title: Barriers to mobility during hospitalization from the perspectives of older patients and their nurses and physicians.
abstract: BACKGROUND
  Low mobility is common during hospitalization and is associated with adverse outcomes. Understanding barriers to the maintenance or improvement of mobility is important to the development of successful interventions.
  
  
  OBJECTIVE
  To identify barriers to mobility during hospitalization from the perspectives of older patients and their primary nurses and physicians, to compare and contrast the perceived barriers among these groups, and to make a conceptual model.
  
  
  METHODS
  Qualitative interviews analyzed and interpreted using a grounded theory approach.
  
  
  METHODS
  Medical wards of a university hospital.
  
  
  METHODS
  Twenty-nine participants--10 patients >or= 75 years, 10 nurses, and 9 resident physicians.
  
  
  METHODS
  Participants were interviewed using a semistructured interview guide, with similar questions for patients and health care providers. Interviews were audiotaped, transcribed, and reviewed for common themes by independent reviewers. Perceived barriers to mobility were identified, and their nature and frequency were examined for each respondent group.
  
  
  RESULTS
  Content analysis identified 31 perceived barriers to increased mobility during hospitalization. Barriers most frequently described by all 3 groups were: having symptoms (97%), especially weakness (59%), pain (55%), and fatigue (34%); having an intravenous line (69%) or urinary catheter (59%); and being concerned about falls (79%). Lack of staff to assist with out-of-bed activity was mentioned by patients (20%), nurses (70%), and physicians (67%). Unlike patients, health care providers attributed low mobility among hospitalized older adults to lack of patient motivation and lack of ambulatory devices.
  
  
  CONCLUSIONS
  Recognizing and understanding perceived barriers to mobility during hospitalization of older patients is an important first step toward developing successful interventions to minimize low mobility.
authors.affiliation: Birmingham/Atlanta Veterans Affairs Geriatric Research, Education, and Clinical Center (GRECC), Birmingham, AL 35294, USA. cbrown@aging.uab.edu
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Brown
authors.forename: Beverly R
authors.initials: BR
authors.lastname: Williams
authors.forename: Lesa L
authors.initials: LL
authors.lastname: Woodby
authors.forename: Linda L
authors.initials: LL
authors.lastname: Davis
authors.forename: Richard M
authors.initials: RM
authors.lastname: Allman
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D005260:Female; D005851:Geriatric Nursing; D005853:Geriatrics; D006272:Health Facility Environment; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation; D008297:Male; D051346:Mobility Limitation; D008962:Models, Theoretical; D009042:Motivation; D036301:Qualitative Research; D014546:Urinary Catheterization / Q000295:instrumentation