Management of care using self-control and self-reflection for maintaining health status, spirituality, and quality of life among older adults farmers: a quasi-experimental study.

Background: The escalating aging trend and health challenges faced by older adult farmers in Indonesia underscore the need for targeted interventions, yet no study has evaluated behavioural support programmes. Integrating self-control and self-reflection (SCSR) as drivers of change may provide novel care management to enhance their physical, mental, and spiritual quality of life (QoL). Aims: This study examined the effectiveness of care management using SCSR on the health status, spirituality and QoL among older adult farmers in Indonesia. Methods: A two-group pre- and post-test quasi-experimental design was adopted among 120 participants. Participants in the intervention group completed a 4-week self-care programme and 8-weeks of healthcare self-management activities. Health status, spirituality, and QoL were assessed using physical parameters, the Geriatric Depression Scale (GDS), the Mini-Mental State Examination (MMSE), the Short Portable Mental Status Questionnaire (SPMSQ), the Daily Spiritual Experience Scale (DSES) and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Results: Compared to those in the control group, participants who received management of care using SCSR showed a significant reduction in blood pressure but not in body mass index and blood sugar. The ANCOVA test indicated significant positive effects, with lower GDS and fewer SPMSQ errors, as well as higher MMSE, DSES and WHOQOL scores. Conclusions: Care management using SCSR emerges as a promising nursing intervention strategy for enhancing health status, spirituality, and QoL among older adult farmers. Since SCSR can be delivered by nurses through community-based services, these findings reinforce the value of nurse-led self-management support for older adults in agricultural settings.