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Johansson MM, Nätt M, Peolsson A, Öhman A. Frail community-dwelling older persons' everyday lives and their experiences of rehabilitation - a qualitative study. Scand J Occup Ther 2023; 30:65-75. [PMID: 35786360 DOI: 10.1080/11038128.2022.2093269] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The number of older persons with frailty is increasing, and rehabilitation to improve the consequences of frailty are important for both the individual and society. However, the perspective of older persons themselves in research and planning of interventions is scarce. AIM The aim of this study was to describe frail older persons' everyday lives and their experiences and views of rehabilitation. MATERIAL AND METHODS Twenty older persons were interviewed, and analyses were performed using a qualitative content analysis method. RESULTS The two main categories were 'Frailty impacts everyday lifé and 'Experiences and perceptions of rehabilitation'. The participants described that they had to adapt their everyday lives in line with their health conditions. They all used strategies and were dependent on support in their activities of daily living. Their social network had decreased. All participants strived to stay active and independent, and wanted rehabilitation and support from professionals, experiencing decreased access to rehabilitation. CONCLUSIONS AND SIGNIFICANCE Frail older persons are a vulnerable group who often need support in everyday life. There is room for improvement when it comes to helping frail older persons to stay active and facilitate participation in both individual and group interventions.
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Affiliation(s)
- Maria M Johansson
- Department of Activity and Health, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Malin Nätt
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Rehabilitation Medicine in Linköping, and Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden.,Department of Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Unit of Clinical medicine, Linköping University, Linköping, Sweden
| | - Annika Öhman
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational Therapy, Linköping University, Norrköping, Sweden
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Ćwirlej-Sozańska A, Sozański B, Wilmowska-Pietruszyńska A, Kizowska-Lepiejza B, Wiśniowska-Szurlej A. Development of the Polish Version of the ICF Core Set for the Environment of Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16341. [PMID: 36498407 PMCID: PMC9738278 DOI: 10.3390/ijerph192316341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The percentage of older people in Polish society increases every year. The interaction between the individual health condition and the barriers in the environment of the elderly leads to the development of disability and the limitation of activity and participation in daily activities. AIM This study was aimed at selecting the category of the International Classification of Functioning, Disability, and Health (ICF) to assess the environment of older adults in Poland in the context of their daily functioning. MATERIALS AND METHODS The study was designed to develop a user-friendly tool collecting ICF-based data on the living environment of older people, consisting of five phases: (1) the systematic review of the literature, (2) the empirical multicenter study, (3) the qualitative study based on interviews conducted among the elderly, (4) the experts' study-an assessment of selected codes from the perspective of experts, (5) the consensus conference. RESULTS Consensus was reached for 20 ICF categories, creating a comprehensive core set for the assessment of the living environment of older people, which included six codes from chapter 1, Products and technology, three codes from chapter 2, Natural environment and human-made changes to the environment, four codes from chapter 3, Support and relationships, four codes from Chapter 4, Attitudes, and three codes from Chapter 5, Services, systems, and policies. CONCLUSIONS The core set for the assessment of the living environment of older people living in Poland is a comprehensive and important set of 20 ICF codes that reflect the most important elements of the environment affecting the health and functioning of the elderly. This set can contribute to the optimal management of care services and support in the area of adapting the environment to the older population. The core set for environmental assessment was developed for use by medical and care facilities, as well as by social workers, who should also pay attention to the elements of the environment that affect the level of functioning of older people. In the future, it may also form the basis of national surveys and screening tests for the assessment of the living environment of older people. Optimizing and enhancing the surrounding environment can contribute to a greater degree of independence, even with existing health problems in the older population.
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Affiliation(s)
- Agnieszka Ćwirlej-Sozańska
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
- Laboratory of Geronto-prophylaxis, Center for Innovative Research in Medical and Natural Sciences, Rzeszow of University, Warzywna Street 1A, 35-310 Rzeszow, Poland
| | - Bernard Sozański
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
| | | | - Beata Kizowska-Lepiejza
- Center for Foreign Language Studies, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
| | - Agnieszka Wiśniowska-Szurlej
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Rejtana Street 16C, 35-959 Rzeszow, Poland
- Laboratory of Geronto-prophylaxis, Center for Innovative Research in Medical and Natural Sciences, Rzeszow of University, Warzywna Street 1A, 35-310 Rzeszow, Poland
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Fritz H, Hu YL. Habit Formation Intervention to Reduce Frailty Risk Factors: A Feasibility Study. Am J Occup Ther 2022; 76:23276. [PMID: 35616653 DOI: 10.5014/ajot.2022.045948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Frailty is common, detrimental, and costly in later life. Interventions can reduce the risk for frailty. OBJECTIVE To assess the feasibility of a frailty prevention intervention. DESIGN A two-arm, prospective randomized controlled trial with blinded participant allocation and data collection at baseline and 1 wk postintervention by data collectors blinded to participant assignment. SETTING Community. PARTICIPANTS Thirty community-dwelling, English-speaking, older African-Americans who were classified as prefrail were randomly recruited from a university research subject registry. INTERVENTION The habit formation treatment was delivered face to face during 12 weekly home-based sessions approximately 45 min in length. OUTCOMES AND MEASURES We assessed feasibility as reflected in participant recruitment, retention, session attendance, and program satisfaction. Clinical outcomes included sedentary time and dietary quality (primary) as well as frailty status, physical activity, physical function, depression, quality of life, and anthropometry (secondary). Habit formation (mechanism of change) was assessed in the treatment group only. RESULTS Twenty women (M age = 73.5 yr) completed the study. The recruitment rate was 69.8%, and we retained 95.2% of participants through the end of the study, with session attendance rates of 98.1% and 88.6% for the treatment and control groups, respectively, and mean acceptability scores of 30.3 and 28.0 for the treatment and control groups, respectively. Changes in primary and secondary clinical outcomes were largely in the expected direction. CONCLUSIONS AND RELEVANCE The intervention was feasible to deliver. Although future efficacy studies are needed, our preliminary data suggest the potential of an occupational therapy intervention to reduce frailty risk. What This Article Adds: Although it may be possible to slow or prevent the progression to frailty by modifying existing habits and occupations, few occupational therapy interventions address frailty. Our data provide new and much-needed insights about the potential feasibility of an occupational therapy intervention to reduce frailty risk.
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Affiliation(s)
- Heather Fritz
- Heather Fritz, PhD, OTR/L, CHC, is Associate Professor and Founding Director, School of Occupational Therapy, Pacific Northwest University of Health Sciences, Yakima, WA;
| | - Yi-Ling Hu
- Yi-Ling Hu, PhD, OTR, is Assistant Professor, Department of Occupational Therapy, Chang Gung University, Taoyuan City, Taiwan
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Arias-Casais N, Amuthavalli Thiyagarajan J, Rodrigues Perracini M, Park E, Van den Block L, Sumi Y, Sadana R, Banerjee A, Han ZA. What long-term care interventions have been published between 2010 and 2020? Results of a WHO scoping review identifying long-term care interventions for older people around the world. BMJ Open 2022; 12:e054492. [PMID: 35105637 PMCID: PMC8808408 DOI: 10.1136/bmjopen-2021-054492] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/20/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The global population is rapidly ageing. To tackle the increasing prevalence of older adults' chronic conditions, loss of intrinsic capacity and functional ability, long-term care interventions are required. The study aim was to identify long-term care interventions reported in scientific literature from 2010 to 2020 and categorise them in relation to WHO's public health framework of healthy ageing. DESIGN Scoping review conducted on PubMed, CINHAL, Cochrane and Google Advanced targeting studies reporting on long-term care interventions for older and frail adults. An internal validated Excel matrix was used for charting.Setting nursing homes, assisted care homes, long-term care facilities, home, residential houses for the elderly and at the community. INCLUSION CRITERIA Studies published in peer-reviewed journals between 1 January 2010 to 1 February 2020 on implemented interventions with outcome measures provided in the settings mentioned above for subjects older than 60 years old in English, Spanish, German, Portuguese or French. RESULTS 305 studies were included. Fifty clustered interventions were identified and organised into four WHO Healthy Ageing domains and 20 subdomains. All interventions delved from high-income settings; no interventions from low-resource settings were identified. The most frequently reported interventions were multimodal exercise (n=68 reports, person-centred assessment and care plan development (n=22), case management for continuum care (n=16), multicomponent interventions (n=15), psychoeducational interventions for caregivers (n=13) and interventions mitigating cognitive decline (n=13). CONCLUSION The identified interventions are diverse overarching multiple settings and areas seeking to prevent, treat and improve loss of functional ability and intrinsic capacity. Interventions from low-resource settings were not identified.
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Affiliation(s)
- Natalia Arias-Casais
- ATLANTES Global Observatory for Palliative Care, University of Navarra, Pamplona, Spain
| | | | | | - Eunok Park
- College of Nursing, Jeju National University, Jeju, Republic of Korea
| | - Lieve Van den Block
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Yuka Sumi
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Ritu Sadana
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Anshu Banerjee
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Zee-A Han
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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Nunes ADS, Batista MPP, Almeida MHDM. Atuação de terapeutas ocupacionais com idosos frágeis. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2021. [DOI: 10.1590/2526-8910.ctoao2207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução Terapeutas ocupacionais compõem as equipes que prestam assistência a idosos frágeis em diferentes contextos de atenção, dentre eles saúde, assistência social e cultura. Objetivo Identificar a atuação de terapeutas ocupacionais com idosos frágeis. Método Estudo qualitativo e exploratório. Realizaram-se entrevistas com terapeutas ocupacionais que atuam com idosos frágeis na cidade de São Paulo, SP, Brasil, utilizando roteiro semiestruturado de questões. Empregou-se a técnica “bola de neve”. Os resultados foram analisados por meio da análise de conteúdo temático-categorial. Resultados Foram entrevistadas nove terapeutas ocupacionais atuantes na saúde, assistência social e cultura. As categorias encontradas foram: I) ações desenvolvidas por terapeutas ocupacionais na assistência a idosos frágeis; II) trabalho em equipe e articulação de saberes, contribuições e desafios; III) articulação de redes e intersetorialidade; IV) aspectos relevantes na assistência integral a idosos frágeis. As entrevistadas realizam ações diversificadas, considerando a inserção cultural e social do idoso e as políticas públicas; compartilhadas com profissionais da equipe e com serviços da rede setorial e intersetorial; além de incluírem cuidadores na assistência prestada aos idosos frágeis. Conclusão Dentre os desafios encontrados pelas terapeutas ocupacionais na atuação com idosos frágeis, encontra-se a incorporação das premissas da integralidade, intersetorialidade e trabalho em equipe. As diferentes ações realizadas estão amparadas nas políticas públicas para o envelhecimento, e buscam o cuidado singular baseado na complexidade biopsicossocial e nos aspectos contextuais que influenciam o envelhecimento. Os resultados indicam a necessidade de ampliação da inserção de terapeutas ocupacionais em equipes que ofertam cuidados para idosos frágeis em diferentes contextos de atenção.
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