The University of Southampton
University of Southampton Institutional Repository

A mixed methods evaluation of outcomes and experiences of older adults identified as being at risk of frailty and attending a frailty-prevention group

A mixed methods evaluation of outcomes and experiences of older adults identified as being at risk of frailty and attending a frailty-prevention group
A mixed methods evaluation of outcomes and experiences of older adults identified as being at risk of frailty and attending a frailty-prevention group
Background: Frailty is a syndrome associated with poor health outcomes and, with an ageing population, it has become a focus for research and intervention. Pre-frailty, as a distinct stage of emerging age-related changes, is less well considered in the literature. Interventions to prevent progression from pre-frailty to frailty are being introduced, but lack supporting evidence on the needs and outcomes of this group. There is a need for improved understanding of patient outcomes, including experiential accounts of the application of such outcomes to daily lives.

Methods: The research used a mixed methods realistic evaluation of the experience and outcomes of people identified as being at risk of developing frailty and engaged in a frailty-prevention course. Pre/post-test data, relating to physical and functional health outcomes generated at three time points, were analysed for 212 participants. A mixed methods exploration, using framework analysis, of experiences and perceptions of participants occurred based on nineteen semi-structured interviews with eight participants. This considered the way physical health, functional status, well-being and activity participation are understood and interact.

Results and Findings: Classification of frailty highlighted that 64.7% of the sample were living with frailty and a further 29.4% with pre-frailty. At baseline there were weak, but significant associations, between increased lower frailty classification and more favourable functional outcomes for all measures, except for the Falls Efficacy Scale. Functional and frailty measures showed improvement after the twelve-week intervention, which was maintained for functional measures only at six-month follow-up. The mixed methods analysis developed knowledge from these outcomes, highlighting that the experience of participants did not closely align with measured outcomes. Participants rejected the term frailty, yet engaged with the need to mitigate for, and adapt to, age-related deterioration that threatened independence and well-being. This was achieved through occupational adaptation to preserve function and well-being.

Conclusion: Considering frailty in terms of physical and functional status, mental well-being and occupational performance aligns with the experiences of those living with pre-frailty and frailty. The frailty-prevention intervention was highly acceptable to participants as it adopted a function and assets-based approach to health, which aligned with their conceptualisation of health and self-management. Additionally, improvement, or at least maintenance, of function, was of greatest importance to participants.
University of Southampton
Mercer, Sarah
6b9e60c0-cfef-44a2-8719-f8f45a530da2
Mercer, Sarah
6b9e60c0-cfef-44a2-8719-f8f45a530da2
Walsh, Bronagh
5818243e-048d-4b4b-88c5-231b0e419427
Hunt, Katherine
53d9f4ce-2402-4bda-93c2-4dcb467ac724

Mercer, Sarah (2020) A mixed methods evaluation of outcomes and experiences of older adults identified as being at risk of frailty and attending a frailty-prevention group. University of Southampton, Doctoral Thesis, 355pp.

Record type: Thesis (Doctoral)

Abstract

Background: Frailty is a syndrome associated with poor health outcomes and, with an ageing population, it has become a focus for research and intervention. Pre-frailty, as a distinct stage of emerging age-related changes, is less well considered in the literature. Interventions to prevent progression from pre-frailty to frailty are being introduced, but lack supporting evidence on the needs and outcomes of this group. There is a need for improved understanding of patient outcomes, including experiential accounts of the application of such outcomes to daily lives.

Methods: The research used a mixed methods realistic evaluation of the experience and outcomes of people identified as being at risk of developing frailty and engaged in a frailty-prevention course. Pre/post-test data, relating to physical and functional health outcomes generated at three time points, were analysed for 212 participants. A mixed methods exploration, using framework analysis, of experiences and perceptions of participants occurred based on nineteen semi-structured interviews with eight participants. This considered the way physical health, functional status, well-being and activity participation are understood and interact.

Results and Findings: Classification of frailty highlighted that 64.7% of the sample were living with frailty and a further 29.4% with pre-frailty. At baseline there were weak, but significant associations, between increased lower frailty classification and more favourable functional outcomes for all measures, except for the Falls Efficacy Scale. Functional and frailty measures showed improvement after the twelve-week intervention, which was maintained for functional measures only at six-month follow-up. The mixed methods analysis developed knowledge from these outcomes, highlighting that the experience of participants did not closely align with measured outcomes. Participants rejected the term frailty, yet engaged with the need to mitigate for, and adapt to, age-related deterioration that threatened independence and well-being. This was achieved through occupational adaptation to preserve function and well-being.

Conclusion: Considering frailty in terms of physical and functional status, mental well-being and occupational performance aligns with the experiences of those living with pre-frailty and frailty. The frailty-prevention intervention was highly acceptable to participants as it adopted a function and assets-based approach to health, which aligned with their conceptualisation of health and self-management. Additionally, improvement, or at least maintenance, of function, was of greatest importance to participants.

Text
1. Final thesis - Version of Record
Available under License University of Southampton Thesis Licence.
Download (4MB)
Text
2. Permission to deposit thesis - form - Sarah Mercer
Restricted to Repository staff only

More information

Published date: March 2020

Identifiers

Local EPrints ID: 447803
URI: http://eprints.soton.ac.uk/id/eprint/447803
PURE UUID: 7e6d44d7-a0ce-4ca6-ab55-164626a7ea47
ORCID for Sarah Mercer: ORCID iD orcid.org/0000-0002-3004-2012
ORCID for Bronagh Walsh: ORCID iD orcid.org/0000-0003-1008-0545

Catalogue record

Date deposited: 23 Mar 2021 17:32
Last modified: 24 Mar 2021 02:46

Export record

Contributors

Author: Sarah Mercer ORCID iD
Thesis advisor: Bronagh Walsh ORCID iD
Thesis advisor: Katherine Hunt

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×