Frailty in Aging Research Department, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium; Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium.
Frailty in Aging Research Department, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium; Gerontology Department, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium; Geriatrics Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan, Brussels, Belgium.
J Am Med Dir Assoc. 2015 May 1;16(5):371-9. doi: 10.1016/j.jamda.2014.12.010. Epub 2015 Feb 7.
Information regarding factors that hinder or stimulate older adults in long-term care facilities (LTCF) for being physically active is available in the literature, but much less is known regarding perceived motivators and barriers among physiotherapists (PTs) to organize physical activity (PA) in LTCF.
The main purpose of this study was to examine factors influencing PTs to organize PA in LTCF for older adults. A secondary goal was to examine the PTs' knowledge about and their barriers at the PA guidelines for older adults of the World Health Organization (WHO).
A mixed qualitative and quantitative study was carried out using semistructured interviews (n = 24) followed by an online survey (n = 254). As a frame the social-ecological model (McLeroy) was used, distinguishing factors at the intrapersonal, interpersonal, and community level.
In the qualitative component the PTs reported 41 motivators and 35 barriers for organizing PA in LTCF. The survey revealed that although the majority of the respondents (71%) are convinced of the usefulness of PA in LTCF, 84% are not familiar with the WHO-guidelines. Seventy-five percent of the respondents believe that the WHO-guidelines are not feasible for LTCF-residents. The strongest motivators on the intrapersonal level were maintaining the independence of the residents (98%), reducing the risk of falling (98%), and improving the physical (93%) and psychological (90%) wellbeing of LTCF-residents. The social interaction among LTCF-residents (91%) during PA was the strongest motivator on the interpersonal level. Motivators on the community level are the belief that PA is the basis of their physiotherapeutic work (89%) and that offering varied activities avoids PA becoming monotonous (71%). Barriers on the intra- and interpersonal level were of less influence. On the community level, they felt hindered to organize PA because of lack of time (38%) and the overload of paperwork (33%).
This study described different motivators and barriers for PTs to organize PA in LTCFs. The majority does not know the WHO guidelines regarding the amount of PA for adults aged 65 and over. Although they agree that the guidelines are useful, they believe the guidelines are not feasible. There is a need for a multifactorial strategy that acts on different determinants in order to stimulate PA in LTCF.
关于阻碍或激励长期护理机构（LTCF）中的老年人进行身体活动的因素的信息在文献中有记载，但对于物理治疗师（PT）在组织 LTCF 中的身体活动（PA）方面的动机和障碍知之甚少。
本研究的主要目的是调查影响 PT 组织老年人 LTCF 中 PA 的因素。次要目标是检查 PT 对世界卫生组织（WHO）老年人 PA 指南的了解程度及其障碍。
采用半结构式访谈（n=24）和在线调查（n=254）相结合的混合定性和定量研究方法。以社会生态学模型（McLeroy）为框架，区分个体内部、人际和社区层面的因素。
在定性部分，PT 报告了组织 LTCF 中 PA 的 41 个促进因素和 35 个障碍。调查显示，尽管大多数受访者（71%）认为 PA 在 LTCF 中有用，但 84%的人不熟悉 WHO 指南。75%的受访者认为 WHO 指南不适用于 LTCF 居民。个体层面最强的促进因素是保持居民的独立性（98%）、降低跌倒风险（98%）以及改善 LTCF 居民的身体（93%）和心理（90%）健康。LTCF 居民在 PA 中的社交互动（91%）是人际层面最强的促进因素。社区层面的促进因素是相信 PA 是他们物理治疗工作的基础（89%），提供多样化的活动可以避免 PA 变得单调乏味（71%）。个体和人际层面的障碍影响较小。在社区层面，他们认为由于缺乏时间（38%）和文书工作负担过重（33%），组织 PA 受到阻碍。
本研究描述了 PT 组织 LTCF 中 PA 的不同促进因素和障碍。大多数人不了解关于 65 岁及以上成年人 PA 量的 WHO 指南。尽管他们认为这些指南很有用，但他们认为这些指南不可行。需要采取多因素策略，针对不同的决定因素，以促进 LTCF 中的 PA。
