A 10-step participatory program for developing, implementing, and evaluating physical activity promoting actions in nursing homes in Germany.
Nursing homes
Participatory Integrated Counselling Approach
Physical Activity Promotion
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
09 Feb 2024
09 Feb 2024
Historique:
received:
17
11
2023
accepted:
10
01
2024
medline:
10
2
2024
pubmed:
10
2
2024
entrez:
9
2
2024
Statut:
epublish
Résumé
Since multidimensional barriers challenge nursing homes, a socio-ecological approach is needed for physical activity promotion in this setting. So far, little is known about how such an approach can be transferred into the successful development and implementation of PA-promoting actions together with stakeholders on-site. We aimed to investigate the actions and dimensions of PA-promoting actions and their sustainable implementation. To contribute to closing this gap, we present a 10-step program for co-developing and co-evaluating PA-promoting actions in nursing homes through an integrated counselling approach. We used a multiple case study approach that built upon manifold data sources, collected in 7 nursing homes over 3 years between 2021 and 2023. We collected fieldnotes and photologs from 14 future workshops (2 per home); 7 evaluation workshops (1 per home); 36 individual counsellings (2 sessions per resident), as well as 87 implementation protocols (action type and frequency), 11 evaluation questionnaires (changes among resources, cooperations, and collaborations); 7 goal attainment scales and 18 individual activity schedules. In addition, we retrieved and documented progress information at regular intervals by phone or email. With staff, residents, relatives, and volunteers, we co-developed 112 ideas for PA promotion; from which 54 ideas were implemented and integrated into everyday life, differentiated into "activities of daily living," "structured activities," and "activity-friendly environments."; 18 residents in 4 homes participated in individual counselling to develop individual activity schedules. Eighteen actions were rated as "(much) more successful than expected"; 10 "(much) worse than expected," and 23 "as successful as expected." Three actions were not evaluated. The participatory integrated counselling approach led to home-specific actions and promoted implementation into everyday life. The number and dimensions of actions implemented largely depended on the mission and vision of the respective home. The lack of staff could partially be compensated for by involving neighbourhoods, volunteers, and community organisations, such as local clubs. To effectively promote PA in nursing homes, a tailored approach considering structural conditions, locations, volunteer engagement, and organisational visions is essential. Long-lasting partnerships and low-threshold opportunities prove promising. Future research should delve into structural-level change processes and outcomes in this context.
Sections du résumé
BACKGROUND
BACKGROUND
Since multidimensional barriers challenge nursing homes, a socio-ecological approach is needed for physical activity promotion in this setting. So far, little is known about how such an approach can be transferred into the successful development and implementation of PA-promoting actions together with stakeholders on-site. We aimed to investigate the actions and dimensions of PA-promoting actions and their sustainable implementation. To contribute to closing this gap, we present a 10-step program for co-developing and co-evaluating PA-promoting actions in nursing homes through an integrated counselling approach.
METHODS
METHODS
We used a multiple case study approach that built upon manifold data sources, collected in 7 nursing homes over 3 years between 2021 and 2023. We collected fieldnotes and photologs from 14 future workshops (2 per home); 7 evaluation workshops (1 per home); 36 individual counsellings (2 sessions per resident), as well as 87 implementation protocols (action type and frequency), 11 evaluation questionnaires (changes among resources, cooperations, and collaborations); 7 goal attainment scales and 18 individual activity schedules. In addition, we retrieved and documented progress information at regular intervals by phone or email.
RESULTS
RESULTS
With staff, residents, relatives, and volunteers, we co-developed 112 ideas for PA promotion; from which 54 ideas were implemented and integrated into everyday life, differentiated into "activities of daily living," "structured activities," and "activity-friendly environments."; 18 residents in 4 homes participated in individual counselling to develop individual activity schedules. Eighteen actions were rated as "(much) more successful than expected"; 10 "(much) worse than expected," and 23 "as successful as expected." Three actions were not evaluated.
DISCUSSION
CONCLUSIONS
The participatory integrated counselling approach led to home-specific actions and promoted implementation into everyday life. The number and dimensions of actions implemented largely depended on the mission and vision of the respective home. The lack of staff could partially be compensated for by involving neighbourhoods, volunteers, and community organisations, such as local clubs.
CONCLUSION
CONCLUSIONS
To effectively promote PA in nursing homes, a tailored approach considering structural conditions, locations, volunteer engagement, and organisational visions is essential. Long-lasting partnerships and low-threshold opportunities prove promising. Future research should delve into structural-level change processes and outcomes in this context.
Identifiants
pubmed: 38336672
doi: 10.1186/s12889-024-17727-3
pii: 10.1186/s12889-024-17727-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
419Informations de copyright
© 2024. The Author(s).
Références
Auerswald T, Meyer J, von Holdt K, Voelcker-Rehage C. Application of activity trackers among nursing home Residents—A pilot and feasibility study on physical activity behavior, usage behavior, Acceptance, Usability and Motivational Impact. Int J Environ Res Public Health. 2020;6683(17).
Baert V, Gorus E, Guldemont N, De Coster S, Bautmans I. Physiotherapists’ perceived motivators and barriers for Organizing Physical activity for older Long-Term Care Facility residents. JAMDA. 2015;16(2015):371–9.
pubmed: 25669669
Schaeffer D, Buescher A. Möglichkeiten Der Gesundheitsförderung in Der Langzeitversorgung: Empirische Befunde Und Konzeptionelle Überlegungen. Z Gerontol Geriat. 2009;42(6):441–51.
doi: 10.1007/s00391-009-0071-3
Webber SC, Porter MM, Menec VH. Mobility in Older Adults: A Comprehensive Framework. The Gerontologist. 2010.
Banzer W, Füzéki E. Körperliche Inaktivität, Alltagsaktivitäten Und Gesundheit. Handbuch Bewegungsförderung Und Gesundheit. Bern: Huber; 2012. pp. 33–48.
Cirkel M, Juchelka R. Gesundheit Und Mobilität Im Alter. Public Health Forum. 2007;15(56):24–6.
Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J, An ecological approach to creating active living communities. Annu Rev Public Health. 2006;27(2006):297–322.
doi: 10.1146/annurev.publhealth.27.021405.102100
pubmed: 16533119
Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of physical activity: why are some people physically active and others not? Lancet Phys Act Ser Work Group. 2012;380:258–71.
Kalinowski S, Wulff I, Kölzsch M, Kopke K, Kreutz R, Dräger D. Physical activity in nursing homes— barriers and facilitators: a cross-sectional study. J Aging Phys Act. 2012;20:421–41.
doi: 10.1123/japa.20.4.421
pubmed: 22234875
Joseph A, Zimring C, Harris-Kojetin L, Kiefer K. Presence and visibility of outdoor and indoor physical activity features and participation in physical activity among older adults in Retirement communities. J Hous Elder. 2008;19(3–4):141–65.
Benjamin K, Edwards N, Guitard P, Murray MA, Caswell W, Perrier MJ. Factors that Infuence Physical Activity in Long-Term Care: perspectives of residents, Staff, and Signifcant others. Can J Aging. 2011;30(02):247–58.
doi: 10.1017/S0714980811000080
pubmed: 24650673
Parker C, Barnes S, McKee K, Morgan K, Torrington J, Tregenza P. Quality of life and building design in residental and nursing homes for older people. Ageing Soc. 2004;24(6):941–62.
doi: 10.1017/S0144686X04002387
Sallis JF, Johnson MF, Calfas KJ, Caparosa S, Nichols JF. Assessing perceived physical environmental variables that May influence physical activity. Res Q Exerc Sport. 1997;68(4):345–51.
doi: 10.1080/02701367.1997.10608015
pubmed: 9421846
Guerin M, Mackintosh S, Fryer C. Exercise class participation among residents in low-level residential aged care could be enhanced: a qualitative study. Aust J Physiother. 2008;54:111–7.
doi: 10.1016/S0004-9514(08)70044-8
pubmed: 18492002
Klenk J, Becker C, Rapp K. Heat-related mortality in residents of nursing homes. Age Ageing. 2010;39(2):245–52.
doi: 10.1093/ageing/afp248
pubmed: 20093248
Frahsa A, Altmeier D, John JM, Gropper H, Granz H, Pomiersky R, et al. I trust in Staff’s Creativity—the impact of COVID-19 lockdowns on Physical Activity Promotion in Nursing Homes through the Lenses of Organizational Sociology. Front Sports Act Living. 2020;2:589214.
doi: 10.3389/fspor.2020.589214
pubmed: 33345161
pmcid: 7739680
Resnick B, Petzer-Aboff I, Galik E, Russ K, Cayo J, Simpson M et al. Barriers and benefits to implementing a restorative care intervention in nursing homes. JAMDA. 2008;102–8.
Peryer G, Kelly S, Blake J, Burton JK, Irvine L, Cowan A, et al. Contextual factors influencing complex intervention research processes in care homes: a systematic review and framework synthesis. Age Ageing. 2022;51:1–16.
doi: 10.1093/ageing/afac014
Chen YM. Perceived barriers to physical activity among older adults residing in long-term care institutions. J Clin Nurs. 2010;19:432–9.
doi: 10.1111/j.1365-2702.2009.02990.x
pubmed: 20500283
Phillips LJ, Flesner M. Perspectives and experiences related to physical activity of elders in Long-Term-Care settings. J Aging Phys Act. 2013;21:33–50.
doi: 10.1123/japa.21.1.33
pubmed: 22715114
Brett L, Stapley P, Meedya S, Traynor V. Effect of physical exercise on physical performance and fall incidents of individuals living with dementia in nursing homes: a randomized controlled trial. Physiother Theory Pract. 2019.
Galik E, Resnick B, Hammersla M, Brightwater J. Optimizing function and physical activity among nursing home residents with dementia: testing the impact of function-focused care. Gerontologist. 2013;54(6):930–43.
doi: 10.1093/geront/gnt108
pubmed: 24092822
Logan P, Horne J, Allen F, Armstrong S, Clark A, Conroy S, et al. A multidomain decision support tool to prevent falls in older people: the FinCH Cluster RCT. Vol. Health Technology Assessment. Southampton: NIHR Journals Library; 2022.
Henskens M, Nauta IM, van Eekeren MCA, Scherder EJA. Effects of physical activity in nursing home residents with dementia: a Randomized Controlled Trial. Dement Geriatr Cogn Disord. 2018;2018(46):60–80.
doi: 10.1159/000491818
Lok N, Lok S, Canbaz M. The effect of physical activity on depressive symptoms and quality of life among elderly nursing home residents: Randomized controlled trial. Arch Gerontol Geriatr. 2017;70:92–8.
doi: 10.1016/j.archger.2017.01.008
pubmed: 28110207
Oswald WD, Gunzelmann T, Rupprecht R, Hagen B. Differential effects of single versus combined cognitive and physical training with older adults: the SimA study in a 5-year perspective. Eur J Ageing. 2006;3(2006):179–92.
doi: 10.1007/s10433-006-0035-z
pubmed: 28794762
pmcid: 5546372
Grönstedt H, Frändin K, Bergland A, Helbostad JL, Granbo, Puggaard L, et al. Effects of individually tailored physical and daily activities in nursing home residents on activities of Daily Living, physical performance and physical activity level: a Randomized Controlled Trial. Gerontology. 2013;59:220–9.
doi: 10.1159/000345416
pubmed: 23258191
Benjamin K, Rankin J, Edwards N, Ploeg J, Legault F. The social organization of a sedentary life for residents in long-term care. Nurs Inq. 2016;23(2):128–37.
doi: 10.1111/nin.12120
pubmed: 26314937
Forster A, Airlie J, Ellwood A, Godfrey M, Green J, Cundill B, et al. An intervention to increase physical activity in care home residents: results of a cluster-randomised, controlled feasibility trial (the REACH trial). Age Ageing. 2021;50:2063–78.
doi: 10.1093/ageing/afab130
pubmed: 34304268
pmcid: 8581372
Galik E, Resnick B, Holmes S, Vigne E, Lynch K, Ellis J, et al. A cluster randomized controlled Trial Testing the impact of function and behavior focused care for nursing home residents with dementia. JAMDA. 2021;22:1421–8.
pubmed: 33454311
Jeon Y, Tudball J, Nelson K. How do residents of aged care homes perceive physical activity and functional independence? A qualitative study. Health Soc Care Community. 2019;27:1321–32.
pubmed: 31149767
Koskela S, Jones F, Clarke N, Anderson L, Kennedy B, Grant R et al. Active residents in Care homes (ARCH): study protocol to investigate the implementation and outcomes of a whole-systems activity programme in residential care homes for older people. Physiotherapy. 2015.
Hurley M, Wood J, Smith R, Grant R, Jordan J, Gage H et al. The feasibility of increasing physical activity in care home residents: active residents in Care homes (ARCH) programme. Physiotherapy. 2019.
Thiel A, Sudeck G, Niess A, Eschweiler GW, Altmeier D, Haigis D, et al. BaSAlt — a mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes. Contemp Clin Trials Commun. 2021;23(2021):100828.
doi: 10.1016/j.conctc.2021.100828
pubmed: 34401598
pmcid: 8350408
Creswell JW. Qualitative inquiry and research design: Choosing among five approaches. 3rd ed. London: SAGE; 2013.
Schaefer I. Leitfaden Goal Attainment Scaling (Zielerreichungsskalen) [Internet]. Bielefeld; 2015 [cited 2023 Jul 19]. Available from: https://www.lzg.nrw.de/_php/login/dl.php?u=/_media/pdf/evalua_tools/leitfaden_gas_endversion.pdf .
von Unger H, Block M, Wright M. SMART-Methode [Internet]. Berlin; 2011 [cited 2023 Jul 19]. Available from: https://www.pq-hiv.de/system/files/document/SMART-Methode_Qualitaet_Aidshilfe_11491.pdf .
Whitlock E, Orleans T, Pender N, Allan J. Evaluating primary care behavioral counseling interventions. An evidence-based Approach. Am J Prev Med. 2002;22(4).
Schmid J, Molinari V, Lehnert K, Sudeck G, Conzelmann A. BMZI-HEA. Adaption Des Berner Motiv- Und zielinventars Im Freizeit- Und Gesundheitssport für Menschen Im höheren Erwachsenenalter. Z Für Gesundheitspsychologie. 2014;22(3):104–17.
doi: 10.1026/0943-8149/a000119
Lally P, van Jaarsveld CHM, Potts HWW, Wardle J. How are habits formed: modelling habit formation in the real world. Eur J Soc Psychol. 2010;40(2010):998–1009.
doi: 10.1002/ejsp.674
Verein Geschäftsstelle Qualitätsausschuss Pflege e.V. Expertenstandard nach § 113a SGB XI. „Erhaltung und Förderung der Mobilität in der Pflege. Oct, 2020.
Altmeier D, Thiel A, Frahsa A. ‘All we have to decide is what to do with the time that is given to us’ a Photovoice study on physical activity in nursing homes. Int J Env Res Public Health. 2021;18(10).
Sauter A, Curbach J, Rueter J, Lindacher V, Loss J. German senior citizens’ capabilities for physical activity: a qualitative study. Health Promot Int. 2019;1(2019).
Thiel A, Sudeck G, Niess A, Eschweiler GW, Hahn LS, Haigis D, et al. Bewegungsförderung Im Pflegeheim– Ein Praxisleitfaden. 100th ed. Tübingen: Universität Tübingen; 2023.