Bolton Clarke Research Institute, Melbourne, Victoria, Australia.
Griffith Business School, Department of Business Innovation and Strategy, Griffith University, Brisbane, Queensland, Australia.
Health Soc Care Community. 2022 May;30(3):e770-e780. doi: 10.1111/hsc.13447. Epub 2021 May 26.
Australian health and aged care reforms mandate a wellness and reablement (W&R) approach with services and the workforce needing to adjust their way of working with older people, to actively promote independence and participation in life's activities. Studies exploring the older person's perspective are sparse. This study aims to understand the older person's experience of a W&R approach, supplemented with experiences of staff trained in the approach. The study evaluates a W&R approach implemented across three community-based sites of a large Australian aged care provider. Staff from participating sites underwent training and were asked to use a W&R approach with at least one older person. Eighteen older people aged 65+ were engaged in the 4-month programme. Semi-structured interviews with older people and staff were conducted on completion of the programme. The W&R approach showed variable benefits and experiences of older people related to goal setting and outcomes. Overall, older people were unfamiliar with goal setting or displayed negative attitudes. Negative emotional responses to health decline and ageing, such as apathy, frustration, embarrassment and sense of helplessness, were identified as barriers to goal pursual. In contrast, enabling factors, such as assistive equipment, staff and social connection, triggered positive emotional responses, which acted as protective factors and enhanced goal pursual. Staff knowledge and understanding of the W&R approach also influenced older people's experience and outcomes. These findings recommend a stronger focus on the social and emotional aspects of W&R and co-developing goals in line with the older person's sense of wellbeing. This approach supports the multiple dimensions of W&R and aligns with principles of positive and healthy ageing. Additional training for staff should be provided, with ongoing mentoring and support from W&R champions. Ensuring that goals are meaningful and valuable to individual older people will enhance successful goal pursual and improve outcomes.
澳大利亚的卫生和老年护理改革要求采用健康和康复(W&R)方法,服务和劳动力需要调整与老年人合作的方式,积极促进独立和参与生活活动。探索老年人观点的研究很少。本研究旨在了解 W&R 方法对老年人的体验,并辅以接受过该方法培训的工作人员的经验。该研究评估了在一家大型澳大利亚老年护理提供商的三个基于社区的站点实施的 W&R 方法。参与站点的工作人员接受了培训,并被要求至少与一位老年人一起使用 W&R 方法。18 名 65 岁以上的老年人参加了为期 4 个月的计划。在计划完成后,对老年人和工作人员进行了半结构化访谈。W&R 方法显示出老年人与目标设定和结果相关的不同收益和体验。总体而言,老年人对目标设定不熟悉或持负面态度。对健康下降和衰老的负面情绪反应,如冷漠、沮丧、尴尬和无助感,被确定为追求目标的障碍。相比之下,辅助设备、工作人员和社交联系等有利因素会引发积极的情绪反应,这些反应起到保护因素的作用,增强了目标追求。工作人员对 W&R 方法的了解和理解也会影响老年人的体验和结果。这些发现建议更加关注 W&R 的社会和情感方面,并根据老年人的幸福感共同制定目标。这种方法支持 W&R 的多个维度,并符合积极和健康老龄化的原则。应该为工作人员提供更多培训,并由 W&R 拥护者提供持续的指导和支持。确保目标对个别老年人有意义和有价值将增强成功追求目标的能力,并改善结果。