Nursing Assistants’ Perceptions of Physical Activity and Exercise among Older People : a Phenomenographic Study

Abstract: Nursing assistants’, as frontline caregivers in the care of older people, have a unique opportunity to encourage physical activity and exercise in older people. Hence, the perceptions by these care providers of physical activity and exercise among older people are an essential factor. The aim of this study is to  describe how nursing assistants perceive physical activity and exercise for older people, over the age of 65, receiving home care and home help. Method: Data was collected through interviews with 19 nursing assistants, selected by strategic sampling and analysed using a phenomenographic approach. Results: The findings show two different perceptions of physical activity for the older people: “physical activity is to  move” described as everyday movements i.e. everyday activities and outdoors activities and “physical activity is to make an effort”, described as older people handling their day-to-day tasks and outdoor activities or struggling to be less inactive and performing healthy activities. Three different perceptions of exercise for the older people emerged: “exercise as physical activity”, described as movement performed, based on individual exercise programmes from the physiotherapist or through day-to-day tasks such as dressing, cleaning or shopping; “exercise as rehabilitation” described as part of the rehabilitation process or as a prescription to follow, and “exercise as an agent” described as enhancing the health and well-being of older people, principally related to mobility or enhancing the older people’s social activities. Conclusion: This study shows that there are a variety of perceptions of physical activity and exercise among nursing assistants which can be important for health professionals to be aware of, in order to provide targeted support. This study also shows two different approaches by nursing assistants towards older people: a health-promotion one and a preventive one; it would seem to be important to be aware of these approaches, if a shift towards promoting health and well-being should be implemented in the care of older people.