Perceptions, attitudes and training needs of primary healthcare professionals in identifying and managing frailty: a qualitative study

Abstract

Purpose Although frailty can be delayed or prevented by appropriate interventions, these are often not available in countries lacking formal education and infrastructure in geriatrics. The aim of this study was to: (a) explore ideas, perceptions and attitudes of primary health care (PHC) professionals towards frailty in a country where geriatrics is not recognised as a specialty; (b) explore PHC professionals’ training needs in frailty; and (c) define components of a frailty educational programme in PHC. Methods Qualitative design, using two focus groups with PHC professionals conducted in Thessaloniki, Greece. Focus groups were audio recorded and transcribed. Data were analysed with thematic analysis. Results In total 31 PHC professionals (mean age: 46 years; gender distribution: 27 females, 4 males) participated in the study (physicians n = 17; nurses n = 12; health visitors n = 2). Four main themes were identified: (1) Perceptions and understanding of frailty; (2) Facilitators and barriers to frailty identification and management; (3) Motivation to participate in a frailty training programme; (4) Education and training. The main barriers for the identification and management of frailty were associated with the healthcare system, including duration of appointments, a focus on prescribing, and problems with staffing of allied health professionals, but also a lack of education. Training opportunities were scarce and entirely based on personal incentive. Professionals were receptive to training either face-to-face or online. A focus on learning practical skills was key. Conclusion Education and training of professionals and interdisciplinary collaboration are essential and much needed for the delivery of person-centred care for people with frailty living in the community.

Feasibility and impact of a short training course on frailty destined for primary health care professionals

“…PHC professionals neither considered frailty as a fatality nor its screening pointless or beyond their duties. This perception implies the unmet need of PHC professionals for education and training in dealing with frailty, which was also pointed out in the qualitative part of the present study [22] and in another qualitative study from Italy [29].…”

“…The focus groups aimed at investigating the status of clinical practice, attitudes and educational needs of participants regarding frailty; results of which can be found in another publication [22].…”

Yonder: Frailty, gestational diabetes, shared cancer care, and Positive Health

“…A research team from one such country, Greece, therefore sought to explore the possibility of developing a primary care frailty service. 1 They found that primary care clinicians considered the main barriers for the identification and management of frailty to be associated with the structure of the healthcare system, including duration of appointments, a focus on prescribing, a lack of allied health professionals, and a lack of training opportunities. The authors offer various solutions as to how primary care clinicians can be trained to improve frailty care but notably, do not include the apparently more obvious solution of developing geriatric medicine as a dedicated specialty training pathway.…”

The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians

“…Consequently, basic principles of GM, essential for dealing with older people, are commonly unknown. Recent research has demonstrated the gap in GM education as the main barrier to providing person-centered care for older people with frailty in the community [ 4 ]; nevertheless, it has been observed that physicians and nurses are motivated and receptive to training in geriatric skills with a direct clinical application [ 5 ]. Moreover, even in countries with developed GM systems, there is often a vague understanding amongst GPs and specialists of what GM is and what geriatricians do [ 3 , 6 , 7 ].…”