Efectividad de intervenciones que promueven autonomía en salud en personas mayores: revisión sistemática y metaanálisis

• Carol Rodway ^[1] ; Ana Jara ^[1] ; Rosario Spencer ^[2] ; Juan Carlos Oliveros ^[1]
  1. [1] Universidad Católica del Maule

     Universidad Católica del Maule

     Provincia de Talca, Chile

     
  2. [2] Universidad de Talca

     Universidad de Talca

     Provincia de Talca, Chile

     
• Localización: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica, ISSN 1134-928X, Vol. 37, Nº. 1, 2026, págs. 24-29
• Idioma: español
• Títulos paralelos:
  • Effectiveness of interventions promoting autonomy in health decision-making among elderly: a systematic review and meta-analysis
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Introducción: La toma de decisiones en salud es un derecho fundamental de las personas mayores y un imperativo ético para los profesionales, centrando al paciente activamente en su cuidado.

    Aunque hay varias intervenciones para fomentar la autonomía en la toma de decisiones en este grupo, no se ha evaluado sistemáticamente su efectividad. Objetivo: Evaluar la efectividad de las intervenciones que promueven la autonomía en la toma de decisiones de salud en personas mayores, en distintos niveles asistenciales, mediante una revisión sistemática y un metaanálisis. Metodología: Se incluyeron ensayos controlados aleatorizados de intervenciones dirigidas a mayores de 60 años, seleccionados de 5 bases de datos (PubMed, Web of Science, Scopus, Cochrane, LILACS), sin limitaciones de tiempo ni idioma. El riesgo de sesgo se evaluó mediante el protocolo de Cochrane. Resultados: De 8.417 estudios identificados, 8 fueron seleccionados para la revisión sistemática y 3 para el metaanálisis, con un total de 1.224 participantes. El metaanálisis no halló efectos significativos globales (p > 0,05). Las intervenciones multicomponentes mostraron un mayor potencial para mejorar la toma de decisiones, aumentando el conocimiento y la autoeficacia de los participantes, junto al contexto sanitario donde se aplicó la intervención.

    Conclusiones: Las intervenciones centradas en el paciente y el profesional tienen un impacto positivo en la autonomía de la toma de decisiones en salud en los mayores, su efectividad varía según el contexto y tipo de intervención. Se requieren estudios adicionales para evaluar su coste-efectividad y sostenibilidad, así como para fortalecer las políticas públicas enfocadas en mejorar el bienestar integral de las personas mayores.

  • English

    Introduction: Health decision-making is a fundamental right of older adults and an ethical imperative for professionals, actively centering the patient in their care. Although various interventions aim to foster decision-making autonomy in this population, their effectiveness has not been systematically evaluated. Objective:

    To evaluate the effectiveness of interventions promoting healthrelated decision-making autonomy among older adults across different healthcare settings through a systematic review and metaanalysis. Methodology: Randomized controlled trials targeting individuals aged 60 and above were included, selected from five databases (PubMed, Web of Science, Scopus, Cochrane, LILACS) without time or language restrictions. The risk of bias was assessed using the Cochrane protocol. Results: From 8,417 identified studies, eight were selected for the systematic review, and three for the meta-analysis, involving a total of 1,224 participants.

    The meta-analysis found no significant overall effects (p > 0.05).

    However, multicomponent interventions demonstrated greater potential in improving decision-making, enhancing participants’ knowledge and self-efficacy, along with the healthcare setting in which the intervention was applied. Conclusions: Patient- and professional-centered interventions positively impact healthrelated decision-making autonomy in older adults, though their effectiveness varies depending on the context and type of intervention. Further research is needed to evaluate costeffectiveness and sustainability, as well as to strengthen public policies aimed at improving the comprehensive well-being of older adults

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