Perceptions of community-dwelling older people on ProPA -home-based rehabilitation and physical activity

Abstract

The purpose of this Master’s thesis study was to qualitatively explore the perceptions of the participants of ProPA -project on the home-based rehabilitation program and to investigate the barriers and facilitators of adhering to physical activity related rehabilitation. There is a gap in existing research concerning the perceptions of older adults with musculoskeletal injuries on their home-based rehabilitation experiences and perceived barriers and facilitators on physical activity tasks related to rehabilitation. The present study strived to contribute to that void by representing an interpretation on ageing home-based rehabilitation participants’ experiences and perceptions of their barriers and facilitators of physical activity related to the intervention. Bringing the voice of older adults into the planning of person-centered rehabilitation programs may lead to implementation of more effective rehabilitation strategies.

The data was collected as semi-structured face-to-face interviews from participants (n=5) of ProPA-project after the 6-month follow-up of the research intervention. Data was analysed using Interpretive phenomenological Analysis.

The results of this study suggest that the participants perceived the ability to stay mobile, to take care of oneself and everyday chores, to build muscle strength and to enhance motivation to stay active, as the most important benefits of rehabilitation. Having a human contact was perceived as one of the most valuable aspects of the rehabilitation program. Seven major themes with multiple sub themes of barriers and facilitators of adhering to physical activity related rehabilitation emerged from the data set. The major themes were identified as physiological, emotional, and learned factors, and factors related to social support, the physical environment, healthcare, and rehabilitation. A bilateral nature of function enhancing (facilitator) and disability maintaining (barrier) aspects of the same phenomena could be perceived in the themes.

Previous and comorbid health problems, pain, and fear of falling emerged as prominent barriers to physical activity related rehabilitation tasks in this study, which supports previous research on older people’s PA and rehabilitation determinants. Yet, the perception of not being heard by healthcare and rehabilitation personnel over these issues was a unique and recurrent factor across the study. Social support factors and trust towards professionals were perceived facilitators, suggesting that emphasis on social support approaches with a psychological behavior change focus can facilitate participation in rehabilitation tasks that are PA related. The results also underline the importance of individual tailoring in different levels of planning of rehabilitation designs.

Further research on the effects of integrating psychological behavior change techniques, and functional assessment methods, to physical activity related home-based rehabilitation, are recommended. Furthermore, investigating the influence of psychological emotion regulation or acceptance techniques on fear of falling are suggested. Moreover, research on physical activity and mobility of older adults living at home compared to other living options is needed.