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Promoting self-management and adherence with strength and balance training for older people with long-term conditions: a mixed-methods study

Lookup NU author(s): Dr Lisa Robinson, Emerita Professor Julia Newton


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Rationale, aims and objectives In the context of an ageing population, increasing numbers of older people with long-term conditions are presenting to secondary health care facilities in the United Kingdom having experienced a fall or fall-related injury. Despite such observations, falls and long-term conditions have traditionally been regarded as entirely separate entities. The purpose of this study was to explore the process of behaviour change in a small sample of older people with the fall-associated chronic liver disease primary biliary cirrhosis (PBC) receiving either a standard or an enhanced programme of strength and balance training (SBT).Methods A qualitatively driven mixed-methods approach was employed that juxtaposed semi-structured interviews with graphical representations of patient-reported outcome measures collected during the course of an experimental case series in nine older people with the fall-associated chronic liver disease PBC.Results Participants receiving both the standard and enhanced intervention completed the programme of SBT as instructed throughout the course of the case series. However, only the enhanced intervention, which focused on self-determination and self-management support, was associated with continued active participation on completion of the programme.Conclusions Longer, but not necessarily more intensive, periods of clinical intervention are necessary to support individuals at risk of falling to move through the incremental stages of behaviour change. Effective self-management support should focus on the development of a wide range of strategies and behaviours to empower older people with long-term conditions develop an ongoing active commitment to SBT.

Publication metadata

Author(s): Robinson L, Newton JL, Jones D, Dawson P

Publication type: Article

Publication status: Published

Journal: Journal of Evaluation in Clinical Practice

Year: 2014

Volume: 20

Issue: 4

Pages: 318-326

Print publication date: 01/08/2014

Online publication date: 25/04/2014

Acceptance date: 18/03/2014

ISSN (print): 1356-1294

ISSN (electronic): 1365-2753

Publisher: Wiley-Blackwell


DOI: 10.1111/jep.12128


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Funder referenceFunder name
MR/K501037/1Medical Research Council
MR/L001489/1Medical Research Council