Purpose: Physical activity (PA) is increasingly being used in hospice care as a rehabilitation strategy to help patients manage symptoms and improve quality of life. However, little is known about how to design and deliver interventions that promote uptake and maintenance of PA in this population. Single-level approaches (i.e., psychological models) have primarily been used to study factors that influence PA engagement among patients with advanced, incurable disease and therefore offer a limited perspective on strategies that target changes beyond the individual level. This study explored perspectives on factors perceived important for influencing PA participation in hospice care using a social-ecological framework.
Method: Patients (n = 27) and health providers (n = 5) from multiple hospices (n = 5) across the UK were involved in this study. Data were collected using focus group and individual semi-structured interviews and analyzed using a thematic framework approach.
Results: Eight main themes were perceived to be important for influencing PA engagement at the individual, interpersonal, physical environment, community, and policy levels including: (1) PA as therapy; (2) apprehension about PA-induced harm; (3) group-based PA with peers; (4) supervised PA sessions; (5) limited facilities and access; (6) patient-centered approach; (7) lack of a strong PA culture and; (8) absence of a policy and guidance for PA provision.
onclusion: Hospice-based PA interventions that target multiple levels simultaneously may be more effective at successfully changing and sustaining patients' PA behavior. Study findings provide evidence-based recommendations that may facilitate the effective delivery of PA interventions in hospice care.
A human rights approach to end-of-life care supports health and social care practitioners in making balanced, and often difficult, decisions with people at the end of life, in order to make personalised care a reality. The approach is based on the UK Human Rights Act, 1998, which outlines the legal duty of all practitioners to respect and protect the human rights of those in their care. Many practitioners are unaware of their legal duty under the UK Human Rights Act, and so, in collaboration with the British Institute of Human Rights, Sue Ryder developed a three-year training programme to educate and empower the end-of-life care workforce in the UK, to enable them to better understand their legal duty and to feel confident in embracing human rights as an integral component of end-of-life care. This paper presents the results from the first six months of implementation of the Sue Ryder training programme.