Intervention Protocol

A detailed description of goal attainment-based empowerment intervention (AGE) is presented

below.

Nursing intervention Goal attainment-based empowerment

Determining a
theoretical/conceptual
framework Imogene Kings goal attainment theory

Self-efficacy (primary outcome)

Desired outcomes Health empowerment (secondary outcome)

Sociodemographic and clinical profile questionnaire (SCPQ)

Defining measures Self-Efficacy to Manage Chronic Disease Scale (SEMCD)

Health Empowerment Scale (HES)

Defining target population Chronically ill older persons in the community

Determining intervention In addition to the standard health information provision, the

content AGE integrates health goal-setting and phone-assisted follow-up
for four weeks.

Degree of person- An individualized intervention as the nurse, guided by the

centeredness elements of the theory of goal attainment-based empowerment
intervention protocol, acts as a facilitator in empowering the
patient.

Simple versus complex A simple intervention that features health goal-setting and
intervention phone-assisted follow-up.

Delivery method Communication through interview and use of technology

(phone).

Dose Amount: Single face to face session up to 30 minutes

Weekly phone calls lasting to 20 minutes each

Frequency: Weekly

Duration: Four weeks

Managing the integrity Pilot study

Study protocol and guidelines

Competency training for nurse interveners

Standardized phone script

Weekly meeting with nurse interveners

Performance evaluation and data sheets

The intervention is initially delivered through a face-to-face interaction during the out-
patient consultation of the chronically ill older person. In addition to standard health information
provision on the treatment plan, the participants are encouraged to identify their personal health
goal. The health goal will be reflected in a goal-oriented health action plan that includes the
resources and commitment to achieve them. The nurse intervener records the health goal in the
tracking sheet and the participants progress will be followed up by way of weekly phone calls.

One week after the interview, a phone call will be initiated by the nurse intervener to
follow-up on the participants. A standardized phone contact script guide will be utilized. The
phone call will be conducted weekly at a time that is most convenient for the participant. The
purposes of the phone call are to: (1) enhance participants knowledge on their medical condition
and understand his/her health beliefs, practices and experiences; (2) develop meaningful
interactions and communication between the nurse and the clients; (3). provide support and
assistance; (4) monitor the progress of the respondents in attaining their goals; (5) identify
emerging health problems.
 A summary of content during each phone call will be documented in the health goal
setting tracking sheet under the nurse interveners keeping. Before each phone call, the nurse
intervener reviews previous records so that communication would be consistent with
participants stated health goal. This mechanism also serves as a verification procedure to ensure
that the one who receives the phone call is the study participant. Participants who will be
reporting any acute condition and worsening symptoms will be advised to consult the physician
immediately. The participant will have a total of four phone calls throughout the duration of the
study.

Timing of intervention

Week Phone call

1st week Face-to-face interview

First phone call (One week after face to face interview)

2nd week Second phone call

3rd week Third phone call

4th week Fourth phone call