The Effect of Empowerment Based on 5A Model on Fall Self-Efficacy, Self-Care and Quality of Life in Older Adults: A Parallel Randomized Clinical Trial

Background: With aging and declining functional abilities in older adults, the fear of falling increases, leading to decrease in quality of life. Self-care is an important factor in maintaining older adults' overall health and quality of life. This study aimed to determine the effect of empowerment via the 5A model on fall self-efficacy, self-care, and quality of life in older adults. Methods: This clinical trial study was conducted with 110 elderly individuals residing in the community. The participants were selected via a sequential sampling method and were allocated to the control and intervention groups viablock randomization in sets of four. The control group received routine care from comprehensive health service centers, whereas the intervention group received 5A model-based empowerment over a 12-week program. The data collection instruments included a demographic characteristics form and questionnaires such as the Activities-Specific Balance Confidence Scale, the WHO-5 Well-Being, and the Elderly Self-Care, which were completed before random allocation and after the twelfth week. The data were analyzed using chi-square tests, Fisher's exact tests, independent t-tests, and analysis of covariance. Results: The mean and standard deviation (SD) of the participants' age were 68.28±3.14. The mean differences in the scores of fall self-efficacy (p<0.001), self-care (p<0.001), and quality of life (p<0.001) before and after the intervention were significantly different between the control and intervention groups. Conclusion: Empowerment based on the 5A model led to improvements in fall self-efficacy, self-care, and quality of life among older adults. Health caregivers and nurses can utilize this model to increase fall self-efficacy, reduce fear of falling, improve self-care, and improve quality of life among older adults, as well as to design care programs. Trial registration: Iranian Registry of Clinical Trials (IRCT20221231057000N2; 11/12/2023)