreted as a uniform intervention or as an explanation for effectiveness. Programs incorporating clearly defined components, structured monitoring, education, care coordination, and sustained follow-up appear particularly relevant to geriatric practice; however, further research is necessary to determine the effects of individual components.