- Title
- Like a breath of fresh air: yoga and tai chi for frail older people in residential care: a mixed methods study
- Creator
- Saravanakumar, Padmapriya
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2014
- Description
- Research Doctorate - PhD Nursing
- Description
- Older people who live in residential aged care settings are at a high risk for falls; many of them are frail with high levels of dependence. Fall injuries, if not fatal, can result in permanent disability, loss of independence and poor quality of life for those affected. Many older people develop an ongoing fear of falling and are at high risk of subsequent falls. In addition, there can be delayed recovery from fall injuries with much pain, sleep disturbances, and depression. Older people with poor balance function are at risk of fall injuries. The management of falls in residential care is a major concern with the monitoring of falls and prevention strategies one of the mainstays of care in this setting. The importance of exercise interventions for improvement in balance for older people has been recognised and as a mechanism for fall prevention in residential care facilities. The aims of the research reported in this thesis were to implement, “map” and evaluate a 14 week program of yoga and tai chi for frail older adults in residential care. The objectives were: to determine the feasibility of conducting randomised clinical trial (RCT) in a residential aged care facility (RACF) with frail older people to test the hypotheses that 1) a 14 week modified yoga program is more effective than usual RACF activity program in improving balance function, quality of life, pain experience and in reducing number of falls in a RACF and 2) a 14 week modified tai chi program is more effective than usual activity programs in improving balance function, quality of life, pain experience and in reducing number of falls in a RACF. Other objectives were to explore the participant (the residents and staff) perspectives on whether the14 week modified program of tai chi and yoga was feasible and appropriate and to observe and map the implementation of modified approaches of yoga and tai chi with older people in a RACF. The study used a concurrent mixed methods design, incorporating a RCT and qualitative focus group (FG) interviews to explore the residents’ and staffs’ perspectives on whether the14 week modified program of tai chi and yoga was feasible and appropriate. The qualitative arm of the study utilised FG interviews with the participants of the study and descriptive analysis based on the tenets of naturalistic inquiry. The qualitative arm of the study was designed to complement the findings of the RCT by providing a broader perspective of the program, thereby adding richness to the research. Both quantitative and qualitative findings determined that the modified yoga and tai chi programs are feasible in the RACF. The quantitative indicators of feasibility were as follows: recruitment of 33 participants, high attendance (≥70%) and completion rates (28/33). The RCT demonstrated that a 14 -week modified yoga and tai chi program was feasible in a residential aged care setting, and provided evidence that yoga and tai chi may be associated with improvement in balance, pain and quality of life. These findings support growing evidence that interventions such as yoga and tai chi could reduce fall risk factors and also have holistic benefits. The qualitative findings showed that practicing yoga and tai chi led to perceived improvements in multiple wellness domains. This suggests that these interventions provide opportunities for frail and dependent older residents to experience enhanced quality of life and active aging. The qualitative findings also revealed important insights concerning what was most valued by the participants and the factors that motivated their participation in the programme. In particular, it identified lack of suitable physical activity and social isolation as key issues to be addressed in order to improve quality of life. Attributes of the yoga and tai chi programmes such as the instruction, group exercise, such as mindfulness, slow movements and guided imagery were important aspects motivating participation and facilitating confidence. The study reported in this thesis makes an important contribution to the literature. It is the first RCT with an embedded qualitative study to examine a 14 - week tai chi and yoga program implemented in an Australian residential care facility. The mixed method design was appropriate in addressing the aim and research questions because it led to a comprehensive understanding of the feasibility and appropriateness of the yoga and tai chi intervention for older adults in residential aged care setting. The methods used in this study also resulted in the development of a comprehensive pictorial and explanatory map of suitable forms of yoga and tai chi for use with frail and dependent older adults in RACFs.
- Subject
- yoga; tai chi; residential aged care; balance; pain; quality of life; complementary and alternative medicine
- Identifier
- http://hdl.handle.net/1959.13/1055356
- Identifier
- uon:15871
- Rights
- Copyright 2014 Padmapriya Saravanakumar
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Abstract | 228 KB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Thesis | 9 MB | Adobe Acrobat PDF | View Details Download |