Douma Johanna G, Volkers Karin M, Engels Gwenda, Sonneveld Marieke H, Goossens Richard H M, Scherder Erik J A
Clinical Neuropsychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, the Netherlands.
Present address: Philadelphia Care Foundation, Amersfoort, the Netherlands.
BMC Geriatr. 2017 Apr 28;17(1):97. doi: 10.1186/s12877-017-0487-3.
Despite the detrimental effects of physical inactivity for older adults, especially aged residents of residential care settings may spend much time in inactive behavior. This may be partly due to their poorer physical condition; however, there may also be other, setting-related factors that influence the amount of inactivity. The aim of this review was to review setting-related factors (including the social and physical environment) that may contribute to the amount of older adults' physical inactivity in a wide range of residential care settings (e.g., nursing homes, assisted care facilities).
Five databases were systematically searched for eligible studies, using the key words 'inactivity', 'care facilities', and 'older adults', including their synonyms and MeSH terms. Additional studies were selected from references used in articles included from the search. Based on specific eligibility criteria, a total of 12 studies were included. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT).
Based on studies using different methodologies (e.g., interviews and observations), and of different quality (assessed quality range: 25-100%), we report several aspects related to the physical environment and caregivers. Factors of the physical environment that may be related to physical inactivity included, among others, the environment's compatibility with the abilities of a resident, the presence of equipment, the accessibility, security, comfort, and aesthetics of the environment/corridors, and possibly the presence of some specific areas. Caregiver-related factors included staffing levels, the available time, and the amount and type of care being provided.
Inactivity levels in residential care settings may be reduced by improving several features of the physical environment and with the help of caregivers. Intervention studies could be performed in order to gain more insight into causal effects of improving setting-related factors on physical inactivity of aged residents.
尽管身体活动不足对老年人有不利影响，但尤其是居住在养老机构的老年人可能会花费大量时间处于不活动状态。这可能部分归因于他们较差的身体状况；然而，也可能存在其他与环境相关的因素影响不活动的时长。本综述综述的目的是回顾在广泛的养老机构环境（如养老院、辅助护理设施）中，可能导致老年人身体活动不足的与环境相关的因素（包括社会和物理环境）。
系统检索了五个数据库以查找符合条件的研究，使用关键词“不活动”、“护理设施”和“老年人”，包括其同义词和医学主题词。从检索到的文章中引用的参考文献中挑选其他研究。根据特定的纳入标准，共纳入12项研究。使用混合方法评估工具（MMAT）评估纳入研究的质量。
基于使用不同方法（如访谈和观察）且质量各异（评估质量范围：25%-100%）的研究，我们报告了与物理环境和护理人员相关的几个方面。可能与身体活动不足相关的物理环境因素包括，除其他外，环境与居民能力的兼容性、设备的存在、环境/走廊的可达性、安全性、舒适性和美观性，以及可能存在的一些特定区域。与护理人员相关的因素包括人员配备水平、可用时间以及所提供护理的数量和类型。
通过改善物理环境的几个特征并在护理人员的帮助下，可降低养老机构中的不活动水平。可以进行干预研究，以便更深入地了解改善与环境相关因素对老年居民身体活动不足的因果影响。
