Dataset Information

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities.

ABSTRACT: Appropriate goal setting for frail older adults is important because it drives effective rehabilitation. However, more insights into the types and degrees of frailty and goal-setting trends should be obtained. We conducted a multicenter prospective study to qualitatively examine the relation between each frailty domain (physical, social, and cognitive) and the goals of 201 subjects (median age: 79, 43.8% male) who began rehabilitation at a long-term care prevention facility. Goal setting was determined by the specific, measurable, achievable, relevant, and time to goal (SMART) framework up to three months, categorized according to the International Classification of Functioning, Disability, and Health. The results showed that approximately 90% of the subjects had frailty in at least one domain, and about half had frailties in two or more domains. In total, 176 (87.6%) subjects had goals corresponding to activities and participation. The tendency to set goals to improve mobility was confirmed when the number of overlapping frailties was high, especially those in the physical and social domains. Those with milder frailties were more likely to establish goals targeting improvements in community, social, and civic life. These findings will lead to the development of practical goal-setting guidelines for frail older adults.

SUBMITTER: Yamashita M

PROVIDER: S-EPMC9865582 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities.

Yamashita Masashi M Mashizume Yuki Y Yama Kento K Sasaki Shun S Uehara Daiki D Kamiya Kentaro K

International journal of environmental research and public health 20230116 2

Appropriate goal setting for frail older adults is important because it drives effective rehabilitation. However, more insights into the types and degrees of frailty and goal-setting trends should be obtained. We conducted a multicenter prospective study to qualitatively examine the relation between each frailty domain (physical, social, and cognitive) and the goals of 201 subjects (median age: 79, 43.8% male) who began rehabilitation at a long-term care prevention facility. Goal setting was det ...[more]

PMID: 36674369

Similar Datasets

Project description:BackgroundAlthough goal setting and goal management (GSGM) is a key component of chronic disease management and rehabilitation practice, there is currently no widely used evidence-based intervention system available. This paper describes the theoretical underpinnings and development of a new intervention called MyGoals. MyGoals is designed to guide occupational therapy (OT) practitioners to implement theory-based, client-engaged GSGM for adults with chronic conditions in community-based OT rehabilitation settings.MethodsWe first developed a planning team with two adults with chronic conditions, two clinicians, and two researchers. As a collaborative team, we co-developed MyGoals by following Intervention Mapping (IM) steps 1-4 and incorporating community-based participatory research principles to ensure equitable, ecologically valid, and effective intervention development. In the first step, the planning team conducted a discussion-based needs assessment and a systematic review of current GSGM practice to develop a logic model of the problem. In the second step, the planning team identified performance objectives, intervention target personal determinants, and change objectives, and created a logic model of change and matrics of change objectives. In the third step, the planning team designed MyGoals. Lastly, in the fourth step, the planning team produced, pilot-tested, and refined MyGoals.ResultsThe ultimate goal of the MyGoals intervention is to enable clients to achieve personally meaningful rehabilitation goals. The planning team identified four target determinants (e.g., self-efficacy), six intervention activities (e.g., Education, Reflection, Find My Goals, Make My Goals, Make My Plans, My Progress), eight performance objectives (e.g., List potential goals), and 26 change objectives (e.g., Understand the importance of GSGM). Two pilot tests indicated that MyGoals is feasible for clients and identified areas for improvement. Based on the feedback, minor refinements were made to the MyGoals intervention materials.ConclusionsWe completed rigorous and collaborative IM to develop MyGoals. Establishing the theoretical and developmental foundation for MyGoals sets the groundwork for high-quality, evidence-based GSGM. Future studies on effectiveness and implementation are necessary to refine, translate, and scale MyGoals in rehabilitation practice.

Project description:BackgroundThe majority of institutionalized older adults do not exercise, despite the many health benefits. The current study investigated whether a framed intervention can motivate older adults in assisted living facilities (ALFs) to perform functional resistance exercises. It was hypothesized that repeated framing of these exercises from a prevention perspective (e.g., to avoid health deterioration) would nurture the development of controlled motivation to exercise. By contrast, repeated framing of the exercises from a promotion perspective (e.g., to improve health) was expected to lead to higher exercise frequencies over time and to foster the development of autonomous motivation. Autonomous motivation was hypothesized to predict higher exercise frequencies over time.MethodsA total of 111 residents, aged 65+ years (M = 81.4 y; SD = 6.4 y) participated in the study. These participants received a printed three-week individual program with a standard session of eight functional resistance exercises. Four weekly sessions were recommended. Participants were semi-randomized into three framing conditions: neutral (i.e., control), prevention or promotion. They received condition-specific written and spoken messages about the exercises at the beginning of the intervention. The spoken messages were repeated at the end of each week. Participants kept a checklist with their weekly exercise frequency and at corresponding points in time, they completed a questionnaire about their levels of autonomous and controlled motivation to exercise.ResultsAcross conditions and time points, the exercise frequencies and the levels of autonomous motivation were generally high, whereas the levels of controlled motivation were generally low. Contrary to the expectations, there were no significant framing effects. However, higher levels of autonomous motivation predicted higher exercise frequencies. During the final exercise week, this was especially the case for intrinsic regulation (i.e., for the sake of the activity).ConclusionsThis study indicates that older adults who live in ALFs can be motivated to perform functional resistance exercises. Given the importance of intrinsic regulation, we advise to create an exercise atmosphere that allows for immediate, positive experiences and in which the basic psychological needs for autonomy, competence and relatedness are satisfied.Trial registrationClinicalTrialsID NCT02780037 (23 February 2016).

Project description:Background and objectivesRegular resistance exercise (RE) showed a promising effect in reducing frailty in older adults. However, the participation of RE among this population remains low. This study was, therefore, aimed at developing a complex intervention tailored to community-dwelling frail older adults in China to promote participation in RE and reduce frailty ultimately.Research design and methodsUsing a multimethods qualitative study design, this study included 2 parts: (1) a qualitative study was performed to explore barriers and facilitators for participation in RE among frail older adults through stakeholder interviews. The interview was guided by the comprehensive framework of implementation research; (2) two rounds of expert consultation, guided by the social cognitive theory, were conducted to identify the key barriers and facilitators, and corresponding implementation strategies for promoting participation in RE. A complex intervention was developed accordingly.ResultsInterviews were conducted with 16 frail older adults (mean age = 72.9) and 10 community workers (mean working years = 11.2). A total of 10 barriers and 16 facilitators were identified; safety concerns, decline in physical function, and lack of knowledge were frequently mentioned barriers, while health needs, social support, and professional guidance were common facilitators. Then 10 experts (mean working years = 20.9) were consulted to determine the main barriers and facilitators, and a list of corresponding implementation strategies was developed subsequently. Thus, a tailored complex intervention delivered by community workers in the community setting, including the core component of "group elastic-band RE," and supplementary components of "community education, feedback, goal setting, and reinforcement guidance" was developed.Discussion and implicationsThis study constructed a list of key barriers and facilitators as well as corresponding implementation strategies for promoting participation in RE among community-dwelling frail older adults. A tailored complex intervention was developed accordingly, which will facilitate the management of frail older adults in the Chinese community setting.

Project description:BackgroundExercise is effective in preventing frailty status in older adults, but the effect of an exercise program based on Wellness Motivation Theory (WMT) on the frailty status, self-efficacy for exercise, and quality of life for older adults with pre-frailty remains unclear. Our objective was to examine the efficacy of a multicomponent exercise program based on WMT on frailty status, self-efficacy, and quality of life among pre-frail older adults.MethodsThis was a randomized controlled trial of pre-frail older adults aged from 60 years to 85 years. Participants in the intervention group performed exercise three times a week for 24 weeks, once at a community health service station instructed by two researchers and two times at home. Participants in the control group were given one-time advice on physical activity. The assessor was the only one blinded. The primary outcome was the reversal rate of pre-frailty. The secondary outcomes included self-efficacy and quality of life.ResultsOne hundred and forty-four participants were randomized into two groups (n = 72 in the intervention group and n = 72 in the control group) and analyzed. After 24 weeks, the proportion of pre-frailty was significantly lower in the intervention group than in control (31.8% versus 74.6%, P < 0.001). The absolute risk reduction was 42.8% [95% CI, 25.1-57.1]. In the 8th week and the 24th week, the frailty score of the intervention group was significantly lower than that of the control group. There were significant improvements in self-efficacy at week 2, week 8, and week 24. In weeks 8 and 24, participants in the intervention group reported a higher quality of life than the control group. There were no exercise-related injuries or falls among the participants.ConclusionsThe exercise intervention based on WMT for pre-frail older adults could reverse pre-frailty, increase self-efficacy for exercise, and improve the quality of life in older Chinese.Study registration detailsThis study was registered in www.Clinicaltrialsgov on the 25th of July, 2024, with the identifier NCT06519695.Reporting methodThe Consolidated Standards of Reporting Trials (CONSORT) checklist was used in this study for properly reporting how the randomized trial was conducted.

Project description:BACKGROUND:Physical frailty, characterized by reduced physiologic complexity and ability to cope with stressors, is closely associated with cognitive impairment, which increases the risk of poor clinical outcomes. To better capture the association between frailty and cognitive impairment, a new construct, cognitive frailty, has been proposed. Cognitive frailty is a clinical condition characterized by the simultaneous presence of physical frailty and cognitive impairment. There is little evidence on the relationship between physical frailty and cognition, as well as cognitive frailty, in Chinese older adults. We aimed to elucidate whether physical frailty is associated with cognitive impairment in an older Chinese population. METHODS:Data were obtained from the China Comprehensive Geriatric Assessment Study. The sample comprised 3202 community-dwelling adults, aged 60 years and older, from seven Chinese cities. Physical frailty was assessed using a modified, four-item version of the Fried criteria, according to frailty phenotype. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). RESULTS:The prevalence of physical frailty, prefrailty, cognitive impairment, and cognitive frailty was 9.9, 33.9, 7.5, and 2.3%, respectively (weighted: 8.8, 33.8, 6.5, and 2.0%). The prevalence of the combination of prefrail/frail and cognitive impairment was 5.1% (weighted 4.5%). Frail participants performed worse on global cognition and all cognitive domains than robust and prefrail participants. The MMSE total score was positively correlated with walking speed and negatively correlated with age and frailty. A multivariate logistic regression revealed that after adjusting for age, gender, education level, living area, and chronic diseases, frailty, exhaustion, slowness, and inactivity were significantly associated with poor global cognition. CONCLUSIONS:The standard prevalence of physical frailty, prefrailty, cognitive impairment, and cognitive frailty in community-dwelling older adults in China was 8.8, 33.8, 6.5, and 2.0%, respectively. Frailty, exhaustion, slowness, and inactivity were significantly associated with poor global cognition.

Dataset Information

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities.

Publications

Protocols and Features of Goal-Setting-Based Intervention for Frail Older Adults in Community Exercise Facilities.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets