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Background: Physical activity (PA) is beneficial for older adults' health, however they remain the least active age group in the UK. This qualitative longitudinal study aims to understand motivations in older adults receiving the REACT physical activity intervention, through the lens of self-determination theory. Methods: Participants were older adults randomised to the intervention arm of the Retirement in ACTion (REACT) Study, a group-based physical activity and behaviour maintenance intervention to prevent decline of physical functioning in older adults (≥ 65 years). Stratified purposive sampling by physical functioning (Short Physical Performance Battery scores) and 3-month attendance was employed. Fifty-one semi-structured interviews were conducted at 6, 12 and 24-months with twenty-nine older adults (Mean age (baseline) = 77.9 years, SD 6.86, 69% female) and at 24-months with twelve session leaders and two service managers. Interviews were audio recorded, transcribed verbatim and analysed using Framework Analysis. Results: Perceptions of autonomy, competence and relatedness were associated with adherence to the REACT programme and maintenance of an active lifestyle. Motivational processes and participants' support needs, changed during the 12-month REACT intervention and across the 12-months post-intervention. Group interactions were an important source of motivation during the first six months but increased competence and mobility drove motivation at the later stages (12 months) and post-intervention (24 months). Conclusions: Motivational support needs vary in different stages of a 12-month group-based programme (adoption and adherence) and post-intervention (long-term maintenance). Strategies to accommodate those needs include, (a) making exercise social and enjoyable, (b) understanding participants' capabilities and tailoring the programme accordingly, (c) capitalising on group support to motivate participants to try other activities and prepare sustainable active living plans. Trial registration: The REACT study was a pragmatic multi-centre, two-arm, single-blind, parallel-group, RCT (ISRCTN registration number 45627165). [ABSTRACT FROM AUTHOR]

Undergoing an amputation is a life-altering experience that can involve a protracted and intensive period of care from a range of healthcare professionals. Amputation care within the NHS has historically been criticised. Here we seek to understand how patients are experiencing care by exploring their stories and identifying features of both high- and low-quality care. We analysed patient stories posted on the patient feedback site Care Opinion during the period 2018–2020 to examine how amputee patients (and their families) experience NHS care. Using thematic analysis, we identified four key themes. We found that patients' stories of undergoing an amputation as posted on Care Opinion give overwhelmingly positive feedback on their experiences. Patients report feeling well-supported by empathetic staff, and that the outcomes, in terms of quality of life and restoration of mobility, are beneficial. Time was a common feature within the posts we examined and negative experiences of care often related to untimeliness in a variety of ways. Care Opinion provides a useful and accessible resource for understanding how patients experience amputation care; analysis of stories posted there provides preliminary ideas of the features of "good care" from a patient-centred perspective. Patients undergoing amputations view professionalism of staff as important for good care. Timeliness is important to patients in seeing care in positive terms, ensuring patients are supported in their care during and after amputation in a timely manner is therefore important for achieving good rehabilitation care. Rehabilitation and related services supporting patients who have undergone amputations could usefully patient feedback sites as a means for further understanding the experiences of their patients and for improving services where necessary. [ABSTRACT FROM AUTHOR]

Guillain‐Barré syndrome (GBS) has several enduring effects that can lead to further harm and/or lower quality of life. These effects include falling and body pain, neither of which have been fully explored. This study aims to examine the risk factors associated with falling and potential causes of body pain in a post‐GBS population. A cross‐sectional survey of 216 participants was conducted using an electronic questionnaire that included. Self‐report measures for: overall health, balance, anxiety and depression levels, body pain and demographics related to GBS experience and falls. A large proportion of individuals post‐GBS experience ongoing problems beyond those expected with ageing. Comparative tests indicated that people reporting falls in the previous 12 months had: poorer levels of mobility, poorer F‐scores, higher levels of body pain, poorer balance, poorer anxiety and depression scores and higher levels of fatigue. Gender did not appear to contribute to falls. Injuries following falls were associated with a lack of physiotherapy postdischarge and time since GBS. In a regression analysis of the identified and expected key variables, age and body pain statistically predicted falls. In over a quarter of cases reported here, respondents did not receive community physiotherapy following hospital discharge. In the midst and aftermath of COVID‐19, provision of rehabilitation needs to be recalibrated, not just for COVID patients, but the wider community with ongoing needs. Issues around well‐being and quality of life in the post‐GBS community also need further consideration. [ABSTRACT FROM AUTHOR]

Aphasia, a language disability, can profoundly affect a person's mood and identity. The experiences of participants who received Solution-Focused Brief Therapy, a psychological intervention, were explored in the Solution-Focused brief therapy In poststroke Aphasia (SOFIA) Trial. Thirty participants with chronic aphasia, 14 with severe aphasia, participated in in-depth interviews that were analyzed using framework analysis. Two overarching themes emerged: valued therapy components (exploring hopes, noticing achievements, companionship, sharing feelings, and relationship with therapist) and perceptions of progress (mood, identity, communication, relationships, and independence). Participants were categorized into four groups: (a) "changed," where therapy had a meaningful impact on a person's life; (b) "connected," where therapy was valued primarily for companionship; (c) "complemental," where therapy complemented a participant's upward trajectory; and (d) "discordant," where therapy misaligned with participants' preference for impairment-based language work. This study suggests that it is feasible to adapt a psychological therapy for people with aphasia, who perceive it as valuable. [ABSTRACT FROM AUTHOR]