B. Teng1,2, I.C.M. Rosbergen1, S.R. Gomersall1,3, A.L. Hatton1, S.G. Brauer1
1The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia, 2Singapore Institute of Technology, Health and Social Sciences, Singapore, Singapore, 3The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Australia
Background: Adherence to exercise is critical for falls prevention. Factors influencing older adults' adherence to exercise are well studied in Western countries, but may differ in the Southeast Asia setting due to differences in culture, health systems and economic status.
Purpose: To seek physiotherapists’ perspectives on patient adherence to exercise prescribed for falls prevention/risk reduction in the Singapore setting.
Methods: Three focus groups with purposely sampled physiotherapists (n=16; 10.5±4.5 years’ experience) were conducted. An inductive thematic analysis was performed to identify main themes by four independent researchers.
Results: Three main themes were identified: ‘it’s about the patient’, ‘delivery of the programme’, and ‘carer/family support and facilitation’. Physiotherapists believed that home exercise programmes should be tailored to suit each patients’ characteristics, health/cultural beliefs, and ability to prioritise time. They proposed physiotherapists need to create opportunities to facilitate exercise adherence among patients by setting expectations, building rapport, using patient-centred communication whilst recognising healthcare system and personal limitations.
Conclusions: Physiotherapists perceived that multiple factors, including characteristics of patients and the role of caregivers as facilitators in the delivery of programmes, influenced adherence to exercise prescription in older adults. Tailored individualised exercise programmes that have cultural relevance are important to promote exercise adherence in older Singaporeans to prevent and reduce risk of falls. These results support Singaporean patient perspectives. Future research should determine which factors are most relevant and effective in improving exercise adherence and how they should be selected for each patient.
Implications: To maximise older Singaporeans’ adherence to falls prevention exercise programmes, physiotherapists believe individualised approaches that cater to patient needs and beliefs are essential. Exercise adherence is multifactorial: physiotherapists should educate, build relationships, and offer practical and emotional support. Non-adherence is not merely a patient problem, it is also influenced by clinicians and the healthcare system and local contextual factors.
Funding acknowledgements: Seed funding from Singapore Institute of Technology
Keywords:
adherence
exercise
accidental falls
adherence
exercise
accidental falls
Topics:
Older people
Health promotion & wellbeing/healthy ageing/physical activity
Professional practice: other
Older people
Health promotion & wellbeing/healthy ageing/physical activity
Professional practice: other
Did this work require ethics approval? Yes
Institution: Singapore National Healthcare Group and The University of Queensland, Australia
Committee: DSRB and UQ Human Research Ethics
Ethics number: (2018/01372) and (HREC/2019001991)
All authors, affiliations and abstracts have been published as submitted.
