Barriers and facilitators of health self-management for the managers in long-term care facilities—a qualitative exploration based on Theoretical Domains Frame

Abstract

Background: Long-term care development has become a global demand. Nurse directors play a crucial role in managing a long-term care facility's quality and costs. In terms of health self-management, they face many challenges. Health self- management of nursing service quality managers, however, is relatively unknown. Methods: An interview outline were developed based on the framework of theoretical domains. 17 managers were selected for semistructured interviews using purposeful sampling and the snowball method. Nurses, nursing managers, and nursing directors participated in this study. Content analysis was conducted using transcripts of interview recordings, interview notes, reflection diaries, and other materials. Results: Data saturation was reached after the 17th face-to-face interview. Five barriers topics and related sub-topics were categorised in ten domains of the Theoretical Domains Framework. The main barriers to healthy self-management were: (1)Negative emotional influence, (2) Limited time resources, (3) Fetters from professional roles, (4) Lack of positive reinforcement, (5) Concerns about physical red flags. In the ten TDF domains, six facilitators topics and related sub-themes were also identified. These key facilitators included: (1) Highlight the benefits of good habits, (2) Intention to balance life and work, (3) The impact of being considered a benchmark, (4) Fragmented exercise management, (5) Find the team, (6)Wear sports electronic equipment. Conclusion: This study identified a wide range of barriers and facilitators of self-healthy behaviors in long-term care facilities. Managers may consider whether these barriers and facilitators operate in their work. To promote health self-management, provide ideas and references for future research.