European Journal of General Practice (Oct 2019)

A qualitative study examining everyday frailty management strategies adopted by Polish stakeholders

  • Maria Magdalena Bujnowska-Fedak,
  • Holly Gwyther,
  • Katarzyna Szwamel,
  • Barbara D’Avanzo,
  • Carol Holland,
  • Rachel L. Shaw,
  • Donata Kurpas

DOI
https://doi.org/10.1080/13814788.2019.1668372
Journal volume & issue
Vol. 25, no. 4
pp. 197 – 204

Abstract

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Background: Frailty is a multidimensional clinical state that is common in older age and can be managed through intervention. Strategies to manage frailty have not been previously explored with stakeholders in Poland. This may stem from misperceptions about the nature and malleability of frailty, which has resulted in it being viewed as a lower priority healthcare concern. Objectives: To explore stakeholders’ views to determine whether there are effective everyday strategies that they can adopt to reduce, reverse or prevent frailty. Methods: Semi-structured focus groups were conducted with five stakeholder groups (frail/pre-frail and robust older adults, health and social care professionals and family caregivers) in Poland (n = 44). Data was analysed using a reflexive thematic analysis approach. Results: Two themes were developed. The first emphasized both the positive everyday and more effortful strategies used by individuals to counter frailty; these included the adoption of healthy lifestyle behaviours, social engagement and shared experiences. Stakeholders perceived that older adults, even frail ones, might benefit from engaging in meaningful activities to build resilience against frailty. The second examined formal interventions delivered by health and social care professionals. Stakeholders noted the need to increase awareness of the malleability of frailty among professionals. Conclusion: Raising awareness of the malleability of frailty amongst health and social care professionals is critical. Further, information provision and personal support should be essential elements of health interventions aimed at older adults and family caregivers. Interventions to support resilience building in older adults should also be framed within a model of fostering self-efficacy. KEY MESSAGES Stakeholders suggested that frailty should be viewed as a dynamic process with opportunities for treatment and improvement. Stakeholders believed that even frail older adults would benefit from engaging in meaningful but everyday activities to build resilience against frailty. Interventions designed to manage frailty should be carefully labelled to avoid stigma.

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