Introduction: The incidence of hip fracture among older adults in Nigeria is on the rise. As a result, there is increased frequency of hospitalization, patient suffering, family burden, and societal cost. One dimension that has not been sufficiently explored is the burden of care experienced by informal and formal caregivers. Objectives: To describe the care burden experience of informal and formal caregivers for older adults with hip fractures in a specialized orthopedic center in Nigeria and to explore in detail how their experience differs in caregiving roles. Method: This study was conducted in the phenomenological approach of qualitative methods. Face-to-face interviews and focus group interaction with 12 family caregivers and 5 health-care professionals were carried out until data saturation was achieved. Data were analyzed using thematic analysis. Results: The physical, emotional, and general health of elderly hip fracture patients are issues that affect caregiving. Factors that contribute to increased caregivers' burden include system factors (lack of personnel and health-care facilities) and patient factors: comorbidity, patient's cognitive status, and challenges completing activities of daily living (ADL). Social and financial barriers to care contribute to the type of burden experienced by the participants. Conclusions: Caregivers experience difficulty in helping patients complete their ADL because patients with hip fracture have mobility issues that are often complicated by comorbid physical and cognitive problems. Strategies to reduce caregivers' burden for older adults with hip fracture in Nigeria are needed. Greater access to health-care services and ADL aids, and training of caregivers on how to deal with cognitive and multimorbid health problems are potential solutions.
Background: Effective fall prevention practices are essential for reducing falls among older adults. Rehabilitation professionals like physiotherapists are essential members of the fall prevention team, yet little is known about the experiences of physiotherapists practicing fall prevention in developing nations. Objective: To explore the experiences of physiotherapists in Nigeria who practice fall prevention among older adults. Method: We adopted a phenomenological approach to the traditional qualitative design in this study. We purposefully selected and conducted face-to-face interview with twelve physiotherapists who have treated at least one older adult who reported falling two or three times within last six months. Data was analyzed using thematic analysis. Results: Four themes emerged from our participants: characteristics of recurrent fallers, fall prevention practices, hindrances to fall prevention, and strategies to promote fall prevention practices. In practice, understanding the characteristics (risk factors) of older adults with a history of recurrent falls is important for effective fall prevention practices among physiotherapists. Among other characteristics, our participants believed that older adults who have patronized “traditional bone setters/healer” are at the higher risk of having multiple falls. Conclusion: This study adds to the sparse amount of literature concerning the experience of physiotherapist in fall prevention practices in the developing world. More importantly, the findings of this study will strengthen or stimulate discussion around development of fall prevention strategies specific to the developing world context.
Introduction There is a growing interest in collaborative care for older adults in Nigeria; however, little is known about the application of a transdisciplinary approach to care in a typical Nigerian geriatric unit. Therefore, we described healthcare professionals’ (HCPs’) perception of a transdisciplinary approach to older adults’ care in Southern Nigeria. Methods Using Stakian’s approach to a qualitative case study, we purposively invited 16 HCPs working in the geriatric unit of a teaching hospital in Nigeria to a single, in-depth, semi-structured interview. We analysed data using Stakian’s approach of categorical aggregation and direct interpretation. Results Our participants identified five-key features of a transdisciplinary approach to care: consolidated consultation, consolidated care documentation, care files accessibility, shared care decision and a designated care manager. HCPs stated that transdisciplinary approach to care allowed for a consolidated consultation of patients, with all the HCPs (in the same room or via telehealth/telemedicine) and care decisions should be shared between all stakeholders and documented in an accessible unified electronic care document that is managed by a care manager. Factors ranging from lack of consensus on time for a consolidation consultation to inter-professional conflicts were perceived as possible hindrances to a transdisciplinary approach to older adults’ care. Discussion The features of transdisciplinary care described in this study partly aligned with the WHO’s integrated care for older people (ICOPE). Additional components not captured in ICOPE were found. While the description of transdisciplinary was from the perceptive of our study participant, caution should be applied when interpreting these findings.
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