A qualitative study examining everyday frailty management strategies adopted by Polish stakeholders

Abstract

Background: Frailty is a multidimensional clinical state that is common in older age and can be managed through intervention. Strategies to manage frailty have not been previously explored with stakeholders in Poland. This may stem from misperceptions about the nature and malleability of frailty, which has resulted in it being viewed as a lower priority healthcare concern.Objectives: To explore stakeholders’ views to determine whether there are effective everyday strategies that they can adopt to reduce, reverse or prevent frailty.Methods: Semi-structured focus groups were conducted with five stakeholder groups (frail/pre-frail and robust older adults, health and social care professionals and family caregivers) in Poland (n = 44). Data was analysed using a reflexive thematic analysis approach.Results: Two themes were developed. The first emphasized both the positive everyday and more effortful strategies used by individuals to counter frailty; these included the adoption of healthy lifestyle behaviours, social engagement and shared experiences. Stakeholders perceived that older adults, even frail ones, might benefit from engaging in meaningful activities to build resilience against frailty. The second examined formal interventions delivered by health and social care professionals. Stakeholders noted the need to increase awareness of the malleability of frailty among professionals.Conclusion: Raising awareness of the malleability of frailty amongst health and social care professionals is critical. Further, information provision and personal support should be essential elements of health interventions aimed at older adults and family caregivers. Interventions to support resilience building in older adults should also be framed within a model of fostering self-efficacy.KEY MESSAGESStakeholders suggested that frailty should be viewed as a dynamic process with opportunities for treatment and improvement.Stakeholders believed that even frail older adults would benefit from engaging in meaningful but everyday activities to build resilience against frailty.Interventions designed to manage frailty should be carefully labelled to avoid stigma.

Managing frailty in an Irish primary care setting: A qualitative study of perspectives of healthcare professionals and frail older patients

“…The perceptions of frailty among HCPs are consistent with literature findings describing a dynamic, multi-dimensional geriatric condition, often triggered by illness or an acute event and which has the potential to be improved [19][20][21] . However, dissent was evident in views regarding specific markers for frailty and its' reversibility.…”

Care for frail older adults in the community: an integrative review

“…Regarding the measurement of frailty, five articles used the Clinical Frailty Scale 11,15,[22][23][24] , four used the Frailty Phenotype 14,23,25,26 , three used the Tilburg Frailty Indicator [27][28][29] , two used the Comprehensive Frailty Assessment Instrument 10.30 , five defined frailty without an instrument or objective measurement 4.14. [31][32][33] , one article used Prisma-7 6 and one the Edmonton Frailty Scale 34 . Of these, in two articles 14,23 there was the combination of more than one instrument.…”

“…This category addresses how older adults perceive frailty. The older adults' view of frailty is recurrent as a negative, harmful, rejected and associated label, with worsening health conditions, reduced participation and increased stigmatization 11,15,25,32 . A qualitative study on the perception and attitude of older adults towards frailty identified a discrepancy between operationalization in clinical contexts and the understanding of older adults 11 .…”

“…Even the most frail older adults display engagement in daily activities as a subsidy for building resilience against frailty 32 . The perspective of frail older adults also demonstrates the experience of anxiety, insecurity, uncertainty and fear regarding frailty, when daily life becomes precarious and challenging 18,38 .…”

Perceptions, attitudes and training needs of primary healthcare professionals in identifying and managing frailty: a qualitative study

“…Psychological and socioeconomic factors were perceived to have a major impact on frailty by PHC professionals in our study. Similarly, in another study examining everyday frailty management strategies by Polish stakeholders, professionals stated that frailty was often initiated by a lack of mental wellbeing, due to psychological hardships, social isolation and loneliness, and they suggested that frailty is caused by the psychological inability to cope with illness [ 23 ]. In a Swedish study exploring healthcare professionals’ views, frailty was perceived as a multidimensional concept with several interacting aspects.…”