The perspectives of health professionals in Denmark on physical exercise and nutritional interventions for acutely admitted frail older people during and after hospitalisation

Abstract

Frailty is associated with several negative health outcomes, such as readmissions to hospital. Physical exercise, including strength training and nutritional optimisation are essential parts of documented interventions for frail older people in preventing or minimising frailty. Further knowledge is necessary to ensure feasible and successful interventions encompassing both physical exercise and nutritional optimisation. The aim of this qualitative study was to investigate the perspectives of health professionals on which factors may affect interventions, including physical exercise and nutrition, for frail older people in relation to discharge after acute admission to hospital. Data were gathered in two semi-structured focus groups, totalling 11 health professionals working with frail older people in a Danish university hospital and a municipality. The sampling of participants was purposive and the interviews were facilitated by a semi-structured interview guide. Data were analysed applying a six-step datadriven thematic analysis. Findings showed that health professionals experienced working with nutritional optimisation and physical exercise within a frail older population as challenging, and they mostly used extrinsic motivation, such as incentives, deals or intensified messages, as external factors in their approaches as to affect specific behaviours. A discourse on the importance of activity-and functional training was prevalent, while diverging perspectives were present in relation to strength training, which was considered less feasible or meaningful in a community-dwelling setting. Organisational barriers such as communication between sectors and time limitations affected negatively the work of health professionals, as they hindered coordinated and adequate interventions from the health professionals. Findings and theory-based knowledge indicate that health professionals should work towards a person-centred approach, which includes goal-setting, to improve physical training and nutritional interventions for frail older people. Furthermore, health professionals | 2141

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

“…A total of 4334 studies were screened based on titles and abstracts. Of the 143 articles that were assessed as full texts, 45 were identified for inclusion [ 11 , 14 – 16 , 18 – 21 , 36 – 39 , 42 – 74 ]. An additional 11 studies were included after hand-searching the reference lists of included studies [ 17 , 75 – 84 ], resulting in a total of 56 included studies [ 11 , 14 – 21 , 36 – 39 , 42 – 84 ].…”

Perspectives of health professionals on physical activity and sedentary behaviour in hospitalised adults: A systematic review and thematic synthesis

“…Forty studies were included in the review, with study characteristics for these presented in Table 1, and more detailed characteristics summarised in Supplemental File 3. Twenty-five of the studies explored perspectives from multiple disciplines, 31,47–70 and the remaining 15 included participants from a single profession only. 71–85 Overall, studies explored the perspectives of a combined 1408 health professionals working across acute hospitals, 31,48–52,54,57–59,61–65,67–74,…”

“…Twenty-five of the studies explored perspectives from multiple disciplines, 31,47–70 and the remaining 15 included participants from a single profession only. 71–85 Overall, studies explored the perspectives of a combined 1408 health professionals working across acute hospitals, 31,48–52,54,57–59,61–65,67–74,76,78,80,82–84 rehabilita...…”

Fear of Falls and Frailty: Cause or Consequence or Both?

“…These include, but are not limited to and the fear of falling may similarly help to increase independence, confidence and energy [7,37,50]. Further efforts directed towards reducing harmful medications, improving calcium and vitamin D status, diabetes control, and desirable home adaptations [44,51,52], efforts to provide a person-centered and goal setting approach [48] and encouraging social engagement [53] will also likely prove helpful, as will proactive careful screening to identify at risk adults [38,53,54]. Programs that try to encourage personal development and growth, in spite of aging, and physical, social, emotional, and economic environments that foster wellbeing and active aging appear highly promising as well [55].…”

“…approaches and occupational therapy strategies designed to improve muscle and bone mass and function believed to help reduce both frailty as well as falls risk[39,[44][45][46][47]. As well as structured exercises, strength training, or physical activities that involve functional training and coordination exercises[48], structured nutrition interventions[49], and/or cognitive behavioral intervention approaches to reduce frailty, as well as falls Vol-Issue 2 Pg. no.-Ray Marks.…”