Table 3 MAINtAIN-C Barriers

Context of the clients

 1. Clients are often able to control factors that influence their situation.

 2. Clients are often able to perform ADLs more independently than they now do.

 3. I see that encouraging physical activity has a positive effect on clients.

 4. The capability of family or informal caregivers to encourage clients in the independent performance of ADLs and IADLs is sufficient.

 5. Clients are afraid to walk on their own, without help from others.

 6. Clients ask for help with ADLs so that they can get extra attention.

 7. Family or informal caregivers expect the nurses and nurse assistants to take over the activities that clients themselves can still perform.

 8. Clients do not want to perform activities themselves such as bathing or opening/closing curtains even if they still can.

 9. Financial limitations restrict clients in performing ADLs and IADLs independently.

 10. An overburdened family or informal caregiver limits clients in performing ADLs and IADLs independently.

Context of the professionals

 11. I think that organizing my work so that clients are ready on time is more important than clients performing ADLs independently.

 12. I am afraid that clients will hurt themselves if I encourage them to walk alone.

 13. It is primarily the responsibility of the physical therapist or occupational therapist to encourage clients to perform activities.

 14. Within my team, we think that it is important to encourage clients to perform ADLs as much as possible independently.

 15. Within my team, we think that it is our task to inform the family or informal caregivers about the importance of clients performing activities independently.

 16. I expect that encouraging ADLs and IADLs has no effect on how clients function.

 17. Within my team, sufficient expertise is available to encourage clients to be as independent as possible in performing ADLs (such as bathing, moving about).

 18. Encouraging independence as much as possible in clients’ ADLs, IADLs and social activities gives me less time for other things.

 19. I find it difficult to encourage clients to be self-reliant and independent.

 20. If I want, I am able to allow clients to perform ADLs and IADLs more independently.

The social context (the team functioning)

 21. Within my team, the collaboration with experts (for example occupational or physical therapists) is not good enough to encourage clients in performing ADLs as independently as possible.

 22. I can count on enough support from my colleagues when I allow clients to perform ADLs and IADLs as independently as possible.

 23. The manager of my team considers it important that clients perform ADLs and IADLs as independently as possible.

 24. I speak to my colleagues when I hear that they perform activities that clients can still perform themselves.

 25. The team discusses how we can encourage clients to perform ADLs and IADLs as independently as possible.

 26. Within my team, it is our routine to take over the ADLs and IADLs (such as making sandwiches) for our clients.

The organizational context

 27. My organization is not geared towards involving clients in the performance of ADLs and IADLs (such as independently bathing and dressing or preparing a meal).

 28. In my organization, there are enough people available with knowledge about how to encourage self-reliance and independent performance of activities by clients.

 29. My organization offers the possibility to follow internal or external courses that focus on encouraging clients’ physical activity.

 30. In my organization, we do not have agreements or guidelines concerning how we can encourage clients’ physical activity.

 31. I have inadequate time to activate clients to be self-reliant because of the needs assessment determined by the community nurse in my team.

 32. Encouraging self-reliance and independence has a high priority in my organization.

 33. There is a structural shortage of staff available to encourage clients to perform ADLs and IADLs (such as independently bathing and dressing or preparing a meal) as independently as possible.