Physical Activity in Assisted Living Facility Residents

Abstract

PURPOSE: The purpose of this dissertation was to (1) synthesize relevant scientific literature on factors influencing PA in this population (2) explore the experience and meaning of PA in ALF residents and (3) assess the feasibility and acceptability of the activPAL accelerometer and a set of questionnaires for measuring PA behaviors as part of a preliminary step in the development of future research. METHODS: Studies were analyzed using Whittemore and Knafl’s (2005) methodology. deBruin et al. (2008) criteria were used to determine methodological quality. A qualitative design was used to explore the experience and meaning of PA. A semi-structured interview was conducted. Raw data were reduced and analyzed guided by Moustakas’ and Colaizzi’s methodology. The activPAL was taped to the subjects’ thigh for seven consecutive days of 24-hour monitoring of PA. A set of five questionnaires were completed. A structured interview assessed the likability and comfort of the activPAL and questionnaires using Likert scales. RESULTS: The integrative review consisted of 12 articles and nine were found to be cross-sectional, descriptive studies with a mean quality score of 9.58 (range 5.0-19.0, SD=3.70) indicating the strength of evidence for determining factors that influence PA in ALF residents is low to medium. The study sample consisted of 20 older adults in assisted living aged 57-96 years (M=77.4, SD=10.6) and included 16 (80%) females. Twenty-seven meaning units were derived and clustered into five themes. Residents were sedentary but saw themselves as active, in part because they compared themselves to others perceived as less active. PA meant disability could be prevented. Approximately 20 hours per day were spent sitting or lying (M=20.2, SD=2.3) and one hour per day was spent stepping. Significant correlations were detected between steps taken and age (r = - .659), MMSE (r = .466) and CCMI (r = .648). CONCLUSIONS: Quality evidence is lacking regarding factors influencing PA in ALF residents. PA is limited by expectations and understanding of PA. The activPAL and questionnaires are feasible to use for measuring PA in ALF residents. Further research is needed to clarify the importance of PA for healthy living in this population.