Qualitative participatory needs assessment in long-term care facilities: Groundwork for a workplace health promotion program based on traditional, complementary and integrative medicine (TCIM)

Fabian Voigt^1*Judith Czakert¹Wiebke Stritter¹Sophia Shir Teng Yap¹Georg Seifert^1,2Christian S. Kessler^1,3

• ¹Charité Competence Center for Traditional and Integrative Medicine (CCCTIM), Berlin, Germany
• ²University of São Paulo, Faculty of Medicine, São Paulo, Brazil
• ³Immanuel Hospital Berlin, Department of Internal and Nature-Based Therapies, Berlin, Germany

Background: The workload for nursing staff in long-term care facilities will increase in the coming decades, making initiatives to promote health in the work environment increasingly important. The pilot project “Healthy Care Cares for Health” (HCCH) aims to develop, implement, and evaluate a TCIM-based program for workplace health promotion (WHP) in long-term care facilities. To create an overview of health-related challenges and resources of the pilot facility, a needs assessment (NA) with participatory elements was conducted to include participant input. Methods: The NA was based on the framework of a quality-oriented Rapid Participatory Appraisal (RPA). Data was collected through semi-structured interviews and participant observation. The interview sampling used maximum variation based on participant socio-economic data including occupation, age, and gender (n=19). The data was analyzed using deductive-inductive qualitative content analysis. The results from the interviews and observations were contrasted, integrated, and validated in communication with the target group. Results: The NA revealed a complex interplay of health-related resources and challenges. Key challenges included stressors (e.g. insufficient breaks), physical and psychological strain (e.g. emotional stress, physical workload) and unhealthy lifestyle habits, particularly related to eating and exercise. At the same time, staff members demonstrated valuable individual resources and strategies (e.g. trust, a sense of coherence). They also showed approaches related to safety, stress management, workplace relationships, nutrition and physical activity. Notably, some participants already make regular use of TCIM strategies (e.g. breathing exercises). Discussion: The RPA-based NA is an effective, resource-efficient way of exploring target group- and setting-specific data on health-related challenges and potential in long-term care facilities. These results form a crucial basis for a context-adapted WHP program, with TCIM-related resources and strategies guiding the development and implementation of the planned TCIM-based WHP. TCIM approaches offer sustainable, low-threshold, and resource-efficient health promotion measures that can enhance staff health, care quality, and patient safety in long-term care and are also relevant for primary health care professionals broadly. Furthermore, the NA, with its participatory elements based on RPA recommendations, supports continuous target group involvement and provides a basis for consistent nursing staff participation in a WHP program.