HOW TASK COMPLEXITY AND BARRIERS INFLUENCE OLDER ADULT ENGAGEMENT IN AMBULATION DURING HOSPITALIZATION

Abstract

Older adults commonly lose their ability to independently ambulate during a hospital stay. Lack of ambulation has been identified as the most predictable and preventable cause of the loss of independent ambulation. Several ambulation interventions have been developed from the hospital provider perspective. But none have addressed the unique needs of older adults from the patient perspective. Further, what barriers older adults experience that may impact patient engagement in the work of ambulation has not been explored. The purpose of this study was to explore how older adult patients perceive ambulation and identify critical barriers that impacts the work of ambulation during a hospital stay. This qualitative study utilized inductive content analysis. Eleven older adults who had experienced a hospital stay in the past year were recruited to participate in a stakeholder focus group. Five 90-minute focus group sessions were held. Focus groups were audio recorded and transcribed verbatim. Data was analyzed using open coding, categorization, and abstraction. Older adults indicated that ambulation was critical for improving their health outcomes and identified a high degree of complexity in the work of ambulation. Three significant barriers that impact their engagement in ambulation during hospitalization included 1) high task uncertainty, 2) dealing with unfamiliar environments, and 3) reciprocal caring of nursing staff. Older adults face multiple barriers that impact whether or not they will initiate ambulation during hospitalization. Results of this study will inform the design of future ambulation interventions to improve outcomes for hospitalized older adults.