Eliassen Marianne, Hartviksen Trude Anita, Holm Solrun, Sørensen Bodil Anita, Zingmark Magnus
Department of Health and Care Sciences, UiT, The Artic University of Norway, Tromsø, 9037, Norway.
Centre for Care Sciences North, UiT, The Arctic University of Norway, Tromsø, 9037, Norway.
BMC Health Serv Res. 2024 Dec 18;24(1):1580. doi: 10.1186/s12913-024-12031-7.
As populations age in the Western world, interventions aiming for 'aging in place', such as reablement, have gained prominence. Reablement programs have focused on enabling older people to maintain independence in their home environment. However, while a growing body of research points to the considerable benefits of engaging in outdoor environments, reablement rarely addresses outdoor activities. People living in rural Arctic areas often tend to have strong cultural, social, and emotional attachments to outdoor places, emphasizing the outdoors as a meaningful arena for engagement. Concurrently, rural Arctic communities face unique obstacles in facilitating outdoor activities, such as geographic isolation, limited access to services, harsh climate conditions, and seasonal variations. Recognizing these challenges, our study sought to tailor an outdoor reablement model that is appropriate and feasible for the context of a rural Arctic setting.
The study design was inspired by a co-design methodology, incorporating data creation through workshops, focus groups, and individual interviews conducted over an eleven-month period. Three municipalities in rural Arctic Norway were involved, with a total of 35 participants, including older people receiving reablement services and healthcare professionals. A socioecological theory supported the thematic data analysis.
The study yielded experiences that generated a comprehensive model for implementing outdoor reablement that meet the specific needs that the participants experienced in the rural Arctic setting. The model includes the individual level, accounting for physical and mental functioning; the organizational level, necessitating access to aids and equipment and cross-sectorial collaboration; and the environmental level, adapting to climatic, seasonal, and geographic challenges.
This study contributes with knowledge that broadens the scope of reablement as an initiative to support aging in place to include outdoor environments. The tailored outdoor reablement model developed in this study addresses the complexity of aging in place in rural Arctic settings. The study underscores the importance of context-specific strategies that support older people in maintaining a healthy and meaningful life through active engagement with the outdoors.
在西方世界，随着人口老龄化，诸如恢复能力等旨在“就地养老”的干预措施日益受到关注。恢复能力项目致力于使老年人能够在家庭环境中保持独立。然而，尽管越来越多的研究表明参与户外环境有诸多益处，但恢复能力项目很少涉及户外活动。生活在北极农村地区的人们往往在文化、社会和情感上对户外场所有着强烈的依恋，将户外视为一个有意义的参与场所。与此同时，北极农村社区在促进户外活动方面面临着独特的障碍，如地理隔离、服务获取有限、恶劣的气候条件和季节变化。认识到这些挑战，我们的研究旨在量身定制一种适合北极农村环境的户外恢复能力模式。
本研究设计受协同设计方法的启发，通过在为期11个月的时间里举办研讨会、焦点小组和进行个人访谈来收集数据。挪威北极农村地区的三个自治市参与其中，共有35名参与者，包括接受恢复能力服务的老年人和医疗保健专业人员。社会生态理论支持主题数据分析。
该研究得出了一些经验，从而产生了一个全面的户外恢复能力实施模型，该模型满足了参与者在北极农村环境中所经历的特定需求。该模型包括个体层面，考虑身体和心理功能；组织层面，需要获取辅助工具和设备以及跨部门合作；环境层面，适应气候、季节和地理挑战。
本研究提供了相关知识，拓宽了恢复能力这一支持就地养老倡议的范围，将户外环境纳入其中。本研究开发的量身定制的户外恢复能力模型解决了北极农村地区就地养老的复杂性。该研究强调了因地制宜策略的重要性，这些策略通过让老年人积极参与户外来支持他们保持健康且有意义的生活。
