What influences self-efficacy and healthy ageing in older people after hospitalisation? A qualitative study

Background: Hospitalisation of older people can result in significant functional decline, increasing care needs and the risk of re-hospitalisation. Self-efficacy to adapt lifestyle and health behaviours can help older people recover and avoid re-hospitalisation. Understanding what influences older people's self-efficacy can help improve healthy ageing after hospitalisation. Aim: This paper aims to explore social, intrinsic, and environmental influences on the self-efficacy of community-dwelling older people, and subsequent impacts on their resilience and healthy ageing. Methods: This paper reports the qualitative phase of a sequential mixed-method study. Using a qualitative descriptive approach, a subgroup of older people participated in semistructured interviews following hospital admission. Data were analysed using thematic analysis. Findings: Five themes emerged: (1) Remaining connected found supportive social networks positively influenced self-efficacy and attitudes toward ageing; (2) Not giving up even though “I'm getting older” highlights the importance of positive attitudes toward ageing; (3) Learning to live well in older age found health professionals’ interventions and technology improved self-efficacy to adapt and manage health conditions; (4) Dealing with consequences of declining physical function showed that losses in meaningful activities reduced resilience; (5) Impact of previous life experiences highlights the impact on mental health and resilience. Conclusions: Acute hospitalisation in older age can precipitate re-evaluation of self-efficacy to maintain a good quality of life. Interventions that promote social connectedness and positive attitudes to ageing through a collaborative approach can potentially mitigate the negative effects of functional decline and promote adaptive behaviours that optimise health and wellbeing among hospitalised older people.