Health Self-management Barriers and Facilitators in Long-term Care Facilities: A Qualitative Study

Objectives: Long-term care development has become a global demand. Nurse directors play a crucial role in managing a long-term care facility's quality and costs. Health self -management of nursing service quality managers, however, is relatively unknown. In this study, we aimed to assess determinants of longterm care facilities' (LTCF) quality care, including barriers and facilitators to health self -management as reported by service quality managers and their recommendations for further intervention in healthcare. Methods: An interview outline is developed based on the framework of theoretical domains. Using purposive sampling, we selected 17 managers in LTCFs engaged with the quality of nursing services for semi -structured interviews. We conducted thematic analysis using transcripts of interview recordings, interview notes, reflection diaries, and other materials. Results: Five major barriers were associated with the 10 domains of the theoretical domain framework: (1) negative emotional influence, (2) limited time resources, (3) fetters from professional roles, (4) lack of positive reinforcement, and (5) concerns about physical red flags. Six main facilitators were associated with the 10 domains of the theoretical domain framework: (1) highlight the benefits of good habits, (2) intention to balance life and work, (3) the impact of being considered a benchmark, (4) fragmented exercise management, (5) finding the team - for social support, and (6) wearing sports electronic equipment. Conclusion: A variety of factors impair self -health behaviors of nurse directors in LTCFs, and their mechanisms are complicated.