Siette Joyce, Knaggs Gilbert, Nguyen Amy D, Brett Lindsey, Jorgensen Mikaela, Gow Edwina, Georgiou Andrew
Australian Institute of Health Innovation, Macquarie University, Macquarie, New South Wales, Australia.
Centre for Ageing, Cognition and Wellbeing, Macquarie University, Macquarie, NSW, Australia.
Health Soc Care Community. 2022 Sep;30(5):e1746-e1755. doi: 10.1111/hsc.13602. Epub 2021 Oct 11.
Social participation is critical to the health and well-being of older adults, however, participation often declines with age. Research has identified that personal and environmental factors such as high socioeconomic status and accessible transportation are associated with higher levels of social participation. However, the barriers and facilitators to social participation experienced by older adults receiving community aged care services remains largely unexplored. This qualitative study aimed to generate context-rich data and identify the barriers and facilitators to effective community care services that can support older adults' participation in the community and contribute to individual well-being. Semi-structured focus groups were conducted with 40 community aged care clients and 21 staff members between January to July 2018 and thematic analysis was undertaken. Environmental factors, such as availability and accessibility of transportation services emerged as the most important factors influencing participation. Older age, self-attitude towards one's own functional ability and limited social networks were important personal factors affecting participation. Proactive aged care services (e.g., engaged staff, tailored activities) were reported to assist with continual engagement in aged care services. In contrast, the type, location and accessibility of the activity, associated costs and limited options for accessible transportation were key barriers to older adults' social participation. Pathways contributing to positive engagement were complex and variable, but personal well-being and local community resources emerged as important factors encouraging higher social participation. These findings are discussed in the context of the ongoing pandemic and implications for future aged care services are provided.
社会参与对老年人的健康和幸福至关重要,然而,参与度往往会随着年龄的增长而下降。研究表明,个人和环境因素,如高社会经济地位和便捷的交通,与更高水平的社会参与相关。然而,接受社区老年护理服务的老年人在社会参与方面所面临的障碍和促进因素在很大程度上仍未得到探索。这项定性研究旨在生成丰富的背景数据,并确定有效的社区护理服务的障碍和促进因素,这些服务可以支持老年人参与社区活动并促进个人幸福。2018年1月至7月期间,对40名社区老年护理客户和21名工作人员进行了半结构化焦点小组访谈,并进行了主题分析。交通服务的可用性和可达性等环境因素成为影响参与的最重要因素。高龄、对自身功能能力的自我态度以及有限的社交网络是影响参与的重要个人因素。据报道,积极主动的老年护理服务(如敬业的工作人员、量身定制的活动)有助于持续参与老年护理服务。相比之下,活动的类型、地点和可达性、相关成本以及便捷交通的选择有限是老年人社会参与的关键障碍。促进积极参与的途径复杂多样,但个人幸福和当地社区资源成为鼓励更高社会参与的重要因素。这些发现将在当前疫情的背景下进行讨论,并为未来的老年护理服务提供启示。