title: 'I accept it [staff assistance]; no choice': an ethnographic study of residents' attitudes towards mobility within nursing homes.
abstract: BACKGROUND
  Mobility contributes to the quality of life and independence of residents in nursing homes. To perform resident-centred mobility care, staff need to understand residents' physical capacity and perspectives of care.
  
  
  OBJECTIVE
  The aim of the study was to explore residents' perspectives of intrinsic factors influencing their mobility and associations between these factors with a view to informing resident mobility care practice improvements.
  
  
  METHODS
  The study was part of a larger ethnographic project exploring safe resident mobility care in nursing homes.
  
  
  METHODS
  Semi-structured interviews with nursing home residents supplemented by non-participant observations were conducted over a 20-month period from July 2010. Fifteen residents consented to be interviewed in three nursing homes in Melbourne, Australia. Unobtrusive observations of 46 mobility events took place in three nursing homes over 5 months from September, 2011.
  
  
  RESULTS
  Participants identified intrinsic factors that influence their mobility including mobility capacity, strategies to cope with mobility loss, motivation and efforts to remain mobile. Three themes related to resident attitudes and responses to mobility loss emerged: acceptance of mobility loss and staff assistance; motivation to remain mobile; and acquiescence and loss of control during mobility events. A conceptual model developed from the study outlined associations between resident attitudes and mobility and quality of life outcomes. Discussion was framed by theories of ageing and adaptation: selection, optimisation and compensation; learned dependency; and learned helplessness.
  
  
  CONCLUSIONS
  Resident acceptance of mobility loss, and required staff assistance and realistic determination to remain mobile contribute to residents' quality of life. Mobility care based on considerations of resident choice, autonomy and the value of mobility is important.
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Vic., Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Taylor
authors.forename: Jane
authors.initials: J
authors.lastname: Sims
authors.forename: Terry P
authors.initials: TP
authors.lastname: Haines
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000884:Anthropology, Cultural; D001315:Australia; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009735:Nursing Homes; D011788:Quality of Life
keywords: nursing homes; quality care; resident autonomy; resident mobility; resident perspective; resident-centred mobility care