1
|
Ahern L, Curtin C, Timmons S, Lamb SE, McCullagh R. "Exercise… to Me, It's Freedom": Motivation, Support, and Self-Management to Keep Physically Active with Parkinson's Disease: A Qualitative Study. Geriatrics (Basel) 2024; 9:92. [PMID: 39051256 PMCID: PMC11270374 DOI: 10.3390/geriatrics9040092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
The benefits of exercise have been widely explored among people with Parkinson's (PwP). Exercise can improve non-motor (fatigue, pain, sleep, etc.) and motor features (balance, muscle strength, gait speed, etc.), maintain function, as well as prevent disease progression. Although the benefits are well known, PwP continue to show difficulty adhering to physical activity and exercise. This study aims to explore motivation to exercise, support, and self-management needs among people with Parkinson's, their family members, and physiotherapists. Purposeful and maximum-variation sampling methods (age, sex, geographical setting, and disease severity) were employed. PwP and family members were recruited through physiotherapy services and local support groups. Twelve semi-structured interviews with PwP and two group interviews, one with family members (n = 4) and one with physiotherapists (n = 5), were conducted. Interview guides were informed by patient-public input and a recent systematic review. Interviews were recorded, transcribed, and analysed using thematic analysis informed by the Grounded Theory methodology. Four common themes emerged: (1) The value of an intrinsic connection with exercise, for which there are challenges. A greater connection to exercise led to long-term adherence. (2) Adapting exercise to the needs and preferences of a person is essential. Preferred exercises and environments were mixed, with differences emerging between sexes. (3) Physiotherapists' aim to only maintain physical function led to frustration. Limited self-management opportunities, stigma, and dehumanisation were discussed. (4) Non-motor symptoms, stigma, fear, and determination as well as apathy, pain, and low mood were discussed. Exercise provided physical, emotional, and social rewards. Supports are necessary; however, challenges arise when PwP's motivations are mismatched to family members' and physiotherapists' goals. Co-created goals, tailored to their preferences, and exercise plans with supported self-management are recommended.
Collapse
Affiliation(s)
- Leanne Ahern
- Discipline of Physiotherapy, School of Clinical Therapies, University College Cork, T12 X70A Cork, Ireland
| | - Catriona Curtin
- Centre for Gerontology and Rehabilitation, School of Medicine, College of Medicine and Health, University College Cork, T12 FN70 Cork, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, School of Medicine, College of Medicine and Health, University College Cork, T12 FN70 Cork, Ireland
| | - Sarah E. Lamb
- Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Ruth McCullagh
- Discipline of Physiotherapy, School of Clinical Therapies, University College Cork, T12 X70A Cork, Ireland
| |
Collapse
|
2
|
Kikkenborg J, Magelund E, Riise MS, Kayser L, Terp R. Knowledge, Skills, and Experience With Technology in Relation to Nutritional Intake and Physical Activity Among Older Adults at Risk of Falls: Semistructured Interview Study. JMIR Hum Factors 2024; 11:e52575. [PMID: 38717810 PMCID: PMC11112469 DOI: 10.2196/52575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/04/2024] [Accepted: 03/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND More than one-third of older adults (aged ≥65 y) experience falls every year. The prevalent modifiable risk factors for falling are malnutrition and physical inactivity, among others. The involvement of older adults in the prevention of falls can decrease injuries, hospitalizations, and dependency on health care professionals. In this regard, eHealth can support older adults' self-management through more physical activity and adequate food intake. eHealth must be tailored to older adults' needs and preferences so that they can reap its full benefits. Therefore, it is necessary to gain insight into the knowledge, skills, and mindset of older adults living at home who are at risk of falls regarding eHealth. OBJECTIVE This qualitative study aims to explore older adults' use of everyday digital services and technology and how they acquire knowledge about and manage their nutritional intake and physical activity in relation to their health. METHODS Semistructured interviews were conducted with 15 older adults (n=9, 60% women; n=6, 40% men; age range 71-87 y) who had all experienced falls or were at risk of falling. These individuals were recruited from a geriatric outpatient clinic. The interviews were analyzed using deductive content analysis based on a modification of the Readiness and Enablement Index for Health Technology framework. RESULTS The qualitative data showed that the informants' social networks had a positive impact on their self-management, use of technology, and mindset toward nutritional intake and physical activity. Although the informants generally lived active lives, they all lacked knowledge about how their food intake influenced their physical health, including their risk of falling. Another finding was the large diversity in the use of technology among the informants, which was related to their mindset toward technology. CONCLUSIONS Older adults can use technology for everyday purposes, but some need additional introduction and support to be able to use it for managing their health. They also need to learn about the importance of proper nutritional intake and physical activity in preventing falls. Older adults need a more personalized introduction to technology, nutrition, and physical activity in their contact with health professionals.
Collapse
Affiliation(s)
- Julie Kikkenborg
- Department of Clinical Physiology & Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Emma Magelund
- Department of Clinical Physiology & Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Maria Silke Riise
- Department of Clinical Physiology & Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Lars Kayser
- Section of Health Service Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Terp
- Department of Internal Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
| |
Collapse
|
3
|
Teng B, Gomersall SR, Hatton AL, Khan A, Brauer SG. Predictors of real-world adherence to prescribed home exercise in older patients with a risk of falling: A prospective observational study. Aging Med (Milton) 2023; 6:361-369. [PMID: 38239715 PMCID: PMC10792326 DOI: 10.1002/agm2.12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/22/2023] [Accepted: 08/27/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives Using a multi-ethnic Asian population, this study assessed adherence to prescribed home exercise programs, explored factors predicting adherence, and evaluated whether home exercise adherence was associated with physical activity. Methods A prospective cohort study was conducted in 68 older adults (aged ≥65 years) from two geriatric outpatient clinics in Singapore, who were receiving tailored home exercises while undergoing 6 weeks of outpatient physical therapy for falls prevention. Adherence was measured as the percentage of prescribed sessions completed. Predictor variables included sociodemographic factors, clinical characteristics, intervention-specific factors, and physical and psychosocial measures. Multivariable linear regressions were performed to develop a model that best predicted adherence to prescribed exercise. Physical activity levels, measured by accelerometry, were analyzed by cross-sectional univariate analysis at 6 weeks. Results The mean adherence rate was 65% (SD 34.3%). In the regression model, the number of medications [B = 0.360, 95% CI (0.098-0.630)], social support for exercising [B = 0.080, 95% CI (0.015-0.145)], and self-efficacy for exercising [B = -0.034, 95% CI (-0.068-0.000)] significantly explained 31% (R 2 = 0.312) of the variance in exercise adherence. Older adults with better adherence took more steps/day at 6 weeks [B = 0.001, 95% CI (0.000-0.001)]. Conclusions Low adherence to home exercise programs among older adults in Singapore, emphasizing the need for improvement. Counterintuitively, older adults with more medications, lower exercise self-efficacy, but with greater social support demonstrated higher adherence. Addressing unmet social support needs is crucial for enhancing adherence rates and reducing fall risks.
Collapse
Affiliation(s)
- Bernadine Teng
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
- Health and Social Sciences clusterSingapore Institute of TechnologySingaporeSingapore
| | - Sjaan R. Gomersall
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Anna L. Hatton
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Asaduzzaman Khan
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - Sandra G. Brauer
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| |
Collapse
|
4
|
Alfaro Hudak KM, Adibah N, Cutroneo E, Liotta M, Sanghera A, Weeks-Gariepy T, Strunz E, Rein DB. Older adults' knowledge and perception of fall risk and prevention: a scoping review. Age Ageing 2023; 52:afad220. [PMID: 38016017 DOI: 10.1093/ageing/afad220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Falls are a leading cause of injury and mortality among older adults. While multiple strategies are effective at reducing fall risk, uptake is low. Understanding how older adults think about fall risk and prevention activities can inform outreach initiatives and engagement. METHODS We systematically searched PubMed, SCOPUS and Google Scholar for articles published between January 2015 and April 2023. Studies were eligible if they reported on knowledge or perception of fall risk and/or prevention among community-dwelling older adults. RESULTS We included 53 studies from 20 different countries. Over half of the studies used qualitative methods, 19 used quantitative, and three used mixed methods. Most of the older adults could identify some fall risk factors and the consequences of falls. However, many older adults did not view themselves as at-risk for falls. Some older adults consider falls an inevitable part of ageing, while others believe that falls can be prevented. Cultural context may play a role in shaping these beliefs. Several studies reported on older adults' experiences and the perceived barriers and facilitators of participating in fall prevention activities. CONCLUSION Improving the accuracy of older adults' perceptions of their own fall risk and highlighting the fact that many falls are preventable are two key messages that may help motivate older adults to take action to prevent falls. Older adults cite their healthcare provider as a trusted source of prevention information, and clinicians can leverage this opportunity to inform and motivate older adult patients about fall prevention.
Collapse
Affiliation(s)
- Katelin M Alfaro Hudak
- Public Health department, NORC at the University of Chicago, Chicago, IL, USA
- Texas A&M AgriLife Research, Texas A&M University, El Paso, TX, USA
| | - Nada Adibah
- Public Health department, NORC at the University of Chicago, Chicago, IL, USA
| | - Erin Cutroneo
- Public Health department, NORC at the University of Chicago, Chicago, IL, USA
| | - Madeleine Liotta
- Public Health department, NORC at the University of Chicago, Chicago, IL, USA
| | - Anmol Sanghera
- Public Health department, NORC at the University of Chicago, Chicago, IL, USA
| | - Tracy Weeks-Gariepy
- Centers for Disease Control and Prevention (CDC) Foundation, Atlanta, GA, USA
| | - Eric Strunz
- Centers for Disease Control and Prevention (CDC) Foundation, Atlanta, GA, USA
| | - David B Rein
- Public Health department, NORC at the University of Chicago, Chicago, IL, USA
| |
Collapse
|
5
|
Liang IJ, Francombe-Webb J, McGuigan PM, Perkin OJ, Thompson D, Western MJ. The acceptability of homebased exercise snacking and Tai-chi snacking amongst high and low function UK and Taiwanese older adults. FRONTIERS IN AGING 2023; 4:1180939. [PMID: 37593678 PMCID: PMC10428172 DOI: 10.3389/fragi.2023.1180939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/21/2023] [Indexed: 08/19/2023]
Abstract
Introduction: Exercise "snacking" and Tai-chi 'snacking' protocols are designed to overcome typical barriers to older adults' participation in muscle strength and balance exercise, using short bouts of home-based exercise. This study aimed to investigate the acceptability of homebred exercise- and Tai-chi snacking in British and Taiwanese older adults of high and low physical function. Methods: Thirty-three British and Thirty Taiwanese older adults took part in semi-structured interviews, after trying 1-week of exercise- and Tai-chi snacking. The interview schedule and deductive framework analysis was based on the seven components of the Theoretical Framework of Acceptability (TFA). Differences between the Taiwanese and United Kingdom participants and those considered high versus low physical function were also analysed. Results: Both snacking regimes were found to be convenient and easy to implement. Participants reported that no activity had to be given up, and considered the programmes would be beneficial to their physical and mental health. Interestingly, more UK-based participants preferred the elegant and relaxing movements of Tai-chi snacking, yet participants with low physical function experienced difficulties when mastering Tai-chi movements. A few high physical function participants perceived exercise snacking to be tedious. Discussion: Overall, the snacking exercise was found to be acceptable and useful. Personal affective attitude and different cultural backgrounds may affect exercise participation. Nevertheless, it is important to consider individuals' physical function when designing exercise regime. The findings indicate that making Tai-chi snacking easier to master initially, building in progression and adding some upper body movements in the exercise snacking may further enhance acceptability.
Collapse
Affiliation(s)
| | | | | | | | | | - Max J. Western
- Department for Health, University of Bath, Bath, England, United Kingdom
| |
Collapse
|
6
|
Meredith SJ, Cox NJ, Ibrahim K, Higson J, McNiff J, Mitchell S, Rutherford M, Wijayendran A, Shenkin SD, Kilgour AHM, Lim SER. Factors that influence older adults' participation in physical activity: a systematic review of qualitative studies. Age Ageing 2023; 52:afad145. [PMID: 37595070 PMCID: PMC10438214 DOI: 10.1093/ageing/afad145] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Despite the advantages of physical activity (PA), older adults are often insufficiently active to maximise health. Understanding factors that influence PA engagement will support well-designed interventions for older people. Our aim was to review the qualitative evidence exploring the factors affecting older adults' engagement in PA. METHODS We searched six electronic databases for studies of community-dwelling older adults (≥70 years) including qualitative methods. We excluded studies of a single-disease group, individuals with cognitive impairment and care home residents. Methodological rigour was assessed with the Critical Appraisal Skills Programme, and framework synthesis was applied using the Capability Opportunity Motivation-Behaviour (COM-B) model, which hypothesises that behaviour is influenced by three factors: capability, opportunity and motivation. RESULTS Twenty-five studies were included in the review (N = 4,978; mean 79 years) and 32 themes were identified. Older adults' capability was influenced by functional capacity (e.g. strength) and perceived risk of injury from PA (e.g. falls). Opportunity was impacted by the environment 'fit' (e.g. neighbourhood safety), the availability of social interaction and socio-cultural ageing stereotypes. PA was motivated by identifying as an 'exerciser', health gains and experiencing positive emotions (e.g. enjoyment), whereas negative sensations (e.g. pain) reduced motivation. CONCLUSIONS The qualitative synthesis showcased a complex web of interacting factors influencing PA between the sub-domains of COM-B, pinpointing directions for intervention, including a focus on whole systems approaches. There was a lack of research exploring PA influences in the oldest old and in low-income countries. Future research should seek to involve under-served groups, including a wider diversity of older people.
Collapse
Affiliation(s)
- Samantha J Meredith
- Academic Geriatric Medicine, Southampton, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
| | - Natalie J Cox
- Academic Geriatric Medicine, Southampton, UK
- NIHR Southampton Biomedical Research Centre, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Southampton, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
| | | | | | | | | | | | - Susan D Shenkin
- NHS Lothian, Edinburgh, UK
- The University of Edinburgh, Edinburgh, UK
| | - Alixe H M Kilgour
- NHS Lothian, Edinburgh, UK
- The University of Edinburgh, Edinburgh, UK
| | - Stephen E R Lim
- Academic Geriatric Medicine, Southampton, UK
- NIHR ARC Wessex, University of Southampton, Southampton, UK
- University Hospital Southampton NHS FT, Southampton, UK
| |
Collapse
|
7
|
Ioannou E, Chen HL, Bromley V, Fosker S, Ali K, Fernando A, Mensah E, Fowler-Davis S. The key values and factors identified by older adults to promote physical activity and reduce sedentary behaviour using co-production approaches: a scoping review. BMC Geriatr 2023; 23:371. [PMID: 37328734 PMCID: PMC10276377 DOI: 10.1186/s12877-023-04005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/26/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Inactivity and sedentary behaviour in older adults adversely impacts physical function, reduces social networks, and could contribute to population healthcare costs. To encourage and support the planning and uptake of physical activity by older adults, it is important to understand what physical activity means to older adults. Therefore, the aim of this scoping review was to collate what older adults have self-identified as the key factors for sustaining and increasing their physical activities. METHODS Arksey and O'Malley's Scoping Review framework was used to guide the review process. SCOPUS, ASSIA, PsychINFO and MEDLINE databases were searched. Studies were eligible for inclusion if they were peer-reviewed, the target population were older adults (aged 55 and above), co-production related research approaches were explicitly stated in the methods and there was a focus on design of physical activity interventions or products to support or enhance physical activity. Assets and values important for physical activity were first extracted from included studies and were subsequently thematically analysed. Themes are presented to provide an overview of the literature synthesis. RESULTS Sixteen papers were included in the analysis. Data from these papers were gathered via designing interventions or services (n = 8), products (n = 2), 'exergames' (n = 2) or mobile applications (n = 4). Outcomes were varied but common themes emerged across papers. Overarching themes identified by older adults were associated with a desire to increase activity when it was accessible, motivational, and safe. In addition, older adults want to enjoy their activities, want independence and representation, want to stay connected with families and friends, be outdoors, familiarity, activities to be tailored and resulting in measurable/observed progress. CONCLUSIONS Population demographics, personal attributes, and life experiences all affect preferences for physical activity. However, the key factors identified by older adults for increasing physical activity were common-even in separate co-production contexts. To promote physical activities in older adults, activities must fundamentally feel safe, provide a sense of social connectedness, be enjoyable and be accessible in terms of cost and ability.
Collapse
Affiliation(s)
- Elysa Ioannou
- Sport and Physical Activity Research Centre (SPARC), Sheffield Hallam University, Sheffield, UK
| | - Henglien Lisa Chen
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Vicky Bromley
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Sam Fosker
- Royal London Hospital, London; Founder, Cush Health, London, UK
| | - Khalid Ali
- Brighton and Sussex Medical School, Brighton and Hove, UK
| | - Avanka Fernando
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Ekow Mensah
- University Hospitals NHS Trust, Nottingham, UK
| | - Sally Fowler-Davis
- Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, UK.
| |
Collapse
|
8
|
Wilson NA, Peters R, Lautenschlager NT, Anstey KJ. Testing times for dementia: a community survey identifying contemporary barriers to risk reduction and screening. Alzheimers Res Ther 2023; 15:76. [PMID: 37038211 PMCID: PMC10088195 DOI: 10.1186/s13195-023-01219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Advances in pharmacological and non-pharmacological dementia interventions may mean future dementia prevention incorporates a combination of targeted screening and lifestyle modifications. Elucidating potential barriers which may prevent community engagement with dementia prevention initiatives is important to maximise the accessibility and feasibility of these initiatives across the lifespan. METHODS Six hundred seven adults aged over 18 years completed a 54-item, multiple-choice survey exploring contemporary attitudes towards, and barriers to, dementia risk reduction and screening relative to other common health conditions. Participants were sourced from Australia's largest, paid, data analytics service (ORIMA). RESULTS Finances (p = .009), poor motivation (p = .043), and time (p ≤ .0001) emerged as significant perceived barriers to dementia risk reduction behaviours. Lack of time was more likely to be reported by younger, relative to older, participants (p ≤ .0001), while females were more likely than males to report financial (p = .019) and motivational (p = .043) factors. Binary logistic regression revealed willingness to undertake dementia testing modalities was significantly influenced by gender (genetic testing, p = .012; saliva, p = .038, modifiable risk factors p = .003), age (cognitive testing, p ≤ .0001; blood, p = .010), and socio-economic group (retinal imaging, p = .042; modifiable risk-factor screening, p = .019). Over 65% of respondents felt adequately informed about risk reduction for at least one non-dementia health condition, compared to 30.5% for dementia. CONCLUSIONS This study found perceived barriers to dementia risk reduction behaviours, and the willingness to engage in various dementia testing modalities, was significantly associated with socio-demographic factors across the lifespan. These findings provide valuable insight regarding the accessibility and feasibility of potential methods for identifying those most at risk of developing dementia, as well as the need to better promote and support wide-scale engagement in dementia risk reduction behaviours across the lifespan.
Collapse
Affiliation(s)
- Nikki-Anne Wilson
- Dementia Centre for Research Collaboration, Sydney, Australia.
- Neuroscience Research Australia, Margarete Ainsworth Building, 139 Barker Street, Randwick, Sydney, NSW, 2031, Australia.
- School of Psychology, The University of New South Wales, Randwick, Sydney, Australia.
| | - Ruth Peters
- Dementia Centre for Research Collaboration, Sydney, Australia
- Neuroscience Research Australia, Margarete Ainsworth Building, 139 Barker Street, Randwick, Sydney, NSW, 2031, Australia
- School of Psychology, The University of New South Wales, Randwick, Sydney, Australia
- The George Institute for Global Health, Newtown, Sydney, Australia
| | - Nicola T Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Melbourne, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Kaarin J Anstey
- Dementia Centre for Research Collaboration, Sydney, Australia
- Neuroscience Research Australia, Margarete Ainsworth Building, 139 Barker Street, Randwick, Sydney, NSW, 2031, Australia
- School of Psychology, The University of New South Wales, Randwick, Sydney, Australia
| |
Collapse
|
9
|
Janols R, Sandlund M, Lindgren H, Pettersson B. Older adults as designers of behavior change strategies to increase physical activity-Report of a participatory design process. Front Public Health 2022; 10:988470. [PMID: 36620266 PMCID: PMC9811391 DOI: 10.3389/fpubh.2022.988470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Background Despite the significant value of physical activity for the health of older adults, this population often fails to achieve recommended activity levels. Digital interventions show promise in providing support for self-managed physical activity. However, more information is needed about older adults' preferences for digital support to change physical activity behaviors as well as the process of designing them. The aim of this paper was to describe the participatory design process in which older adults were involved in the co-creation of digitally supported behavioral change strategies to support self-managed physical activity, and how the results were integrated in a prototype. Methods The participatory design process involved with nine older adults and two researchers. The participants were divided in two groups, and each group participated in three workshops and completed home tasks in between workshops. Following an iterative design process influenced by theories of behavior change, the workshops and home tasks were continuously analyzed, and the content and process were developed between groups and the next set of workshops. Prototypes of a mobile health (mHealth) solution for fall preventive exercise for older adults were developed in which the conceptualized strategies were integrated. To support coherence in reporting and evaluation, the developed techniques were mapped to the Behavior Change Technique Taxonomy v1 and the basic human psychosocial needs according to the Self-determination Theory. Results The results highlight different preferences of older adults for feedback on physical activity performance, as well as the importance of transparency regarding the identification of the sender of feedback. Preferences for content and wording of feedback varied greatly. Subsequently, the design process resulted in a virtual health coach with three different motivational profiles and tools for goal setting and self-monitoring. These behavior change strategies were integrated in the exercise application Safe Step v1. The conformity of the design concepts with the needs of Self-determination Theory and Behavior Change Technique Taxonomy v1 are presented. Conclusion The participatory design process exemplifies how older adults successfully contributed to the design of theory-based digital behavior change support, from idea to finished solution. Tailoring feedback with a transparent sender is important to support and not undermine motivation.
Collapse
Affiliation(s)
- Rebecka Janols
- Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden,Department of Computing Science, Umeå University, Umeå, Sweden
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Helena Lindgren
- Department of Computing Science, Umeå University, Umeå, Sweden
| | - Beatrice Pettersson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden,*Correspondence: Beatrice Pettersson ✉
| |
Collapse
|
10
|
Gumber L, Timmons S, Coupland C, Gladman JRF, Iliffe S, Kendrick D, Lafond N, Logan P, Masud T, Skelton DA, Timblin C, Orton E. 'It is designed for everybody to find their own level and to improve themselves'; views of older people and instructors of the Falls Management Exercise (FaME) programme. Age Ageing 2022; 51:6527371. [PMID: 35150581 DOI: 10.1093/ageing/afac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older adults are at increased risk of falls due to ageing, decreased muscle strength and impaired balance. Clinical trials have demonstrated the efficacy and effectiveness of the Falls Management Exercise (FaME) programme in improving functioning and preventing falls. However, programme completion is often low, impacting the potential benefits of FaME. OBJECTIVE To explore the barriers and facilitators for participation and completion of the FaME programme from an instructor and participant perspective. METHODS Semi-structured interviews were conducted with 20 FaME users and seven Postural Stability Instructors from the East Midlands region of England, UK. Interviews were conducted using a topic guide and explored their views of the programme, intended benefits, reasons for participating, instructor's approach and venue facilities. Data were transcribed verbatim and analysed using thematic analysis. Written informed consent was obtained from all participants and instructors. RESULTS Common themes identified by participants and instructors for adherence related to perceived health benefits, psychological well-being, intervention characteristics, cost, instructors' qualities, opportunity to socialise, venue accessibility and facilities. Further factors such as maintaining independence, discipline, relationship with peers and caring responsibilities influenced participants' engagement with the programme. Instructor factors such as progression were also reported as important predictors. CONCLUSIONS Instructor and participant factors influence uptake, attendance and adherence of FaME. The findings from this study can inform the development and improvement of additional falls-prevention programmes. It can also guide marketing strategies to promote uptake of exercise-based falls-prevention programmes among older adults.
Collapse
Affiliation(s)
| | | | | | | | - Steve Iliffe
- Research Department of Primary Care & Population Health, University College London, UK
| | | | | | - Pip Logan
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | | |
Collapse
|
11
|
The onset of falls and its effects on perceived social exclusion and loneliness. Evidence from a nationally representative longitudinal study. Arch Gerontol Geriatr 2022; 100:104622. [DOI: 10.1016/j.archger.2022.104622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/19/2021] [Accepted: 01/15/2022] [Indexed: 12/11/2022]
|
12
|
Sawadogo AR, Nys JF, Tran E, Gayot C, Boyer S, Cardinaud N, Thebaut C, Tchalla A. Impact of the abandonment of assistive technologies for mobility on the incidence of serious falls in older adults living at home: Results of the ECOCAT study. J Rehabil Assist Technol Eng 2022; 9:20556683221110866. [PMID: 35770039 PMCID: PMC9234835 DOI: 10.1177/20556683221110866] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose To examine the impact of discontinuing the use of assistive technology for
mobility (ATM) devices on the 6-months incidence of falls in older adults
(OA) living at home. Materials and methods A medico-socioeconomic survey was performed to collect information on the
quality of life and well-being of older adults, before and 6 months after
being loaned an ATM device. Personal data (medical, social, and economic)
were collected via a geriatric survey. Results In all, 102 OA participated in the study. Over the 6-months observation
period, 17 (n = 81) serious falls were recorded among
participants who were using their ATM device optimally; in those who
discontinued device use, 12 falls (n = 21) were recorded
(57.1%; p = 0.001). Factors significantly associated with
falls at home were living in an urban area (odds ratio [OR]: 11.46; 95%
confidence interval [CI]: 1.48; 88.98; p = 0.020), an
Instrumental Activities of Daily Living Scale score > 4 (OR: 34.04; 95%
CI: 1.59; 727.86; p = 0.024), and discontinuation of ATM
device use (OR: 17.41; 95% CI: 2.59; 117.02; p =
0.003). Conclusion Discontinuation of ATM device use was associated with an increased risk for
serious falls.
Collapse
Affiliation(s)
- Abdoul Razak Sawadogo
- Laboratoire VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
- Unité de Prévention, de Suivi et d’Analyse du Vieillissement (UPSAV), Pôle HU Gérontologie Clinique, CHU de Limoges, France
- Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
- Gerontopôle Nouvelle-Aquitaine, Limoges
| | - Jean-François Nys
- Laboratoire VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
| | - Estelle Tran
- Unité de Prévention, de Suivi et d’Analyse du Vieillissement (UPSAV), Pôle HU Gérontologie Clinique, CHU de Limoges, France
| | - Caroline Gayot
- Laboratoire VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
- Unité de Prévention, de Suivi et d’Analyse du Vieillissement (UPSAV), Pôle HU Gérontologie Clinique, CHU de Limoges, France
- Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| | - Sophie Boyer
- Laboratoire VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
- Unité de Prévention, de Suivi et d’Analyse du Vieillissement (UPSAV), Pôle HU Gérontologie Clinique, CHU de Limoges, France
- Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| | - Noëlle Cardinaud
- Laboratoire VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
- Unité de Prévention, de Suivi et d’Analyse du Vieillissement (UPSAV), Pôle HU Gérontologie Clinique, CHU de Limoges, France
- Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| | - Clémence Thebaut
- UMR 1094 Neuroépidémiologie Tropicale (NET), Université Paris Dauphine, PSL, LEDA-Legos, Université de Limoges, France
| | - Achille Tchalla
- Laboratoire VIESANTE - UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
- Unité de Prévention, de Suivi et d’Analyse du Vieillissement (UPSAV), Pôle HU Gérontologie Clinique, CHU de Limoges, France
- Unité de Recherche Clinique et d'Innovation (URCI) de Gérontologie, CHU de Limoges, Pôle HU Gérontologie Clinique, Limoges, France
| |
Collapse
|
13
|
Pettersson B, Janols R, Wiklund M, Lundin-Olsson L, Sandlund M. Older Adults' Experiences of Behavior Change Support in a Digital Fall Prevention Exercise Program: Qualitative Study Framed by the Self-determination Theory. J Med Internet Res 2021; 23:e26235. [PMID: 34328438 PMCID: PMC8367180 DOI: 10.2196/26235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/24/2021] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background Exercise is an effective intervention to prevent falls in older adults; however, long-term adherence is often poor. To increase adherence, additional support for behavior change has been advocated. However, consistency in the reporting of interventions using behavior change techniques is lacking. Recently, a classification system has been developed to increase consistency in studies using behavior change techniques within the self-determination theory. Objective This study aimed to explore expressions of self-determination among community-dwelling older adults using a self-managed digital fall prevention exercise program comprising behavior change support (the Safe Step program), which was developed in co-creation with intended users. Methods The qualitative study design was based on open-ended responses to questionnaires, and individual and focus group interviews. A deductive qualitative content analysis was applied using the classification system of motivation and behavior change techniques as an analytical matrix, followed by an inductive analysis. Twenty-five participants took part in a feasibility study and exercised in their homes with the Safe Step program for 4 months. The exercise program was available on computers,
smartphones, and tablets, and was fully self-managed. Results In the deductive analysis, expressions of support were demonstrated for all three basic human psychological needs, namely, autonomy, competence, and relatedness. These expressions were related to 11 of the 21 motivation and behavior change techniques in the classification system. The inductive analysis indicated that autonomy (to be in control) was valued and enabled individual adaptations according to different rationales for realizing exercise goals. However, the experience of autonomy was also two-sided and depended on the participants’ competence in exercise and the use of technology. The clarity of the program and exercise videos was seen as key for support in performance and competent choices. Although augmented techniques for social support were requested, support through relatedness was found within the program. Conclusions In this study, the Safe Step program supported the establishment of new exercise routines, as well as the three basic human psychological needs, with autonomy and competence being expressed as central in this context. Based on the participants’ experiences, a proposed addition to the classification system used as an analytical matrix has been presented. Trial Registration ClinicalTrials.gov NCT02916849; https://clinicaltrials.gov/ct2/show/NCT02916849
Collapse
Affiliation(s)
- Beatrice Pettersson
- Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå, Sweden
| | - Rebecka Janols
- Occupational Therapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.,Department of Computing Science, Umeå University, Umeå, Sweden
| | - Maria Wiklund
- Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå, Sweden
| | | | - Marlene Sandlund
- Physiotherapy, Department of Community Medicine and Rehabilitation, Umeå, Sweden
| |
Collapse
|
14
|
Worum H, Lillekroken D, Roaldsen KS, Ahlsen B, Bergland A. Reflections of older people about their experience of fall prevention exercise in the community- a qualitative study exploring evidence-based practice. BMC Public Health 2020; 20:1671. [PMID: 33167887 PMCID: PMC7650178 DOI: 10.1186/s12889-020-09630-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence-based practice (EBP) ensures that clinicians use effective interventions to achieve desired outcomes, thereby contributing to the best quality of care. The perspective of the participants is fundamental in EBP, as they have their own individual and meaningful rationale for participating in fall prevention. This study aims to explore community-dwelling older people reflections about their reflections about EBP in physiotherapy based on their experiences of a fall prevention exercise program. METHODS We conducted semi-structured interviews with 16 community-dwelling older people (men = 7; women = 9). Data were analyzed using thematic analysis. RESULTS The analysis revealed three themes: 1) the tension between knowing and doing, 2) the power of the therapist-participant relationship and the process of putting knowledge into action, and 3) research is interwoven with successful therapy and is an integral component of it. EBP was considered as a collective negotiation and learning process of creating knowledge for clinical practice. The negotiation between different types of knowledge must be performed in a transparent dialogue and through interactive collaboration between the persons involved. The participants appreciated that the research findings indicate that practice gives results. CONCLUSIONS EBP was understood and utilized as a seal of approval and a "guarantee of high quality" treatment, and its effects varied based on older people's preferences, needs, and skills. The therapist's relational competence appeared to be crucial for the negotiation of various sources of knowledge relative to the older people's preferences.
Collapse
Affiliation(s)
- Hilde Worum
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Daniela Lillekroken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kirsti Skavberg Roaldsen
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Neurobiology, Health Sciences and Society, Karolinska Institute, Stockholm, Sweden.,Department of Research, Sunnaas Rehabilitation Hospital, Oslo, Norway
| | - Birgitte Ahlsen
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
15
|
Barmentloo LM, Olij BF, Erasmus V, Smilde D, Schoon Y, Polinder S. Personal preferences of participation in fall prevention programmes: a descriptive study. BMC Geriatr 2020; 20:185. [PMID: 32466747 PMCID: PMC7254764 DOI: 10.1186/s12877-020-01586-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 05/19/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Participation in fall prevention programmes is associated with lower risk of injurious falls among older adults. However participation rates in fall prevention interventions are low. The limited participation in fall prevention might increase with a preference based approach. Therefore, the aims of this study are to a) determine the personal preferences of older adults regarding fall prevention and b) explore the association between personal preferences and participation. METHODS We assessed the personal preferences of older adults and the association between their preferences, chosen programme and participation level. Nine different programmes, with a focus on those best matching their personal preferences, were offered to participants. Twelve weeks after the start of the programme, participation was assessed by questionnaire. Logistic regression was performed to test the association between preferences and participation and an ANOVA was performed to assess differences between the number of preferences included in the chosen programme and participation level. RESULTS Of the 134 participants, 49% preferred to exercise at home versus 43% elsewhere, 46% preferred to exercise alone versus 44% in a group and 41% indicated a programme must be free of charge while 51% were willing to pay. The combination of an external location, in a group and for a fee was preferred by 27%, whereas 26% preferred at home, alone and only for free. The presence of preferences or the extent to which the programme matched earlier preferences was not associated with participation. CONCLUSION Despite the fact that preferences can vary greatly among older adults, local programmes should be available for at least the two largest subgroups. This includes a programme at home, offered individually and for free. In addition, local healthcare providers should cooperate to increase the accessibility of currently available group programmes.
Collapse
Affiliation(s)
- Lotte M Barmentloo
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO BOX 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Branko F Olij
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO BOX 2040, 3000, CA, Rotterdam, The Netherlands
| | - Vicki Erasmus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO BOX 2040, 3000, CA, Rotterdam, The Netherlands
| | - Dini Smilde
- GENERO foundation, Rotterdam, the Netherlands
| | - Yvonne Schoon
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO BOX 2040, 3000, CA, Rotterdam, The Netherlands
| |
Collapse
|
16
|
Pettersson B, Lundin-Olsson L, Skelton DA, Liv P, Zingmark M, Rosendahl E, Sandlund M. Effectiveness of a self-managed digital exercise programme to prevent falls in older community-dwelling adults: study protocol for the Safe Step randomised controlled trial. BMJ Open 2020; 10:e036194. [PMID: 32423936 PMCID: PMC7239551 DOI: 10.1136/bmjopen-2019-036194] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Exercise interventions have a strong evidence base for falls prevention. However, exercise can be challenging to implement and often has limited reach and poor adherence. Digital technology provides opportunities for both increased access to the intervention and support over time. Further knowledge needs to be gained regarding the effectiveness of completely self-managed digital exercise interventions. The main objective of this study is to compare the effectiveness of a self-managed digital exercise programme, Safe Step, in combination with monthly educational videos with educational videos alone, on falls over 1 year in older community-dwelling adults. METHODS AND ANALYSIS A two-arm parallel randomised controlled trial will be conducted with at least 1400 community-living older adults (70+ years) who experience impaired balance. Participants will be recruited throughout Sweden with enrolment through the project website. They will be randomly allocated to either the Safe Step exercise programme with additional monthly educational videos about healthy ageing and fall prevention, or the monthly education videos alone. Participants receiving the exercise intervention will be asked to exercise at home for at least 30 min, 3 times/week with support of the Safe Step application. The primary outcome will be rate of falls (fall per person year). Participants will keep a fall calendar and report falls at the end of each month through a digital questionnaire. Further assessments of secondary outcomes will be made through self-reported questionnaires and a self-test of 30 s chair stand test at baseline and 3, 6, 9 and 12 months after study start. Data will be analysed according to the intention-to-treat principle. ETHICS AND DISSEMINATION Ethical approval was obtained by The Regional Ethical Review Board in Umeå (Dnr 2018/433-31). Findings will be disseminated through the project web-site, peer-reviewed journals, national and international conferences and through senior citizen organisations' newsletters. TRIAL REGISTRATION NUMBER NCT03963570.
Collapse
Affiliation(s)
- Beatrice Pettersson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Lillemor Lundin-Olsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Per Liv
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Magnus Zingmark
- Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Erik Rosendahl
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| |
Collapse
|
17
|
Resnick B, Boltz M, Galik E, Holmes S, Fix S, Zhu S. Gender Differences in Function, Physical Activity, Falls, Medication Use, and Life Satisfaction Among Residents in Assisted Living Settings. Res Gerontol Nurs 2020; 13:31-40. [PMID: 31584687 PMCID: PMC6980912 DOI: 10.3928/19404921-20190930-02] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to test for gender differences among residents living in assisted living settings. This was a secondary data analysis using data from the first 64 facilities participating in the ongoing Function Focused Care for Assisted Living study using the Evidence Integration Triangle (FFC-AL-EIT). A total of 593 residents were recruited. Differences by gender with regard to function, physical activity, falls, total number of medications, and satisfaction with assisted living were tested using multivariate analysis of variance. There were 166 (28%) men and 427 (72%) women with a mean age of 88 (SD = 7.5 years). Participants had five (SD = 2) comorbidities and took on average 6.88 medications (SD = 3.47). Participants had moderate functional impairment with a mean of 64.13 (SD = 19.09) on the Barthel Index and engaged in 43.8 (SD = 76.12) minutes daily of moderate level physical activity. Women reported higher satisfaction with activities (4.32 [SD = 1.14]) than men (3.85 [SD = 1.51]), and women received more medications than men (7.09 [SD = 3.51] vs. 6.34 [SD = 3.31]). Current study findings suggest that deprescribing may be particularly important for women versus men and focusing on expanding activity options to include those preferred by men should be considered in assisted living settings. [Research in Gerontological Nursing, 13(1), 31-40.].
Collapse
|
18
|
Giné-Garriga M, Sandlund M, Dall PM, Chastin SFM, Pérez S, Skelton DA. A Novel Approach to Reduce Sedentary Behaviour in Care Home Residents: The GET READY Study Utilising Service-Learning and Co-Creation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E418. [PMID: 30717105 PMCID: PMC6388363 DOI: 10.3390/ijerph16030418] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 01/20/2023]
Abstract
The GET READY study aimed to integrate service-learning methodology into University degrees by offering students individual service opportunities with residential care homes, to co-create the best suited intervention to reduce the sedentary behaviour (SB) of residents throughout the day, with researchers, end-users, care staff, family members and policymakers. Eight workshops with care home residents and four workshops with care staff, relatives and policymakers, led by undergraduate students, were audiotaped, transcribed verbatim and analysed with inductive thematic analysis to understand views and preferences for sustainable strategies to reduce SB and increase movement of residents. Perspectives about SB and movement in care homes highlighted four subthemes. Assets for decreasing SB included three subthemes, and suggestions and strategies encapsulated four subthemes. There is a need to include end-users in decision making, and involve care staff and relatives in enhancing strategies to reduce SB among residents if we want sustainable changes in behaviour. A change in the culture at a policymaker and care staff's level could provide opportunities to open care homes to the community with regular activities outside the care home premises, and offer household chores and opportunities to give residents a role in maintaining their home environment.
Collapse
Affiliation(s)
- Maria Giné-Garriga
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Císter 34, 08022 Barcelona, Spain.
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87 Umeå, Sweden.
| | - Philippa M Dall
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
| | - Sebastien F M Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
- Department of Movement and Sport Science, Ghent University, St. Pietersnieuwstraat 33, 9000 Ghent, Belgium.
| | - Susana Pérez
- Department of Physical Activity and Sport Sciences, Faculty of Psychology, Education and Sport Sciences (FPCEE) Blanquerna, Ramon Llull University, Císter 34, 08022 Barcelona, Spain.
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
| |
Collapse
|