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 crucialrole in managing a long-term care facility’s quality and costs. Health self-management of nursing servicequality managers, however, is relatively unknown. In this study, we aimed to assess determinants of longtermcare facilities’ (LTCF) quality care, including barriers and facilitators to health self-management asreported 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. Usingpurposive sampling, we selected 17 managers in LTCFs engaged with the quality of nursing services forsemi-structured interviews. We conducted thematic analysis using transcripts of interview recordings,interview notes, reflection diaries, and other materials. Results: Five major barriers were associatedwith the 10 domains of the theoretical domain framework: (1) negative emotional influence, (2) limitedtime resources, (3) fetters from professional roles, (4) lack of positive reinforcement, and (5) concernsabout physical red flags. Six main facilitators were associated with the 10 domains of the theoreticaldomain 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) findingthe team – for social support, and (6) wearing sports electronic equipment. Conclusion: A variety offactors impair self-health behaviors of nurse directors in LTCFs, and their mechanisms are complicated.