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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Nutrition | Research

What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study

Authors: Lisa Happe, Andreas Hein, Rebecca Diekmann

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

During geriatric rehabilitation, attempts are made to increase the patients’ health and functional capacity. In order to maintain these improvements in the medium- and long-term, behavioural changes regarding mobility and nutrition are also targeted, but these are often not sustainable. International studies show positive effects on the sustainability of the improvement of physical activity behaviour in healthy seniors through the use of electronic devices and software applications. Comparable approaches that include nutrition topics or combine them and were additionally developed for geriatric rehabilitation patients (≥70 years) to date are not known. The aim of this study was to identify what geriatric rehabilitation patients require from an electronic coaching system (e-coach) to support them in improving their nutritional and physical activity behaviour, and what content and features physiotherapists and dieticians consider relevant.

Method

Focus group interviews (09–11/2019) were conducted in a geriatric rehabilitation centre in Germany with patients aged 70 years and older, relatives and experts (physiotherapists and nutritionists). The focus groups were recorded, transcribed verbatim and analysed using content analysis.

Results

Three focus groups with patients and relatives (n = 17, 65% female, 16 (94%) in age category 70–99 years) and one focus group with experts (2 dieticians and 1 physiotherapist) were conducted. Relevant contents and feedback elements for nutrition and physical activity in old age were identified. The patients’ comments show that an e-coach must offer obvious benefits for the older persons and promote motivation in order to be used. The willingness to change nutrition and physical activity behaviour and the previous experiences in these areas are very heterogeneous, therefore content should be adaptable to different requirements.

Conclusion

Experts and patients identified quite similar contents, barriers and facilitators for a nutrition and physical activity e-coach. The e-coach needs to be able to address different points of behaviour change, enable adaptations to the individual patient and convince the older person that using it will help them to improve their nutrition and physical activity. It is also important that the e-coach is easy to use and can be easily integrated into the patient’s everyday life after rehabilitation.
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Literature
1.
go back to reference Wojzischke J, van Wijngaarden J, van den Berg C, Cetinyurek-Yavuz A, Diekmann R, Luiking Y, et al. Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis. Eur Geriatr Med. 2020;11(2):195–207.CrossRef Wojzischke J, van Wijngaarden J, van den Berg C, Cetinyurek-Yavuz A, Diekmann R, Luiking Y, et al. Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis. Eur Geriatr Med. 2020;11(2):195–207.CrossRef
2.
go back to reference Marshall S, Bauer J, Isenring E. The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults. J Hum Nutr Diet. 2014;27(2):133–41.CrossRef Marshall S, Bauer J, Isenring E. The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults. J Hum Nutr Diet. 2014;27(2):133–41.CrossRef
3.
go back to reference Liguori I, Russo G, Aran L, Bulli G, Curcio F, Della-Morte D, et al. Sarcopenia: assessment of disease burden and strategies to improve outcomes. Clin Interv Aging. 2018;13:913–27.CrossRef Liguori I, Russo G, Aran L, Bulli G, Curcio F, Della-Morte D, et al. Sarcopenia: assessment of disease burden and strategies to improve outcomes. Clin Interv Aging. 2018;13:913–27.CrossRef
4.
go back to reference Diekmann R, Wojzischke J. The role of nutrition in geriatric rehabilitation. Curr Opin Clin Nutr Metab Care. 2018;21(1):14–8.CrossRef Diekmann R, Wojzischke J. The role of nutrition in geriatric rehabilitation. Curr Opin Clin Nutr Metab Care. 2018;21(1):14–8.CrossRef
5.
go back to reference Nascimento CM, Ingles M, Salvador-Pascual A, Cominetti MR, Gomez-Cabrera MC, Viña J. Sarcopenia, frailty and their prevention by exercise. Free Radic Biol Med. 2019;132:42–9.CrossRef Nascimento CM, Ingles M, Salvador-Pascual A, Cominetti MR, Gomez-Cabrera MC, Viña J. Sarcopenia, frailty and their prevention by exercise. Free Radic Biol Med. 2019;132:42–9.CrossRef
6.
go back to reference Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: a systematic review. BMC Geriatr. 2017;17(1):108.CrossRef Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: a systematic review. BMC Geriatr. 2017;17(1):108.CrossRef
7.
go back to reference van Balen R, Gordon AL, Schols JMGA, Drewes YM, Achterberg WP. What is geriatric rehabilitation and how should it be organized? A Delphi study aimed at reaching European consensus. Eur Geriatr Med. 2019;10(6):977–87.CrossRef van Balen R, Gordon AL, Schols JMGA, Drewes YM, Achterberg WP. What is geriatric rehabilitation and how should it be organized? A Delphi study aimed at reaching European consensus. Eur Geriatr Med. 2019;10(6):977–87.CrossRef
8.
go back to reference Bundesverband Geriatrie Herausgebendes O, WKG V, Bundesverband Geriatrie HO, W. Kohlhammer GmbH V, Verlag D, et al. Weißbuch Geriatrie Band 1 : Die Versorgung geriatrischer Patienten : Strukturen und Bedarf. 3. Auflage ed. Stuttgart: Stuttgart : Verlag W. Kohlhammer; 2016. Bundesverband Geriatrie Herausgebendes O, WKG V, Bundesverband Geriatrie HO, W. Kohlhammer GmbH V, Verlag D, et al. Weißbuch Geriatrie Band 1 : Die Versorgung geriatrischer Patienten : Strukturen und Bedarf. 3. Auflage ed. Stuttgart: Stuttgart : Verlag W. Kohlhammer; 2016.
9.
go back to reference Hill A-M, Hoffmann T, McPhail S, Beer C, Hill KD, Brauer SG, et al. Factors associated with older Patients' engagement in exercise after hospital discharge. Arch Phys Med Rehabil. 2011;92(9):1395–403.CrossRef Hill A-M, Hoffmann T, McPhail S, Beer C, Hill KD, Brauer SG, et al. Factors associated with older Patients' engagement in exercise after hospital discharge. Arch Phys Med Rehabil. 2011;92(9):1395–403.CrossRef
10.
go back to reference Forkan R, Pumper B, Smyth N, Wirkkala H, Ciol MA, Shumway-Cook A. Exercise adherence following physical therapy intervention in older adults with impaired balance. Phys Ther. 2006;86(3):401–10.CrossRef Forkan R, Pumper B, Smyth N, Wirkkala H, Ciol MA, Shumway-Cook A. Exercise adherence following physical therapy intervention in older adults with impaired balance. Phys Ther. 2006;86(3):401–10.CrossRef
11.
go back to reference Beck AM, Kjær S, Hansen BS, Storm RL, Thal-Jantzen K, Bitz C. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge: a randomized controlled trial. Clin Rehabil. 2013;27(6):483–93.CrossRef Beck AM, Kjær S, Hansen BS, Storm RL, Thal-Jantzen K, Bitz C. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge: a randomized controlled trial. Clin Rehabil. 2013;27(6):483–93.CrossRef
12.
go back to reference Mehra S, Visser B, Dadema T, van den Helder J, Engelbert RH, Weijs PJ, et al. Translating behavior change principles into a blended exercise intervention for older adults: design study. JMIR Res Protoc. 2018;7(5):e117.CrossRef Mehra S, Visser B, Dadema T, van den Helder J, Engelbert RH, Weijs PJ, et al. Translating behavior change principles into a blended exercise intervention for older adults: design study. JMIR Res Protoc. 2018;7(5):e117.CrossRef
13.
go back to reference Bickmore TW, Silliman RA, Nelson K, Cheng DM, Winter M, Henault L, et al. A randomized controlled trial of an automated exercise coach for older adults. J Am Geriatr Soc. 2013;61(10):1676–83.CrossRef Bickmore TW, Silliman RA, Nelson K, Cheng DM, Winter M, Henault L, et al. A randomized controlled trial of an automated exercise coach for older adults. J Am Geriatr Soc. 2013;61(10):1676–83.CrossRef
14.
go back to reference Silveira P, van de Langenberg R, van het Reve E, Daniel F, Casati F, de Bruin ED. Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial. J Med Internet Res. 2013;15(8):e159.CrossRef Silveira P, van de Langenberg R, van het Reve E, Daniel F, Casati F, de Bruin ED. Tablet-based strength-balance training to motivate and improve adherence to exercise in independently living older people: a phase II preclinical exploratory trial. J Med Internet Res. 2013;15(8):e159.CrossRef
15.
go back to reference Huxhold O, Otte K. Internetzugang und Internetnutzung in der zweiten Lebenshälfte. In: Deutscher Alterssurvey 2019; 2019. Huxhold O, Otte K. Internetzugang und Internetnutzung in der zweiten Lebenshälfte. In: Deutscher Alterssurvey 2019; 2019.
16.
go back to reference Richter M, Flückiger MD. Usability Engineering kompakt. Berlin Heidelberg: Springer Vieweg; 2013. p. 179.CrossRef Richter M, Flückiger MD. Usability Engineering kompakt. Berlin Heidelberg: Springer Vieweg; 2013. p. 179.CrossRef
17.
go back to reference Association WM. World medical Association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef Association WM. World medical Association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.CrossRef
18.
go back to reference Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRef Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.CrossRef
19.
go back to reference Neyer FJ, Felber J, Gebhardt C. Entwicklung und Validierung einer Kurzskala zur Erfassung von Technikbereitschaft. Diagnostica. 2012;58(2):87–99.CrossRef Neyer FJ, Felber J, Gebhardt C. Entwicklung und Validierung einer Kurzskala zur Erfassung von Technikbereitschaft. Diagnostica. 2012;58(2):87–99.CrossRef
20.
go back to reference Schulz M, Mack B, Renn O. Fokusgruppen in der empirischen Sozialwissenschaft : Von der Konzeption bis zur Auswertung. Wiesbaden: VS Verlag für Sozialwissenschaften; 2012.CrossRef Schulz M, Mack B, Renn O. Fokusgruppen in der empirischen Sozialwissenschaft : Von der Konzeption bis zur Auswertung. Wiesbaden: VS Verlag für Sozialwissenschaften; 2012.CrossRef
21.
go back to reference Kuckartz U. Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung: Beltz Verlagsgruppe; 2018. Kuckartz U. Qualitative Inhaltsanalyse. Methoden, Praxis, Computerunterstützung: Beltz Verlagsgruppe; 2018.
22.
go back to reference Jeruszka-Bielak M, Kollajtis-Dolowy A, Santoro A, Ostan R, Berendsen AAM, Jennings A, et al. Are nutrition-related knowledge and attitudes reflected in lifestyle and health among elderly people? A study across five European countries. Front Physiol. 2018;9:994.CrossRef Jeruszka-Bielak M, Kollajtis-Dolowy A, Santoro A, Ostan R, Berendsen AAM, Jennings A, et al. Are nutrition-related knowledge and attitudes reflected in lifestyle and health among elderly people? A study across five European countries. Front Physiol. 2018;9:994.CrossRef
23.
go back to reference Best RL, Appleton KM. The consumption of protein-rich foods in older adults: an exploratory focus group study. J Nutr Educ Behav. 2013;45(6):751–5.CrossRef Best RL, Appleton KM. The consumption of protein-rich foods in older adults: an exploratory focus group study. J Nutr Educ Behav. 2013;45(6):751–5.CrossRef
24.
go back to reference van den Heuvel E, Murphy JL, Appleton KM. Towards a food-based intervention to increase protein intakes in older adults: challenges to and facilitators of egg consumption. Nutrients. 2018;10(10):1409.CrossRef van den Heuvel E, Murphy JL, Appleton KM. Towards a food-based intervention to increase protein intakes in older adults: challenges to and facilitators of egg consumption. Nutrients. 2018;10(10):1409.CrossRef
25.
go back to reference Appleton KM. Barriers to and facilitators of the consumption of animal-based protein-rich foods in older adults. Nutrients. 2016;8(4):187.CrossRef Appleton KM. Barriers to and facilitators of the consumption of animal-based protein-rich foods in older adults. Nutrients. 2016;8(4):187.CrossRef
26.
go back to reference Alley SJ, Samra P, Rebar AL, Schoeppe S, Parkinson L, Power D, et al. A focus group study of older adults' perceptions and preferences towards web-based physical activity interventions. Inform Health Soc Care. 2020;45(3):273–81.CrossRef Alley SJ, Samra P, Rebar AL, Schoeppe S, Parkinson L, Power D, et al. A focus group study of older adults' perceptions and preferences towards web-based physical activity interventions. Inform Health Soc Care. 2020;45(3):273–81.CrossRef
27.
go back to reference Wichmann F, Pischke CR, Jürgens D, Darmann-Finck I, Koppelin F, Lippke S, et al. Requirements for (web-based) physical activity interventions targeting adults above the age of 65 years – qualitative results regarding acceptance and needs of participants and non-participants. BMC Public Health. 2020;20(1):907.CrossRef Wichmann F, Pischke CR, Jürgens D, Darmann-Finck I, Koppelin F, Lippke S, et al. Requirements for (web-based) physical activity interventions targeting adults above the age of 65 years – qualitative results regarding acceptance and needs of participants and non-participants. BMC Public Health. 2020;20(1):907.CrossRef
28.
go back to reference Room J, Hannink E, Dawes H, Barker K. What interventions are used to improve exercise adherence in older people and what behavioural techniques are they based on? A systematic review. BMJ Open. 2017;7(12):e019221.CrossRef Room J, Hannink E, Dawes H, Barker K. What interventions are used to improve exercise adherence in older people and what behavioural techniques are they based on? A systematic review. BMJ Open. 2017;7(12):e019221.CrossRef
29.
go back to reference Romain AJ, Bortolon C, Gourlan M, Carayol M, Decker E, Lareyre O, et al. Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials. J Sport Health Sci. 2018;7(1):50–7.CrossRef Romain AJ, Bortolon C, Gourlan M, Carayol M, Decker E, Lareyre O, et al. Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials. J Sport Health Sci. 2018;7(1):50–7.CrossRef
31.
go back to reference Nymberg VM, Bolmsjö BB, Wolff M, Calling S, Gerward S, Sandberg M. Having to learn this so late in our lives … ' Swedish elderly patients' beliefs, experiences, attitudes and expectations of e-health in primary health care. Scand J Prim Health Care. 2019;37(1):41–52.CrossRef Nymberg VM, Bolmsjö BB, Wolff M, Calling S, Gerward S, Sandberg M. Having to learn this so late in our lives … ' Swedish elderly patients' beliefs, experiences, attitudes and expectations of e-health in primary health care. Scand J Prim Health Care. 2019;37(1):41–52.CrossRef
32.
go back to reference Baric V, Andreassen M, Öhman A, Hemmingsson H. Using an interactive digital calendar with mobile phone reminders by senior people - a focus group study. BMC Geriatr. 2019;19(1):116.CrossRef Baric V, Andreassen M, Öhman A, Hemmingsson H. Using an interactive digital calendar with mobile phone reminders by senior people - a focus group study. BMC Geriatr. 2019;19(1):116.CrossRef
33.
go back to reference Eichhorn C, Plecher DA, Lurz M, Leipold N, Böhm M, Krcmar H, et al. Combining Motivating Strategies with Design Concepts for Mobile Apps to Increase Usability for the Elderly and Alzheimer Patients. Cham: Springer International Publishing; 2020.CrossRef Eichhorn C, Plecher DA, Lurz M, Leipold N, Böhm M, Krcmar H, et al. Combining Motivating Strategies with Design Concepts for Mobile Apps to Increase Usability for the Elderly and Alzheimer Patients. Cham: Springer International Publishing; 2020.CrossRef
Metadata
Title
What do geriatric rehabilitation patients and experts consider relevant? Requirements for a digitalised e-coach for sustainable improvement of nutrition and physical activity in older adults – a qualitative focus group study
Authors
Lisa Happe
Andreas Hein
Rebecca Diekmann
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Nutrition
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02692-y

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