Yu Shiqi, Lin Jie, Song Siping, Huang Shuqi, Liu Fan, Xiao Mingzhao
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
BMC Geriatr. 2025 Feb 1;25(1):73. doi: 10.1186/s12877-025-05702-5.
Regularly engaging in exercise has been recognized as the only therapy found to consistently manage frailty. This study applies structural equation modeling (SEM) to integrate the theoretical perspective of Social cognitive theory (SCT) to better understand and promote regular exercise behavior among frail older adults, providing a foundation for enhancing exercise engagement in this vulnerable population.
A total of 306 frail older adults in Chengdu, China, were selected in this cross-sectional study. Participants completed the the FRAIL scale, the Self-Efficacy for Exercise (SEE) Scale, the behavioral regulation in exercise questionnaire (BREQ-2), the Outcome Expectations for Exercise (OEE), the Exercise Social Support (ESS) Scale. Structural equation modeling (SEM) was used to specify hypothesis between components of social-cognitive theory on regular exercise behavior among frail seniors.
The percentage of regular exercise behavior was 29.1% among participants. There were statistically significant differences in the regular exercise behavior for demographic characters of occupation, disposable monthly income, frail phenotype of fatigue, resistance and weight loss (p < 0.05). SEM showed that the exercise self-efficacy (β = 0.52, p < 0.001) and exercise outcome expectation (β = 0.45, p < 0.011) are the strongest determinants of regular exercise behavior, while social support (β = 0.092, p > 0.05) and self-regulation (β = 0.05, p > 0.05) are non-determinant.
Our study underscores that adherence to regular and structured exercise regimens remains low among frail older adults, suggesting that this population may not be fully benefiting from scientifically guided exercise programs. Integrating self-efficacy and outcome expectations into further exercise promotion is critical. Patient-centered approach is essential for developing more effective and sustainable exercise interventions.
经常锻炼已被公认为是唯一被发现能持续应对身体虚弱的疗法。本研究应用结构方程模型（SEM）来整合社会认知理论（SCT）的理论视角，以更好地理解和促进体弱老年人的规律锻炼行为，为增强这一弱势群体的锻炼参与度提供基础。
本横断面研究选取了中国成都的306名体弱老年人。参与者完成了衰弱量表、运动自我效能量表（SEE）、运动行为调节问卷（BREQ - 2）、运动结果期望量表（OEE）、运动社会支持量表（ESS）。采用结构方程模型（SEM）来明确社会认知理论各组成部分之间关于体弱老年人规律锻炼行为的假设。
参与者中规律锻炼行为的比例为29.1%。在职业、月可支配收入、疲劳、抵抗力和体重减轻等衰弱表型的人口统计学特征方面，规律锻炼行为存在统计学显著差异（p < 0.05）。结构方程模型显示，运动自我效能（β = 0.52，p < 0.001）和运动结果期望（β = 0.45，p < 0.011）是规律锻炼行为的最强决定因素，而社会支持（β = 0.092，p > 0.05）和自我调节（β = 0.05，p > 0.05）则不是决定因素。
我们的研究强调，体弱老年人坚持规律和结构化锻炼方案的比例仍然较低，这表明该人群可能未充分受益于科学指导的锻炼计划。将自我效能和结果期望纳入进一步的锻炼促进中至关重要。以患者为中心的方法对于制定更有效和可持续的锻炼干预措施至关重要。
