Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Nijmegen, The Netherlands.
Radboud University Medical Center, Radboudumc Alzheimer Center, Nijmegen, The Netherlands.
J Geriatr Phys Ther. 2020 Apr/Jun;43(2):71-81. doi: 10.1519/JPT.0000000000000210.
Community-dwelling persons with dementia are inactive most of the day. The purpose of this study was to rank the barriers, motivators, and facilitators that hamper or promote physical activity (PA) participation for persons with dementia. This could provide knowledge that can be used to design effective interventions to promote PA participation for persons with dementia.
Twenty community-dwelling persons with dementia, mean (SD) age = 79 (5.4) years, 25% female, mean (SD) Mini-Mental Status Examination score = 23 (3.5); their informal caregivers, N = 20, mean (SD) age = 70 (11.5) years, 85% female; and an expert group of physiotherapists, N = 15, mean (SD) age = 41 (12.4) years, 73% female, were asked to rank preselected barriers, motivators, and facilitators of PA participation for persons with dementia. These statements were categorized at the intrapersonal, interpersonal, and community levels.
Persons with dementia and their informal caregivers selected only motivators and facilitators as being important for PA participation, with the motivator "beneficial health effects" considered the most important. The experts had a different perspective on PA participation; half of their ranked top 10 most important factors were barriers to PA participation for persons with dementia. This could be explained by the more critical role of a therapist, focusing on symptom control and treatment of disability; in this case, the elimination of barriers to maintain PA participation in their patients. Furthermore, all groups prioritized statements at the intrapersonal level.
The results of this study suggest a difference in perspective between the more optimistic view of persons with dementia and their informal caregivers and the more critical view of physiotherapy experts regarding the most important factors that influence PA participation. In addition, there was a strong focus on the individual characteristics that influence PA behavior that warrant personalized interventions to promote PA in persons with dementia.
社区居住的痴呆症患者一天中大部分时间都不活跃。本研究的目的是对阻碍或促进痴呆症患者参与身体活动(PA)的障碍、动机和促进因素进行排名。这可以提供知识,用于设计有效的干预措施,以促进痴呆症患者的 PA 参与。
20 名社区居住的痴呆症患者,平均(标准差)年龄=79(5.4)岁,25%为女性,平均(标准差)简易精神状态检查得分=23(3.5);他们的非正式照顾者,N=20,平均(标准差)年龄=70(11.5)岁,85%为女性;以及一个由 15 名物理治疗师组成的专家小组,平均(标准差)年龄=41(12.4)岁,73%为女性,被要求对促进痴呆症患者参与 PA 的预先选择的障碍、动机和促进因素进行排名。这些陈述被归类为个人、人际和社区层面。
痴呆症患者及其非正式照顾者仅选择动机和促进因素作为参与 PA 的重要因素,其中“有益的健康影响”被认为是最重要的动机。专家对 PA 参与有不同的看法;他们排名前 10 位的最重要因素中有一半是痴呆症患者参与 PA 的障碍。这可以解释为治疗师的角色更为关键,专注于症状控制和残疾治疗;在这种情况下,消除障碍以维持患者的 PA 参与。此外,所有组都将重点放在个人层面的陈述上。
本研究的结果表明,痴呆症患者及其非正式照顾者的观点较为乐观,而物理治疗专家的观点更为关键,他们认为影响 PA 参与的最重要因素存在差异。此外,个人特征对 PA 行为的影响受到强烈关注,这需要为促进痴呆症患者的 PA 进行个性化干预。