Meyer Claudia, Lee Den-Ching A, Callisaya Michele, Taylor Morag E, Lawler Katherine, Levinger Pazit, Hunter Susan, Mackey Dawn C, Burton Elissa, Brusco Natasha, Haines Terry, Ekegren Christina L, Crabtree Amelia, Hill Keith D
Bolton Clarke Research Institute, Forest Hill, VIC 3131, Australia.
Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, VIC 3199, Australia.
Nurs Rep. 2024 Dec 24;15(1):2. doi: 10.3390/nursrep15010002.
Promoting physical activity among people living with dementia is critical to maximise physical, cognitive and social benefits; yet the lack of knowledge, skills and confidence among health professionals, informal care partners and people with dementia deters participation. As the initial phase of a larger feasibility study, co-design was employed to develop a new model of community care, to facilitate the physical activity participation of older people living with mild dementia.
Co-design methodology was utilised with nine stakeholders (with experience in referring to or providing physical activity programs and/or contributing to policy and program planning) over three workshops plus individual interviews with four care partners of people with dementia. Insights were gathered on the physical activity for people with mild dementia, referral pathways were explored and 'personas' were developed and refined. Materials and resources to support exercise providers and referrers to work effectively with people with mild dementia were finalised.
Three 'personas' emerged from the co-design sessions, aligned with stages of behaviour change: (1) hesitant to engage; (2) preparing to engage; and (3) actively engaged. Referral pathway discussions identified challenges related to limited resources, limited knowledge, access constraints and individual factors. Opportunities were classified as using champions, streamlining processes, recognising triggers for disengagement, influencing beliefs and attitudes, and means of communication.
This study captured the views of physical activity referrers and providers and informal care partners in an inclusive and iterative manner. The use of co-design ensured a robust approach to facilitating participation in formal and informal physical activity options for people living with mild dementia. This study has provided the necessary framework from which to develop and test training and resources for the next stage of intervention (a feasibility trial) to improve physical activity participation for people with dementia.
促进痴呆症患者的身体活动对于最大限度地实现身体、认知和社会效益至关重要；然而，卫生专业人员、非正式护理伙伴和痴呆症患者缺乏知识、技能和信心阻碍了参与。作为一项更大规模可行性研究的初始阶段，采用了联合设计来开发一种新的社区护理模式，以促进轻度痴呆症老年人的身体活动参与。
在三个研讨会中与九名利益相关者（具有推荐或提供身体活动计划和/或参与政策和计划规划的经验）以及对四名痴呆症患者的护理伙伴进行了个人访谈，采用联合设计方法。收集了关于轻度痴呆症患者身体活动的见解，探索了转诊途径，并开发和完善了“人物角色”。确定了支持运动提供者和转诊者与轻度痴呆症患者有效合作的材料和资源。
联合设计会议产生了三个“人物角色”，与行为改变阶段一致：（1）犹豫参与；（2）准备参与；（3）积极参与。转诊途径讨论确定了与资源有限、知识有限、获取限制和个人因素相关的挑战。机会被分类为利用倡导者、简化流程、识别脱离接触的触发因素、影响信念和态度以及沟通方式。
本研究以包容和迭代的方式收集了身体活动转诊者、提供者和非正式护理伙伴的观点。联合设计的使用确保了一种稳健的方法，以促进轻度痴呆症患者参与正式和非正式的身体活动选择。本研究提供了必要的框架，据此开发和测试下一阶段干预（可行性试验）的培训和资源，以提高痴呆症患者的身体活动参与度。
