Department of Primary Care and Population Health, University College London, London, UK.
Department of Psychology, King's College London, London, UK.
Health Soc Care Community. 2019 Sep;27(5):1333-1343. doi: 10.1111/hsc.12781. Epub 2019 May 31.
Mild frailty is common among older people, but it is potentially reversible with health promotion interventions. Behaviour change may be a key to preventing progression of frailty; however, we know little about what interventions work best and how a behaviour change approach would be perceived by this group. The aim of this study was to explore how mildly frail older people perceive health promotion based on behaviour change and what factors affect engagement with this approach. We conducted semi-structured interviews with 16 older people with mild frailty who received a pilot home-based behaviour change health promotion service, including a dyad of older person/family carer, and two service providers delivering the service in two diverse areas of South England. Interviews were audio-recorded, transcribed and thematically analysed. The concept of goal setting was acceptable to most participants, though the process of goal setting needed time and consideration. Goals on maintaining independence, monitoring of progress and receiving feedback were reported to increase motivation. Physical/mental capability and knowledge/perception of own needs were main determinants of the type of goals chosen by participants as well as the approach used by the project workers. Older people with complex needs benefited from care coordination, with a combination of goal setting and elements of social, practical and emotional support in varying proportions. Mildly frail older people responded well to a behaviour change approach to promote health and well-being. Further consideration is needed of the most effective strategies based on complexity of needs, and how to overcome barriers among people with cognitive impairment.
轻度虚弱在老年人中很常见，但通过健康促进干预措施，这种情况可能是可逆的。行为改变可能是预防虚弱进展的关键；然而，我们对哪些干预措施最有效以及行为改变方法在这一人群中是如何被感知的知之甚少。本研究旨在探讨轻度虚弱的老年人如何看待基于行为改变的健康促进，以及哪些因素影响他们对这种方法的参与。我们对 16 名轻度虚弱的老年人进行了半结构化访谈，这些老年人接受了一项基于家庭的行为改变健康促进服务的试点，包括一对老年人/家庭照顾者和两名服务提供者，他们在英格兰南部的两个不同地区提供服务。访谈进行了录音、转录和主题分析。大多数参与者都能接受目标设定的概念，但目标设定的过程需要时间和考虑。保持独立性、监测进展和获得反馈等目标被认为可以提高动力。身体/心理能力以及对自身需求的认识/感知是参与者选择目标类型以及项目工作者使用的方法的主要决定因素。有复杂需求的老年人受益于护理协调，目标设定和社会、实际和情感支持的元素以不同的比例相结合。轻度虚弱的老年人对促进健康和幸福的行为改变方法反应良好。需要进一步考虑基于需求复杂性的最有效策略，以及如何克服认知障碍人群的障碍。
