Identifying social and interpersonal influences on frailty trajectory, self-management and personal responses to change

Hamilton, Kate (2026) Identifying social and interpersonal influences on frailty trajectory, self-management and personal responses to change. Doctoral thesis, University of East Anglia.

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Abstract

Background: ‘Frailty’ means different things to different people but is used in healthcare to reference a specific presentation. A concept analysis exploring how different stakeholder groups conceptualised frailty suggested older people may understand the antecedents, attributes and consequences of frailty differently to health and social care professionals. The influence of social factors on frailty has gained attention as the rhetoric around Ageing Well focuses on prevention and the role of the wider ‘neighbourhood’. A scoping literature review indicated a paucity of UK-based research into social and interpersonal influences on frailty trajectory, self-management and personal responses to change.

Aim: This study aims to address this gap by identifying social and interpersonal influences on frailty trajectory, self-management and personal responses to change in a UK-based community setting. By identifying these influences, systems of health and care may better manage frailty as a holistic condition.

Methods: A 12-month longitudinal study, using qualitative interviews and participant diaries. Recruitment was through Integrated Neighbourhood Teams. Five interviews were completed between two participants, and transcripts thematically analysed alongside participant diary data. Frailty status was assessed following each interview and a Clinical Frailty Score recorded using participant accounts of their own health and support needs, and researcher observations.

Analysis: Transcripts were reviewed against the 6 domains of the frailty fulcrum. Trajectories of continuity or change within each domain were considered longitudinally, within participants accounts.

Outcomes: Frailty remained consistently high within some domains whilst simultaneously lower in others. Frailty levels in the ‘systems of care’ and ‘physical environment’ domains remained high, whilst in the ‘psychological status’ and ‘social environment’ domains progression was slower. Strategies, resources and interpersonal influences on anticipating and responding to change were highly personal. This study contributes to the growing evidence that acknowledgement of social and interpersonal influences on frailty, may enhance care opportunities.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
Depositing User:	Amy Millward-Doherty
Date Deposited:	01 Oct 2026 09:02
Last Modified:	01 Oct 2026 09:02
URI:	https://ueaeprints.uea.ac.uk/id/eprint/104689
DOI:

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