School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, HNES suite 343, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.
BMC Health Serv Res. 2022 Jul 13;22(1):907. doi: 10.1186/s12913-022-08289-4.
Physical activity in the post-discharge period is important to maximize patient recovery and prevent hospital readmission. Healthcare providers have identified family caregivers as potential facilitators of patients' engagement in physical activity. Yet, there is very little research on family caregivers' perspectives on their preparedness to support the physical activity of patients, particularly those at risk for hospital readmission in rural communities. Accordingly, this study explored the challenges related to family caregivers' preparedness to support the physical activity of a recently discharged, rural-dwelling relative at risk for hospital readmission.
In this interpretive descriptive study, semi-structured interviews were conducted by telephone with 16 family caregivers. Interview transcripts were analyzed using thematic analysis.
Participants were predominantly women (n = 14; 87.5%) with an average age of 49 years (range 26-67) who were the primary caregivers of a relative who had been hospitalized for a medical illness (n = 12; 75%) and was at high risk for hospital readmission. Four themes were identified: 1) family caregivers generally felt unprepared to support their relative's physical activity, 2) some family caregivers believed that rest was more important than physical activity to their relative's recovery, 3) insufficient physical activity preparation led to family caregiver-relative conflicts, and 4) to defuse these conflicts, some family caregivers wanted healthcare providers to be responsible for promoting physical activity.
Despite assertions that family caregivers are a potential source of support for patient physical activity, our findings indicate that family caregivers are largely unprepared to assume that role and that more work needs to be done to ensure they can do so effectively. We suggest that healthcare providers be conscious of the potential for family caregiver-patient conflict surrounding physical activity, assess family caregivers' ability and willingness to support physical activity, educate them on the hazards of inactivity, and provide physical activity instructions to family caregivers and patients conjointly. Preparing family caregivers to support their relative's physical activity is particularly important given the current emphasis on early discharge in many jurisdictions, and the limited formal healthcare services available in rural communities.
出院后的身体活动对于最大限度地促进患者康复和预防再次住院至关重要。医疗保健提供者已经确定家庭照顾者是促进患者参与身体活动的潜在促进者。然而，关于家庭照顾者对支持身体活动的准备情况的观点的研究非常少，特别是在农村社区有再次住院风险的患者。因此，本研究探讨了与家庭照顾者准备支持最近出院、有再次住院风险的农村居住亲属身体活动相关的挑战。
在这项解释性描述研究中，通过电话对 16 名家庭照顾者进行了半结构化访谈。使用主题分析对访谈记录进行了分析。
参与者主要是女性（n=14；87.5%），平均年龄为 49 岁（26-67 岁），是因医疗疾病住院的亲属（n=12；75%）的主要照顾者，且有再次住院的高风险。确定了四个主题：1）家庭照顾者普遍感到对支持亲属的身体活动没有准备；2）一些家庭照顾者认为休息比身体活动对亲属的康复更重要；3）身体活动准备不足导致家庭照顾者-亲属冲突；4）为了化解这些冲突，一些家庭照顾者希望医疗保健提供者负责促进身体活动。
尽管有人断言家庭照顾者是支持患者身体活动的潜在来源，但我们的研究结果表明，家庭照顾者在很大程度上没有准备好承担这一角色，需要做更多的工作来确保他们能够有效地承担这一角色。我们建议医疗保健提供者注意身体活动可能引起的家庭照顾者-患者冲突，评估家庭照顾者支持身体活动的能力和意愿，教育他们活动不足的危害，并共同向家庭照顾者和患者提供身体活动指导。鉴于许多司法管辖区目前强调提前出院，以及农村社区有限的正规医疗服务，让家庭照顾者做好支持其亲属身体活动的准备工作尤为重要。
