Stakeholders’ views and experiences of care and interventions for addressing frailty and pre-frailty: A meta-synthesis of qualitative evidence

• Published in: PloS one Vol. 12; no. 7; p. e0180127
• Main Authors: D’Avanzo, Barbara, Shaw, Rachel, Riva, Silvia, Apostolo, Joao, Bobrowicz-Campos, Elzbieta, Kurpas, Donata, Bujnowska, Maria, Holland, Carol
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.07.2017; Public Library of Science (PLoS)
• Subjects: Adaptation, Psychological; Age; Aged; Aged, 80 and over; Aging; Analysis; Biology and Life Sciences; Care and treatment; Caregivers; Evidence-based nursing; Frail Elderly; Frailty; Health Knowledge, Attitudes, Practice; Health sciences; Health screening; Humans; Intervention; Management; Medical examination; Medicine and Health Sciences; Mental health; Meta-synthesis; Older people; Overview; Patients; People and Places; Practice; Prevention; Public health; Public opinion; Qualitative Research; Research and Analysis Methods; Resilience; Social Sciences; Studies; Portugal
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0180127

Frailty is a common condition in older age and is a public health concern which requires integrated care and involves different stakeholders. This meta-synthesis focuses on experiences, understanding, and attitudes towards screening, care, intervention and prevention for frailty across frail and healthy older persons, caregivers, health and social care practitioners. Studies published since 2001 were identified through search of electronic databases; 81 eligible papers were identified and read in full, and 45 papers were finally included and synthesized. The synthesis was conducted with a meta-ethnographic approach. We identified four key themes: Uncertainty about malleability of frailty; Strategies to prevent or to respond to frailty; Capacity to care and person and family-centred service provision; Power and choice. A bottom-up approach which emphasises and works in synchrony with frail older people's and their families' values, goals, resources and optimisation strategies is necessary. A greater employment of psychological skills, enhancing communication abilities and tools to overcome disempowering attitudes should inform care organisation, resulting in more efficient and satisfactory use of services. Public health communication about prevention and management of frailty should be founded on a paradigm of resilience, balanced acceptance, and coping. Addressing stakeholders' views about the preventability of frailty was seen as a salient need.