Healthcare Providers' Perception of Implementing the Bedside Exercises for Hospital Fitness (BE-FIT) Patient-Led Rehabilitation Program for Older Patients: A Qualitative Descriptive Study

医疗服务提供者对实施“床旁运动促进医院健身”(BE-FIT)患者主导的老年患者康复计划的看法:一项定性描述性研究

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Abstract

BACKGROUND: Delayed mobilization in older surgery patients is a major risk factor for postoperative complications, including functional decline, prolonged hospital stays, and a higher risk of hospital readmission. Although postoperative mobilization is a foundational nursing intervention, it is not consistently performed due to competing demands such as staffing shortages and high patient acuity. The Bedside Exercises for hospital FITness (BE-FIT) program is a patient-led rehabilitation initiative that shifts the traditional model of care by positioning patients as active participants in performing exercises after surgery, rather than relying on healthcare providers to carry out the exercises with them. OBJECTIVE: This study aims to explore healthcare providers' experiences and perceptions of the delivery of the BE-FIT program to older postoperative patients in acute care surgical units and to identify strategies to improve program acceptance and sustainability. METHODS: A qualitative descriptive design was implemented. Semi-structured in-person interviews were conducted with 14 healthcare providers who participated in BE-FIT implementation across four surgical units. Interviews were audio-recorded and data were analyzed using an inductive content analysis approach. FINDINGS: Three themes emerged: (A) barriers and (B) facilitators for the implementation of the BE-FIT program, and (C) recommendations to enhance BE-FIT exercise uptake. Participants recognized the program's value in promoting early postoperative mobilization for older patients and appreciated the program's flexibility, simplicity, and patient-centred approach. However, operational barriers and patient resistance to mobilization affected implementation in clinical practice. Recommendations emphasized interdisciplinary engagement, integration into routine clinical workflows, family involvement, and leveraging technology. CONCLUSION: Healthcare providers perceive BE-FIT as a useful and adaptable tool to support early mobilization in older surgical patients. Insights gathered from frontline healthcare providers will inform strategies to improve the program's implementation, enhance adherence and support long-term sustainability.

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