Experiences of supporting older persons in completion of an exercise and nutrition intervention: an interview study with nursing home staff

S Vikström,G Faxén-Irving,T Cederholm,Å Seiger,E Franzén,A.-M Boström,H K Grönstedt

doi:10.1186/s12877-021-02039-7

Abstract

BackgroundThe interactions between nursing home (NH) staff and their residents are crucial not only for the atmosphere at the NH but also for achieving care goals. In order to test the potential effects of daily physical activities (sit-to-stand (STS) exercises) combined with oral nutritional supplementation (ONS), a randomized intervention trial (the Older Person’s Exercise and Nutrition (OPEN) Study) was performed in NH residents. One aspect of the study was to interview and report the NH staff’s experiences of supporting the residents in fulfilling the intervention.MethodsIn this qualitative study, individual and focus group interviews were performed in eight NH facilities with NH staff who had assisted residents in performing the 12-week ONS/STS intervention. An interview guide developed for this study was used to assess staff experiences of the intervention and its feasibility. The transcribed interviews were analyzed inductively following a constant comparative method and with input from experts in the area, described in Grounded Theory as a reliable technique for researchers to form theory and hypothesis in unexplored areas.ResultsThree main themes relating to the health-promoting intervention emerged. These included: 1) insights into attitudes towards health in general and NH care specifically; 2) intervention-related challenges, frustrations and needs, and 3) aspects of collaboration and opportunities.The overarching hypothesis derived from the analysis reads: A health-promoting intervention such as the OPEN-concept has great potential for integration into NH life if a combined empathic and encouraging attitude, and a structure to keep it sustainable, are in place.ConclusionsNH staff experienced the health-promoting intervention as a potentially positive concept, although it was suggested that it works best if introduced as a general routine in the unit and is integrated into the daily planning of care.Trial registrationClinicalTrials.govIdentifier: NCT02702037. Date of trial registration February 26, 2016. The trial was registered prospectively

Highlights

The interactions between nursing home (NH) staff and their residents are crucial for the atmosphere at the NH and for achieving care goals
With reference to the above hypothesis, we identified that staff motivation is a crucial factor in the intervention’s success when integrating a health-promoting intervention such as the Older Person’s Exercise and Nutrition study (OPEN) concept
The combined intervention of high protein oral nutritional supplementation and exercise is experienced by nursing staff as a positive concept

Summary

Introduction

The interactions between nursing home (NH) staff and their residents are crucial for the atmosphere at the NH and for achieving care goals. One aspect of the study was to interview and report the NH staff’s experiences of supporting the residents in fulfilling the intervention. Nursing home (NH) residency is commonly associated with a passive lifestyle as most of the residents spend their daily lives in a seated or lying position. This passive lifestyle results in lower physical capacity regarding balance, walking speed and aerobic endurance [1]. A NH study in Sweden indicated that, for example, balance can be improved by training, and that reduced physical exercise can lead to a rapid decline in fitness in less than 3 months [4]. Admission to a NH is strongly related to decrease in mobility, which in turn affects quality of life [2, 5]

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