Abstract
(1) Background: Despite high prevalence of physical inactivity and sedentariness among nursing home residents, research on the influence of environments on this topic remains scarce. This Photovoice study explores how structural and social environments relate to residents’ everyday physical activity (PA). (2) Methods: 27 residents, staff, and significant others conducted Photovoice in eight nursing homes in Germany to document factors facilitating or hindering PA. Photographs were discussed with the participants in eight focus groups and analysed using thematic analysis. (3) Results: 169 photographs (between 8 and 42per home) were categorized into three thematic groups: (1) ‘architectural challenges for PA promotion in nursing homes’; (2) ‘opportunities and limitations of using daily work equipment for PA promotion’; (3) ‘social incentives for PA promotion’. Photographs’ foci in the homes differed considerably between participant groups. Staff primarily chose environmental constructions and aids that they perceived to enable residents’ PA. Residents were more likely to express affections and emotions that would encourage them to be active. (4) Conclusions: PA promotion research in this setting should be sensitive to diverse perceptions of different stakeholder groups and existing power imbalances. Interventions are needed that integrate residents’ needs and train staff on how to consider residents’ perspectives.
Highlights
Published: 20 May 2021Sedentary behaviour represents a substantial health risk among older adults [1].Several studies have indicated a link between sedentary behaviour and health risks, and among those an increased risk for all-cause mortality, several chronic conditions, e.g., diabetes, different forms of cancer or cardiovascular diseases [2,3], and a decline in physical functions [4,5]
Sedentary behaviour represents a social norm in nursing homes, visible in procedures, structures, and behavioural patterns typical in this setting: residents sit during mealtimes, in most activities, and during conversations with relatives in the cafeteria
A very limited number of residents in nursing homes meets the recommendations for physical activity (PA) [11] by the World Health Organization [12]
Summary
Published: 20 May 2021Sedentary behaviour represents a substantial health risk among older adults [1].Several studies have indicated a link between sedentary behaviour (prolonged sitting time) and health risks, and among those an increased risk for all-cause mortality, several chronic conditions, e.g., diabetes, different forms of cancer or cardiovascular diseases [2,3], and a decline in physical functions [4,5]. Sedentary behaviour represents a substantial health risk among older adults [1]. Older adults living in nursing homes sit for long periods of time [6,7,8,9]. Sedentary behaviour represents a social norm in nursing homes, visible in procedures, structures, and behavioural patterns typical in this setting: residents sit during mealtimes, in most activities, and during conversations with relatives in the cafeteria. Sedentary time encompasses 90% of a nursing home resident’s day on average [10]. Given the importance of PA for maintaining health and preventing the progression of nursing home residents’ care dependency, increasing PA in everyday life is crucial for the reduction in sedentary time
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