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Healthcare professionals' perspectives on implementing the H.O.M.E mobility intervention in acute care: a
Lay Khoon Lau1, Nien Xiang Tou2, Yew Yoong Ding2,3,4
1Geriatric Education and Research Institute, 2 Yishun Central 2, Singapore, 768024, Singapore. lau.charlene.lk@geri.com.sg.
Background:
Older adults often experience reduced mobilisation during hospitalisation, contributing to functional decline and increased risk of adverse health outcomes. Early mobility interventions in acute care settings are therefore critical to preventing functional loss. This study explored healthcare professionals' experiences and perceptions of the feasibility and acceptability of implementing a multicomponent, mobility-focused intervention - Help, Optimise and Mobilise Elders (H.O.M.E).
Methods:
This is a convergent mixed-methods study in which semi-structured interviews were conducted with a purposive sampling of 18 healthcare professionals involved in the intervention. An inductive approach and thematic content analysis were employed. Quantitative surveys were administered to the 25 implementers to measure the acceptability and feasibility of the intervention. The data on fidelity, specifically adherence and dosage to the intervention was also collected.
Results:
The quantitative survey shows that the H.O.M.E intervention was generally acceptable, although preferences for specific components differed across professional groups. Feasibility was rated lower than acceptability. Three overarching themes were identified from the qualitative data: (a) additional workload and responsibilities; (b) enhanced professional experience; and (c) challenges arising from patients. Although the intervention improved care workflows by enhancing nurses' understanding of patients' conditions and engagement levels, its implementation feasibility was constrained by patient resistance, competing clinical duties, staffing limitations and variations in intervention exposure.
Conclusion:
The quantitative and qualitative data were largely convergent, with the exception of nurses' perceptions regarding the feasibility of implementing frequent mobilisation. While the H.O.M.E intervention was recognised as beneficial for patients, its implementation was constrained by operational challenges. Adaptation of workforce could be a viable option to overcome some of these challenges. Additionally, identifying specific patient subgroups most likely to benefit from group therapy could help optimise implementation outcomes.
Trial Registration:
This study is registered with ClinicalTrials.gov (NCT05484063).
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