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Factors affecting patient and nursing staff adherence to an integrated physical activity and nutritional intervention targeting functional decline on an acute medical ward: a qualitative study

Authors Andreasen J, Soendergaard LN, Holst M

Received 15 March 2018

Accepted for publication 29 May 2018

Published 10 August 2018 Volume 2018:12 Pages 1425—1435

DOI https://doi.org/10.2147/PPA.S168193

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Jane Andreasen,1,2 Lise Noerregaard Soendergaard,3 Mette Holst4

1Department of Physical and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark; 2Public Health and Epidemiology Group, Department of Health, Science and Technology, Aalborg University, Alborg, Denmark; 3Department of Health Promotion, Aalborg University Hospital, Aalborg, Denmark; 4Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital, Aalborg, Denmark

Background: Medical patients are particularly at risk of developing complications during and after hospitalization, due to impaired nutritional intake, physical inactivity, or immobilization. Evaluations of implementation studies on health-promoting interventions for medical patients in hospitals are scarce. The aim of this study was to identify factors affecting the adherence of patients and staff to an integrated physical activity and nutritional intervention on a medical ward.
Methods: Two focus group interviews were conducted: one with patients and another with staff. Three individual telephone interviews were conducted, as three patients were not available at the time of the group interview. An inductive thematic analysis was fundamental to the findings of the study.
Findings: Nine themes describe factors affecting adherence to integrated physical activity and nutrition intervention. Positive factors described by the patients were new knowledge and insight, and that they felt seen and believed in, which made a significant difference to their motivation. The nursing staff felt that the intervention provided important knowledge related to daily practice, prevented bad consciences due to time issues, and that they experienced happier and more active patients. Both staff and patients found that the approaches of the physiotherapist and the dietician positively changed their behavior, however staff members experienced limited resources as a barrier, and a lack of knowledge seemed to hinder full integration of the intervention. Patients reported that their illness situation, “being on their own,” and failure to negotiate a shared goal with the project staff were barriers to adherence.
Conclusions: Both the nursing staff and patients described positive experiences with the integration of a multifaceted health promotion intervention on physical activity and nutrition, however the nursing staff did not fully participate in the intervention and patient adherence differed; particularly, it tended to diminish when the patients were expected to act on their own.

Keywords: qualitative study, focus group interview, physical activity, nutrition, medical ward, barriers and facilitators, nursing staff and patients

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