“Both the Training and the Coffee Afterwards Mattered a Lot”—Factors of Importance in a Complex Intervention After Acute Hospitalization: Perspectives of Older Adults With Frailty

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RATIONALE: Older adults with frailty often face functional decline and limitations in doing everyday activities after being discharged from acute hospital admission affecting their health and quality of life. However, engaging them in training interventions can be challenging. AIMS AND OBJECTIVES: The aim of this study was to evaluate a combined training, nutrition, and social intervention from the perspective of newly discharged older adults with frailty participating in the intervention. METHODS: Semi-structured interviews were conducted with 14 participants of whom 10 were interviewed twice. Data were analyzed using a theory-based evaluation approach using a CIMO (Context-Intervention-Mechanism-Outcome) framework, followed by subsequent analysis of key elements. RESULTS: The study found that a skilled and person-centered physiotherapist was crucial to making strength training feasible for participants, resulting in adherence and effort in training, although continuation after the intervention was challenged by different aspects such as geography and social factors. Including goal setting and test results could potentially be relevant motivational tools, but goal setting was not implemented well, according to the experiences of the participants. The social part of the intervention was important for encouraging participation and the well-being of participants, as groups were cohesive, and participants were accepting of each other. Participants did not recall the nutritional intervention very well, and it seemingly only had a small impact. CONCLUSION: The physiotherapist's approach was essential for ensuring compliance and motivation for strength training for the older adults with frailty. Furthermore, fostering social cohesion within training groups could be important for promoting compliance and participant well-being. Factors influencing the continuation of training should be considered to ensure its long-term sustainability. Further research is warranted on incorporating nutritional guidance to enhance the impact of interventions for newly discharged older adults with frailty.

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