Lessons Learned and Implications of Function Focused Care based Programs of Various Nursing Care Settings: A Thematic Synthesis

Abstract

Background and Objective: Function-Focused Care (FFC) aims to optimize daily functioning of older people by changing clinical nursing practice of care professionals. Recently, three multicomponent FFC-programs were implemented in the Dutch home, nursing home, and hospital care setting. Process evaluations were conducted including eight focus groups with 45 care professionals and one focus group with 8 involved researchers. The objective was to synthesize findings and provide lessons learned and implications to optimize future programs. Methods: A thematic synthesis was conducted of nine focus groups using the COREQ checklist. Deductive coding analysis was applied using Nvivo Software. Results: Six themes emerged from the focus groups: four related to those components to be preserved in future programs (policy and environment, education, goal setting, and coaching), and two related to the impact of FFCprograms, and its facilitators and barriers in practice. FFC-related policy and a facilitating environment were considered prerequisites to successfully implement FFC. Education sessions could be improved by being more interactive, containing sufficient behavior change components, and tailoring its content to participants’ needs. Goal setting was poorly delivered and should receive more attention in practice. Coaching was considered pivotal to consolidate FFC in practice. Conclusions and relevance to clinical practice: We suggest to develop an advanced FFC-program for various care settings, which allows for tailoring to setting-specific elements and requirements of participants. Lessons learned include addressing all FFC-components jointly, including a comprehensive interactive educational component that primarily focusses on behavior change in care professionals. Managers should support FFC in practice by ensuring sufficient time and staff resources.