Physiotherapists' Perceived Motivators and Barriers for Organizing Physical Activity for Older Long-Term Care Facility Residents

Background: Information regarding factors that hinder or stimulate older adults in long-term care facilities (LTCF) for being physically active is available in the literature, but much less is known regarding perceived motivators and barriers among physiotherapists (PTs) to organize physical activity (PA) in LTCF. Objective: The main purpose of this study was to examine factors influencing PTs to organize PA in LTCF for older adults. A secondary goal was to examine the PTs' knowledge about and their barriers at the PA guidelines for older adults of the World Health Organization (WHO). Methods: A mixed qualitative and quantitative study was carried out using semistructured interviews (n = 24) followed by an online survey (n = 254). As a frame the social-ecological model (McLeroy) was used, distinguishing factors at the intrapersonal, interpersonal, and community level. Results: In the qualitative component the PTs reported 41 motivators and 35 barriers for organizing PA in LTCF. The survey revealed that although the majority of the respondents (71%) are convinced of the usefulness of PA in LTCF, 84% are not familiar with the WHO-guidelines. Seventy-five percent of the respondents believe that the WHO-guidelines are not feasible for LTCF-residents. The strongest motivators on the intrapersonal level were maintaining the independence of the residents (98%), reducing the risk of falling (98%), and improving the physical (93%) and psychological (90%) wellbeing of LTCF-residents. The social interaction among LTCF-residents (91%) during PA was the strongest motivator on the interpersonal level. Motivators on the community level are the belief that PA is the basis of their physiotherapeutic work (89%) and that offering varied activities avoids PA becoming monotonous (71%). Barriers on the intra-and interpersonal level were of less influence. On the community level, they felt hindered to organize PA because of lack of time (38%) and the overload of paperwork (33%). Conclusions: This study described different motivators and barriers for PTs to organize PA in LTCFs. The majority does not know the WHO guidelines regarding the amount of PA for adults aged 65 and over. Although they agree that the guidelines are useful, they believe the guidelines are not feasible. There is a need for a multifactorial strategy that acts on different determinants in order to stimulate PA in LTCF. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.