An Exploration of Care Home Staff’s Perceptions Regarding Physical Activity Among Older Adults: A Qualitative Systematic Review

Context: Older adults residing in care home settings often require support from staff to take part in physical activity; however, limited information is available regarding how staff perceive physical activity among this population.

Objective: We aim to explore care home staff’s perceptions of physical activity among older adults.

Method: A systematic review was conducted following the Joanna Briggs Institute (JBI) meta-aggregative approach to qualitative synthesis. Searches were completed in AMED, CINAHL, EMBASE, PsycINFO and MEDLINE. Peer-reviewed studies that used qualitative approaches to study how care home staff perceive physical activity were included. Methodological quality assessment used the JBI Critical Appraisal Checklist for Qualitative Research. Primary findings were extracted, assigned a level of credibility, then aggregated into categories and synthesised findings. Synthesised findings were given a confidence rating using the ConQual approach.

Findings: The qualitative synthesis included 25 studies. From these, 508 primary findings were extracted and supported findings were grouped into 38 categories. Categories formed eight synthesised findings: 1) resident’s individualised needs, preferences and experiences, 2) perceived benefits of physical activity for residents, 3) perceived risks of physical activity for residents, 4) the role of care home staff in physical activity promotion, 5) support from others, 6) environmental influences, 7) organisational influences, and 8) motivational and sustainable physical activity.

Limitations: A low confidence rating was assigned to all synthesised findings due to dependability and credibility issues across the studies which may limit ability to inform policy and practice decisions. Not all studies underwent critical appraisal and data extraction by two reviewers. Grey literature was excluded; therefore, some relevant information may have been missed.

Implications: Based on care home staff’s perceptions, adult social care policies should ensure care homes have sufficient resources to plan and develop personalised physical activity strategies which address the diverse needs and preferences of residents. At a practice level, collaborative, strength-based approaches are required to provide personalised physical activity approaches which are acceptable to older adults and care home staff. Embedding physical activity promotion into each care home’s organisational structures and support systems may be beneficial.