Background
Methods
Study design
Participants
Procedure
Qualitative phase
Quantitative phase
Data analysis
Triangulation
Results
Participants
Seniors | PTs | GPs | HCNs | |
---|---|---|---|---|
Age (in years): mean (range) | 85 (65–88) | 55 (49–59) | 54 (49–60) | 50 (48–54) |
Gender (F/M) | 2/2 | 4/0 | 1/3 | 4/0 |
Area (urban/rural) | 2/2 | NA | 3/1 | 1/3 |
Practice (in years): mean (range) | NA | 32 (29–40) | 24 (14–36) | 10 (3.5–20) |
Seniors (n = 17) | GPs (n = 25) | HCNs (n = 12) | |
---|---|---|---|
Age (in years): mean (SD) | 79.7 (6.2) | 44.2 (9.1) | 53.9 (9.8) |
Gender n (%) | |||
Female | 13 (76.5 %) | 7 (17.5 %) | 11 (91.7 %) |
Male | 4 (23.5 %) | 33 (82.5 %) | 1 ( 8.3 %) |
Area | |||
Urban | 4 (23.5 %) | 12 (30 %) | 4 (16 %) |
Rural | 13 (76.5 %) | 28 (70 %) | 8 (32 %) |
Practice (in years): mean (SD) | NA | 10.8 (8.2) | 18.6 (11.1) |
Satisfaction with organization and processes of the FPP
Ratings from the survey | |||
---|---|---|---|
Seniors (n = 17) | GPs (n = 25) | HCNs (n = 12) | |
“yes” n (%) | “yes” n (%) | “yes” n (%) | |
Were you satisfied with the organization of the project? | 15 (88 %) | 16 (64 %) | 12 (100 %) |
Were you well informed before the start of the project? | 15 (88 %) | 16 (64 %) | 12 (100 %) |
Was the expenditure of time for project participation adequate? | 15 (88 %) | 25 (100 %) | 9 (75 %) |
Strength and benefits of the FPP
Ratings from the survey | |||
---|---|---|---|
Seniors (n = 17) | GPs (n = 25) | HCNs (n = 12) | |
“yes” n (%) | “yes” n (%) | “yes” n (%) | |
General and specific benefits perceived by seniors
| |||
Was the personal visit of the PT at your home helpful? | 13 (76 %) | NA | NA |
Did you recognize your own risk of falling due to the consultation by the PT? | 14 (82 %) | NA | NA |
Interests of seniors
| |||
Why did you participate? | |||
- GP or HCN recommended it to you. | 10 (59 %) | NA | NA |
- You recognized the risk of falling and have been motivated to do something against it actively. | 8 (47 %) | NA | NA |
- You have been interested in the degree of your own risk of falling. | 8 (47 %) | NA | NA |
- Because of your confidence in the HCN. | 6 (35 %) | NA | NA |
Further offers desired by seniors
| |||
Would you participate again if you had the possibility to do so? | 9 (53 %) | NA | NA |
PTs instructions followed by seniors
| |||
Did you investigate changes in your home after the consultation by the PT (i.e. fixating carpets or signalize door sills)? | 10 (59 %) | NA | NA |
Do you execute the instructed physical exercises received from the PT? | 10 (59 %) | NA | NA |
Do you carry out further measures such as group therapies or physiotherapy after the consultation by the PT? | 6 (35 %) | NA | NA |
Project benefits perceived by GPs and HCNs
| |||
Was the project useful to: | |||
- Prevent falls? | NA | 20 (80 %) | 10 (83 %) |
- Draw attention to the risk of falling? | NA | 21 (84 %) | 10 (83 %) |
- Detect sources of risk of falling? | NA | 18 (72 %) | 8 (67 %) |
Barriers to the inclusion of seniors
Ratings from the survey | |||
---|---|---|---|
Seniors (n = 17) | GPs (n = 25) | HCNs (n = 12) | |
“yes” n (%) | “yes” n (%) | “yes” n (%) | |
Lack of clarity regarding the aim of the project
| |||
What is the primary aim of the project (one answer): | |||
- The prevention of first falls. | NA | 20 (80 %) | 4 (33 %) |
- The prevention of further falls. | 6 (24 %) | 8 (67 %) | |
Procedural approach of GPs and HCNs
| |||
Did you know how to recruit seniors? | NA | 21 (84 %) | 12 (100 %) |
Did you use reminders (i.e. flyer, post-it…)? | NA | 4 (16 %) | 4 (33 %) |
Reasons of GPs for not recruiting seniors
| |||
Why did you not recruit any seniors? (n = 13) | |||
- No perceived need/refusal by senior. | NA | 10 (77 %) | NA |
Barriers to participation of seniors
Ratings from the survey | |||
---|---|---|---|
Seniors (n = 17) | GPs (n = 25) | HCNs (n = 12) | |
“yes” n (%) | “yes” n (%) | “yes” n (%) | |
Personal barriers for seniors
| |||
Had you participated in the project in case you had to pay for it? | 6 (35 %) | NA | NA |
Barriers for PTs to do asssessments and give instructions
| |||
Was it possible to perform physical assessments to obtain your risk of falling? | 10 (59 %) | NA | NA |
Barriers in interdisciplinary cooperation
Ratings from the survey | |||
---|---|---|---|
Seniors (n = 17) | GPs (n = 25) | HCNs (n = 12) | |
“yes” n (%) | “yes” n (%) | “yes” n (%) | |
Satisfaction with multidisciplinarity
| |||
Was it positive that the project was multidisciplinary? | NA | 9 (36 %) | 4 (33 %) |
Were you satisfied with the role allocation in the project? | NA | 15 (60 %) | 8 (67 %) |
Would you support the participation of e.g. rehabilitation centers or hospitals in the project? | NA | 9 (36 %) | 9 (75 %) |
Consideration of other professions’ opinions
| |||
Were you satisfied with the report received from PTs? | NA | 9 (36 %) | 6 (50 %) |
Did you partially or in general implement the recommendations by the PTs? | NA | 11 (44 %) | 7 (58 %) |
Information and processes
| |||
Do you think GPs were well informed? | NA | NA | 6 (50 %) |
Were your medical practice assistants informed? | NA | 8 (32 %) | NA |
Allocation of facilitators and barriers to context factors (individual/social/organizational/system)
Context/Point of interest | Individual | Social | Organizational | System |
---|---|---|---|---|
Satisfaction with organization and processes of the FFP | F: Satisfaction of HCNs and seniors with information and organization F: Satisfaction of GP with expenditure of time for project participation F: High satisfaction of physiotherapists with time allocated for the home visit
→ Highlight satisfaction of physiotherapists, HCNs and seniors
| B: Seniors and GPs not sufficiently informed
→ Information strategy tailored to target group
| F: FFP is funded B: Concerns for the future
→ Programme funding has to be granted for the future
| |
Strength and benefits of the FFP | F: Majority of seniors perceives general and specific benefits (such as insight into risk of falling); a concise majority executes instructed exercise and changes in their homes
→ Strengthen motivation and self-efficacy in seniors
| F: Potential of the FPP to prevent falls and draw attention to the risk of falling accepted by GP and HCNs
→ Highlight confidence of GPs and HCNs in potential effectiveness of the FFP
| ||
Barriers to the inclusion of seniors | B: Seniors don’t need or/and refuse participation
→ Highlight the importance that GP and HCNs invest efforts at convincibility, as they exert a great influence in their patients/clients.
→ Invest in information, awareness rising; self-efficacy, empowerment of seniors
| B: Lack of clarity regarding the aim and target group of the project; B: no systematic recruitment procedure
→ Invest in clear messages about the aim of the project and in clear recruitment instructions
| ||
Barriers to participation | B: Recruited seniors are not capable to do exercise or their home has already been checked for extrinsic risk factors
→ Invest in clear messages about the aim of the project and in clear recruitment instructions
| B: Taboo character B: Costs: Participation not for free
→ Programme funding has to be granted for the future
| ||
Barriers in interdisciplinary cooperation | B: Unsatisfactory information-flow
→ Invest in clear information, who should be informed when and how about the project
| B: Procedure reports
→ Invest in clear instructions how to proceed with reports
|