Wray, F orcid.org/0000-0001-9351-5019, Coleman, S orcid.org/0000-0002-1437-421X, Clarke, D et al. (3 more authors) (2022) Risk factors for manifestations of frailty in hospitalized older adults: A qualitative study. Journal of Advanced Nursing, 78 (6). pp. 1688-1703. ISSN 0309-2402
Abstract
Aims
To explore the experiences of older people and ward staff to identify modifiable factors (risk factors) which have the potential to reduce development or exacerbation of manifestations of frailty during hospitalization. To develop a theoretical framework of modifiable risk factors.
Design
Qualitative descriptive study.
Methods
Qualitative interviews with recently discharged older people (n = 18) and focus groups with ward staff (n = 22) were undertaken between July and October 2019. Data were analysed using directed content analysis.
Results
Themes identified related to attitude to risk, communication and, loss of routine, stimulation and confidence. Using findings from this study and previously identified literature, we developed a theoretical framework including 67 modifiable risk factors. Risk factors are grouped by patient risk factor domains (pain, medication, nutritional/fluid intake, mobility, elimination, infection, additional patient risk factors) and linked care management sub-domains (including risk factors relating to the ward environment, process of care, ward culture or broader organizational set up). Many of the additional 36 risk factors identified by this study were related to care management sub-domains.
Conclusion
A co-ordinated approach is needed to address modifiable risk factors which lead to the development or exacerbation of manifestations of frailty in hospitalized older people. Risk assessment and management practices should not be duplicative and, should recognize and address modifiable risk factors which occur at the ward and organizational level.
Impact
Some older people leave hospital more dependent than when they come in and this is, in part, due to the environment and process of care and not just the severity of their presenting illness. Many of the risk factors identified need to be addressed at an organizational rather than individual level. Findings will inform a programme of research to develop and test a novel system of care aimed at preventing loss of independence in hospitalized older people.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Wray, F , Coleman, S , Clarke, D et al. (3 more authors) (2022) Risk factors for manifestations of frailty in hospitalized older adults: A qualitative study. Journal of Advanced Nursing, 78 (6). pp. 1688-1703. ISSN 0309-2402, which has been published in final form at https://doi.org/10.1111/jan.15120. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Funding Information: | Funder Grant number National Inst for Health Research (NIHR) 12/177/04 |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Dec 2021 13:16 |
Last Modified: | 30 Nov 2022 01:13 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/jan.15120 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:181184 |