Unravelling the differences between complexity and frailty in old age: findings from a constructivist grounded theory study

作者：McGeorge S J^*

来源：Journal of Psychiatric and Mental Health Nursing, 2011, 18(1): 67-73.

DOI：10.1111/j.1365-2850.2010.01630.x

• elderly care
• geriatric psychiatry
• mental health
• nursing
• qualitative methodology

Accessible summary
UK health policy is often concerned with meeting the needs of the increasing number of older people in society and within some of this policy the concepts 'frailty' and 'complexity' have been used interchangeably. The concepts are not seen as the same by registered nurses who work in an older people's mental health service.
Frailty is generally described as a physical state leading to inevitable decline and death. There is an abundance of research into frailty, much of which has the ultimate aim of prevention of disability and reduction of health care needs. Some critics view the emphasis on frailty as an example of the way that some health staff turn old age into a problem. To date, there has been little research into complexity in either old age, in mental health, or from a nursing perspective.
Nurses described complexity as a dynamic state from which there can be 'recovery' and movement back and forth.
Understanding complexity is important if the needs of older people are to be met effectively. This study found that nurses share common perceptions of complexity but do not always find it easy to articulate these.
Abstract
UK health policy has used the terms 'frailty' and 'complexity' synonymously but there is no common definition for either. Understanding these concepts is important if demand for health care created by the increasing number of older people in society is to be managed effectively. This paper explores some findings from a study into how mental health nurses who work with older people construct and operationalize the concept of 'age-related complexity'. Constructivist grounded theory was used. Audio-taped interviews were undertaken with 13 registered nurses and were analysed using a constant comparative method. This paper addresses the relationship between frailty and complexity, which was identified as a theme within the category 'dynamic complexity'. The findings suggest that nurses understand important differences between the two concepts. Frailty is exclusively used to describe physical states while complexity is a more encompassing term that has resonance and relevance in mental health services. The dynamic nature of complexity means that older people can become both more and less complex and this has implications for nursing practice that require further study.

• 出版日期2011-2