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影响主观认知衰退老年人身体活动行为的因素:使用 SEM 和 fsQCA 方法的实证研究。

Factors influencing physical activity behavior in older adults with subjective cognitive decline: an empirical study using SEM and fsQCA methods.

机构信息

International Medical Service Department, Peking Union Medical College Hospital (CAMS), Beijing, China.

School of Nursing, Shanxi Medical University, Taiyuan, China.

出版信息

Front Public Health. 2024 Oct 17;12:1409614. doi: 10.3389/fpubh.2024.1409614. eCollection 2024.

Abstract

OBJECTIVES

Despite the evident potential benefits of engaging in physical activity (PA) for older adults with subjective cognitive decline (SCD), their PA levels remains low. Previous research has predominantly focused on PA behaviors in individuals with dementia/mild cognitive impairment, with limited attention given to those with SCD. Therefore, this study aims to identify key factors influencing PA behavior in older adults with SCD based on the Self-Determination Theory (SDT) and the capability-opportunity-motivation (COM-B) model.

METHODS

Three hundred and three individuals aged 60 and above with SCD participated in this study. A face-to-face structured questionnaire survey was conducted. Data were analyzed using Structural Equation Modeling (SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA).

RESULTS

SEM results indicate that PA social support primarily influences PA behavior through three indirect pathways: the separate mediating effect of basic psychological needs, the separate mediating effect of motivation, and the chained mediating effect of both. Physical literacy, on the other hand, influences PA behavior through the separate mediating effect of motivation. Necessary conditions analysis by fsQCA reveals that no single factor is necessary for promoting PA behavior in older adults with SCD, while sufficiency analysis identifies four different combinations of factors leading to PA behavior.

CONCLUSION

The model derived from the framework of SDT and the COM-B model effectively explains and predicts the interrelationships among variables. Physical activity behavior in older individuals with SCD is the result of multifactorial synergies.

摘要

目的

尽管身体活动(PA)对有主观认知下降(SCD)的老年人明显有益,但他们的 PA 水平仍然较低。以前的研究主要集中在痴呆症/轻度认知障碍患者的 PA 行为上,而对 SCD 患者的关注有限。因此,本研究旨在根据自我决定理论(SDT)和能力-机会-动机(COM-B)模型,确定影响 SCD 老年人 PA 行为的关键因素。

方法

本研究纳入了 303 名年龄在 60 岁及以上的 SCD 患者。采用面对面的结构化问卷进行调查。使用结构方程模型(SEM)和模糊集定性比较分析(fsQCA)进行数据分析。

结果

SEM 结果表明,PA 社会支持主要通过三种间接途径影响 PA 行为:基本心理需求的单独中介效应、动机的单独中介效应以及两者的链式中介效应。体育素养通过动机的单独中介效应对 PA 行为产生影响。fsQCA 的必要条件分析表明,没有单一因素对促进 SCD 老年人的 PA 行为是必要的,而充分性分析确定了导致 PA 行为的四个不同因素组合。

结论

该模型源自 SDT 和 COM-B 模型的框架,有效地解释和预测了变量之间的相互关系。有 SCD 的老年人的 PA 行为是多因素协同作用的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4270/11526387/e3cee54be372/fpubh-12-1409614-g001.jpg

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