Effects of a Salutogenic Model-Based Frailty Prevention Program (SAFRAPP) in pre-frail women: a randomized controlled trial

Abstract

Background Frailty is a geriatric syndrome characterized by increased vulnerability to stressors and is more prevalent among women. As a dynamic condition, its progression can be prevented through early interventions. Therefore, this study aimed to evaluate the effect of Salutogenic Model-Based Frailty Prevention Program (SAFRAPP) among pre-frail women on preventing development of frailty and improving sense of coherence (SOC). Methods A single-blinded, two-arm randomized controlled trial was conducted with a total of 84 pre-frail women aged 55 years and older. Participants were randomly assigned to the intervention group (n = 42) or the control (n = 42) groups. SAFRAPP was implemented in the intervention group for six weeks and consisted of health education, case management, and laughter yoga. The primary outcomes were frailty status and SOC. Secondary outcomes were well-being, quality of life, fear of falling, number of falls, and emergency visits. Data were collected at baseline and at 3-month, 6-month, and 9-month follow-ups from both groups. Pearson's chi-square test, independent samples t-test and repeated measures analysis of variance were used for data analysis. Results The results revealed that nearly half of the pre-frail women in the intervention group transitioned to a robust stage, showing a statistically significant improvement compared to the control group at the 3-month, 6-month, and 9-month follow-ups (p<0.001). The intervention group showed a significant improvement in SOC and well-being at the 3-month, 6-month, and 9-month follow-ups (p < 0.001) There was a significant improvement in quality of life and a reduction in fear of falling between baseline, 3-month, and 6-month assessments. However, the SAFRAPP group showed no significant change in falls and emergency visits over time compared to the control group (p > 0.05) Conclusions A nurse-led multicomponent intervention based on the Salutogenic Model appears to be effective in preventing the progression of frailty, improving sense of coherence, well-being, and quality of life among women aged 55 years and older. Future studies should investigate the potential for SAFRAPP in diverse populations and healthcare settings. Trial registration Clinical Trials.gov Identifier: NCT04787432, date of registration: 08/03/2021.