Netherlands Institute for Health Services Research (Nivel), PO Box 1568, 3513 CR, Utrecht, The Netherlands.
Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute (APH), Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
BMC Health Serv Res. 2022 May 20;22(1):677. doi: 10.1186/s12913-022-07952-0.
People with dementia living in nursing homes are mostly sedentary, which is a consequence of various personal, environmental and organizational factors. Until now, studies on physical activity and safety in dementia have focused on residents and caregivers from the viewpoint of (individual) care provision and health benefits. There has been little to no focus on the possible influence of group dynamics between care providers with regard to physical activity and safety. The aim of this study is to gain more insight into the viewpoints and intentions of groups of professional caregivers towards safety and physical activity and the potential influence of the group-oriented setting in long-term care on physical activity of individual residents.
A qualitative study comprising three focus group discussions including professional caregivers (n = 15) was conducted within two long-term care organizations in the Netherlands. Focus group discussions were structured using an interview guide derived from a preliminary framework, based on existing literature and complemented with clinical expertise.
Seven themes could be derived from the focus group discussions that influence physical activity and safety: 1) Individual health and abilities; 2) Balancing physical activity and safety; 3) Physical restraints; 4) Group interests versus the individual interests; 5) Organization of care and physical environment; 6) Perceived responsibilities and tasks of professional caregivers and 7) Change is challenging.
Due to multiple influencing factors, the balance for care providers in long-term care generally tends towards safety over physical activity. Furthermore, in order to stimulate physical activity various limitations are experienced, including the organization of care, the general health of the residents and difficulty to achieve changes in daily care. Most importantly, the group interests of both the professional caregivers and the residents have a substantial influence on the incorporation of physical activity in daily care.
居住在养老院的痴呆症患者大多久坐不动，这是个人、环境和组织等多种因素共同作用的结果。迄今为止，有关痴呆症患者身体活动和安全的研究主要从（个人）护理提供和健康益处的角度关注居民和护理人员。几乎没有关注护理人员之间的群体动态对身体活动和安全的可能影响。本研究旨在更深入地了解专业护理人员群体对安全和身体活动的观点和意图，以及长期护理中以群体为导向的环境对个体居民身体活动的潜在影响。
在荷兰的两个长期护理机构中进行了一项包括三个焦点小组讨论的定性研究，共纳入专业护理人员（n=15）。焦点小组讨论采用基于初步框架的访谈指南进行组织，该框架源自现有文献，并辅以临床专业知识。
从焦点小组讨论中可以得出七个影响身体活动和安全的主题：1）个人健康和能力；2）平衡身体活动和安全；3）身体约束；4）群体利益与个人利益；5）护理组织和物理环境；6）专业护理人员的感知责任和任务；7）改变具有挑战性。
由于多种影响因素，长期护理提供者的平衡普遍倾向于安全而非身体活动。此外，为了促进身体活动，他们面临着各种限制，包括护理组织、居民的整体健康状况以及难以在日常护理中实现改变。最重要的是，专业护理人员和居民的群体利益对将身体活动纳入日常护理有很大影响。
