Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands.
Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
Int J Behav Nutr Phys Act. 2022 Jul 30;19(1):99. doi: 10.1186/s12966-022-01330-z.
To improve older patients' physical activity (PA) behavior, it is important to identify facilitators and barriers to enhancing PA in older patients (≥ 65 years) during hospitalization from the perspectives of patients, caregivers, and healthcare professionals (HCPs).
In this systematic review, a search of PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science (January 2000-May 2021) was performed, and quantitative, qualitative, and mixed-methods studies were included. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Identified facilitators and barriers were categorized using the social ecological model at the intrapersonal, interpersonal, and institutional levels.
The 48 included articles identified 230 facilitators and 342 barriers. The main facilitators at the intrapersonal level included: knowledge, awareness, and attitudes; interpersonal level: social support, including encouragement and interdisciplinary collaboration; and institutional level: stimulating physical environment, patient activities and schedules, and PA protocols. The main barriers at the intrapersonal level included: physical health status, having lines or drains, patients' fear, and HCPs' safety concerns; interpersonal level: patient-HCP relation and HCPs' unclear roles; and institutional level: lack of space and resources, including time and equipment. Best evidence synthesis provided moderate level of evidence for three barriers: patients' unwillingness or refusal to move, patients having symptoms, and patients having lines or drains. No moderate level of evidence was found for facilitators.
The PA behavior of older adults during hospitalization is multidimensional. Our overview highlights facilitators and barriers on multilevel scale (intrapersonal, interpersonal, and institutional levels) that guides patients, caregivers, HCPs, and researchers in future clinical practice, and intervention development and implementation.
为改善老年患者的身体活动（PA）行为，从患者、照护者和医护人员（HCP）的角度了解促进老年患者（≥65 岁）住院期间 PA 的促进因素和障碍因素非常重要。
在这项系统综述中，我们对 PubMed、CINAHL、PsycINFO、EMBASE 和 Web of Science（2000 年 1 月至 2021 年 5 月）进行了检索，并纳入了定量、定性和混合方法研究。使用混合方法评估工具评估纳入研究的方法学质量。使用社会生态学模型在个体内部、人际和机构层面上对确定的促进因素和障碍因素进行分类。
48 篇纳入的文章确定了 230 个促进因素和 342 个障碍因素。个体层面的主要促进因素包括：知识、意识和态度；人际层面：社会支持，包括鼓励和跨学科合作；机构层面：刺激的物理环境、患者活动和日程安排以及 PA 方案。个体层面的主要障碍因素包括：身体健康状况、有管路或引流管、患者的恐惧和 HCP 的安全顾虑；人际层面：医患关系和 HCP 的角色不明确；机构层面：缺乏空间和资源，包括时间和设备。最佳证据综合提供了 3 个障碍因素的中等水平证据：患者不愿意或拒绝移动、患者有症状和患者有管路或引流管。未发现促进因素的中等水平证据。
老年患者在住院期间的 PA 行为是多维度的。我们的综述强调了多层面（个体内部、人际和机构层面）的促进因素和障碍因素，为未来的临床实践、干预措施的制定和实施提供了指导，有助于患者、照护者、HCP 和研究人员。
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