186 Experiences of implementing a group intervention targeting sarcopenia in an integrated care for older persons hub

促进者 肌萎缩 医学 干预(咨询) 晋升(国际象棋) 营养不良 护理部 定性研究 多学科方法 老年学 物理疗法 心理学 政治学 社会学 解剖 政治 社会心理学 社会科学 法学 病理
作者
Ernest J. Grant,Niall Phelan,Pádraig Bambrick
出处
期刊:Age and Ageing [Oxford University Press]
卷期号:52 (Supplement_3)
标识
DOI:10.1093/ageing/afad156.163
摘要

Abstract Background Sarcopenia is associated with declining mobility, falls, frailty, and increased mortality. Research suggests resistance exercises and ensuring adequate protein intake can improve muscle mass, strength and function. Methods Screening for probable sarcopenia was introduced as part of the comprehensive geriatric assessment in the hub. Suitable candidates who screened as having probable sarcopenia were offered a group intervention facilitated by a physiotherapist and a dietitian, followed by an 8 week at home self-management programme. Alongside objective assessments of outcomes, the clinicians conducting the program also undertook a process of reflection on the experience, to provide a qualitative analysis that might inform future work. Results The main barrier identified to the group intervention was enrolment. The primary reason for this appeared to be the presence of other comorbidities that precluded participation. These included active medical conditions, complex social issues, advanced cognitive impairment, complex falls, or malnutrition requiring more specialist intervention. The main facilitator identified was an engaged multidisciplinary team (MDT), willing to upskill to screen for sarcopenia and proactive about discussing the intervention with potential participants. Another facilitator was the practice of contacting participants at the midpoint, to check on compliance and provide encouragement. Conclusion Several conclusions were achieved through a qualitative reflection on the experience. Engaging and upskilling team members and therapist support were seen as facilitators, whilst recruitment was the most significant barrier. During reflection it was suggested that excluding those that did not screen for probable sarcopenia (53% of all screened) may have been a missed opportunity for promotion and prevention. These learnings will be used to inform the design of future such interventions. Despite the challenges encountered, there was a consensus among the MDT that offering a group intervention is a practical way to begin to address sarcopenia within the limited resources of a community hub.
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