BARRIERS TO AND FACILITATORS OF ACUTE INPATIENTS’ PHYSICAL ACTIVITY FROM THE PATIENT PERSPECTIVE IN SWITZERLAND

A.D. Muster¹, G. Luder¹, B. Jutzi¹, P. Metzler¹, S. Klaus², J. Alper³, L. Krause⁴, B. Gubler-Gut⁵

¹Berne University Hospital, Insel Group, Department of Physiotherapy, Bern, Switzerland, ²Cantonal Hospital of Lucerne, Department of Medicine and Physiotherapy, Lucerne, Switzerland, ³Zurich Municipal Hospital, Department of Specialist Nursing and Therapies, Zurich, Switzerland, ⁴Cantonal Hospital Winterthur, Department of Therapies and Rehabilitation, Winterthur, Switzerland, ⁵School of Health Science, University of Applied Science ZHAW, Institut of Physiotherapy, Winterthur, Switzerland

Background: Patients physical activity level in hospitals is generally low, which is associated with hospital acquired disability and/or adverse events such as pneumonia and decubitus. A better understanding of barriers to and facilitators of physical activity from the patient perspective is needed to develop and implement successful interventions and to change patient behaviour. The patient perspective is highly relevant for planning and promoting physical activity interventions in acute care setting successfully.

Purpose: Based on Swiss health care system and culture, patient perspective on barriers to and facilitators of physical activity behaviour are not known yet. To help enhance physical activity during hospitalisation, this work aims to generate insights on influencing factors for patients’ physical activity behaviour during their hospitalisation.

Methods: A multicentre cross-sectional study about barriers to and facilitators of physical activity was performed in five Swiss-hospitals. A questionnaire was developed based on findings from other countries and pretested by physiotherapist experts.
Sixteen domains such as pain, fear of falling, individual motivation etc. were rated by patients on a seven point likert scale. Additionally, demographic variables, the activity level prior to admission, and the medical ward of current treatment, were collected. Descriptive analysis was performed showing relative and absolute frequency for each scale value of the domains rated. Depending on the respective rating, the domains were categorised as barrier or as facilitator.

Results: 204 patients from five hospitals in the German part of Switzerland completed the questionnaire. Response rate of the online questionnaire was 62%. The median age of the study population was 64 years. The gender distribution was 46% female and 54% male.
Tiredness (41%), pain (40%), and fear of falling (26%) were the main barriers to advanced physical activity during hospitalisation. The most important facilitators were goal setting (72%), individual motivation (71%), level of knowledge (71%), personalised exercise program (70%), and availability of auxiliary persons (55%).

Conclusions: This study has generated important findings on barriers to and facilitators of patients’ physical activity in Swiss hospitals. The results were in line with the international literature. Thus, international results on barriers and facilitators can generally be transferred to the Swiss health care system. It will be necessary to investigate how these barriers can be minimised on an individual and organisational level. This should be a target for future multi-component interventions to improve physical activity. The mentioned facilitators could be further strengthened by multidimensional and interprofessional concepts.

Implications: Interventions in clinical settings need to incorporate patient perspective on barriers to and facilitators of physical activity. Focus should be placed on recognising barriers and promoting symptom management with educational interventions, ideally delivered by an interprofessional treatment team. Patients' physical activity should be encouraged and strengthened with behavioural goals in daily hospital life. Physiotherapists should continue to work out individual exercise programmes with the patient to increase physical activity. Individual motivation should be seen as a patient's resource for physical activity.

Funding acknowledgements: This work was supported (not financial) by the interest group physiotherapy rehabilitation acute hospital Switzerland (IGPTR-A).

Keywords:
Physical activity
Patient perspective
Acute care

Topics:
Health promotion & wellbeing/healthy ageing/physical activity
Disability & rehabilitation

Did this work require ethics approval? No

Reason: The Cantonal Ethics Committee Zurich decided that the implementation of the project did not require approval (BASEC-Nr. Req-2021-00653). The project is not set in the area of human research.