Goal Attainment Theory-Based Empowerment for Chronically Ill Older Persons in the Community

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Paul Froilan U. Garma, MAN, RN, RM
Letty G. Kuan, EdD, RN, RGC


Empowerment programs focusing on chronically ill older persons remain limited, fragmented, complex in approach, and lacking in nursing theoretical background. The aim of the study was to test the effects of the goal attainment theory-based empowerment (GATE) on self-efficacy and health empowerment among chronically ill older persons in the community. This is a quasi-experimental with non-equivalent control group pre-test post-test study. Older persons aged 60 years old and above living in an urban community with at least one chronic condition namely hypertension, coronary artery disease and diabetes mellitus were recruited in two health centers. The participants were randomized into control and intervention groups. The GATE intervention integrated Imogene King’s goal attainment theory and empowerment principles in a phone-assisted follow-up. Data were collected at baseline and four weeks after the intervention. A total of 59 participants completed the study. Both intervention (n= 30) and control groups (n= 29) were homogenous in baseline characteristics except for personal monthly income. The intervention group had significantly higher health empowerment than the control group after four weeks. Although self-efficacy did not differ between the groups, there was a significant increase in the intervention group from baseline. Preliminary findings showed that GATE improves health empowerment and self-efficacy of chronically ill older persons in the community. Goals of chronic disease management should be shaped by the older person’s health goals and life situation. Further studies are needed to explore the use of nursing theory, empowerment framework and technology in caring for older persons with chronic conditions.

Keywords: Health empowerment, goal attainment theory, chronic care, gerontologic nursing


About the Authors

Mr. Paul Froilan U. Garma works as a nurse clinician, training and research coordinator at the University of the Philippines Manila Philippine General Hospital. His clinical experiences include adult acute and critical care and midwifery practice. He finished his Bachelor of Science in Nursing, magna cum laude, at the Far Eastern University Manila as a University Scholar. He obtained his Master of Arts in Nursing (Major in Adult Health), dean’s list, from the UP Open University through a scholarship grant.

Dr. Letty G. Kuan is a Professor Emeritus of the University of the Philippines Manila College of Nursing, and is an active member of Southeast Asia Bioethics Board and Network of Outstanding Teachers Education (NOTED) of Metrobank Foundation. She mentor-advices MA and PhD students in the University of the Philippines, University of Santo Tomas, Cebu Normal University, Cebu Doctors’ University, Father Saturnino Urios University, San Pedro College and Silliman University.