| Summary: | 博士 === 臺灣大學 === 護理學研究所 === 95 === The purposes of this study were: (1) To develop the “attitude, perceived social influences, perceived behavior control questionnaire for community elderly with chronic diseases” (Attitude to PA Questionnaire for elderly). (2) To explore the types and three components (frequency, duration, caloric expenditure) of physical activity (PA) and leisure time physical activity (LTPA) among community elderly with chronic diseases. (3) To identify the related factors on PA and LTPA among community elderly with chronic diseases.
The framework of this study was modified from the theory of planned behavior. Purposive convenience sampling was used to recruit participants. Inclusion criteria were living in Xinyi District of Taipei, aged 65 and older, with at least a diagnostic chronic disease, being independent concerning activity of daily living, with intact cognitive function. In stage I, qualitative data were generated from a total of 20 in-depth interviews. Based on the qualitative results, the 50-item, initial version of the “Attitude to PA Questionnaire for elderly” was proposed. The content validity of the questionnaire was established by initially reviewing the items with a group of five experts. Ongoing instrument refinement and testing were conducted in a sample of 30 community elderly in stage II. For stage III, a purposive convenience sample was recruited from the “three-in-one on-spot screen test activity. A total of 206 elderly agreed to participate this study and complete three questionnaires: (1) Demographic Information and Health Status; (2) Attitude to PA Questionnaire for elderly; (3) Modified Community Healthy Activities Model Program for Seniors (CHAMPS) physical activity Questionnaire. Data were analyzed using SPSS 12.0 statistical computer software with descriptive statistics, Chi-square, independent t-test, ANOVA, Pearson’s correlation, multiple regression, and logistic regression.
The descriptive statistic results showed that walking leisurely was the most frequent PA for participants, followed by light housework, light calisthenics, hiking uphill and various forms of Chinese Kung Fu, such as Tai Chi or Chi Kung. More men were engaged in LTPA than women. When the 333 standard of exercising was applied (including three or more times per week for at least 30 minutes activity of moderate intensity per session), only 25.7% participants reported to have met the criteria.
The age, gender, living arrangement, and self-reported health status were associated factors of PA and LTPA. The findings also showed the different determinants on different components of PA among community elderly. Based on the multiple regression analysis results, the duration of the LTPA model was shown as the best predictive model. The significant variables included gender, affective feeling for PA, and environmental control. All the independent variables could explain 27% of the total variance in the duration of LTPA. When comparing different gender participants, the multiple regression analysis showed that the best predictive model for male participants was the frequency of LTPA. The significant variables included living arrangement, affective feeling for PA, and environmental control. All the independent variables could explain 34% of total variance in the frequency of LTPA. For female participants, the best predictive model was the duration of LTPA. The significant variables included behavioral belief, affective feeling for PA, social support, and personal control. All the independent variables could explain 30% of total variance in the duration of LTPA.
An effective PA program could be designed by different gender, age and living arrangement among community elderly. Health professionals could provide more information and community resources for older adults, improve PA environment, increase their positive attitudes toward PA, and increase their PA opportunities. For older female, a stronger emphasis on LTPA, providing more social support, and enhancing their confidence of performing PA could be valuable directions for future interventions.
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