Factors associated with older patients' engagement in exercise after hospital discharge

Anne Marie Hill, Tammy Hoffmann, Steven McPhail, Christopher Beer, Keith D. Hill, Sandra G. Brauer, Terrence P. Haines

Research output: Contribution to journalArticleResearchpeer-review

53 Citations (Scopus)
56 Downloads (Pure)

Abstract

Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge. Design: A prospective observational study using qualitative and quantitative evaluation. Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital. Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge. Interventions: Not applicable. Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and self-reported barriers to engagement in exercise measured at 6 months after discharge using a telephone survey. Results: Six months after discharge, 305 participants remained in the study, of whom 109 (35.7%) were engaging in a structured exercise program. Multivariable logistic regression analysis demonstrated participants were more likely to be engaging in exercise if they perceived they were at risk of serious injury from a fall (odds ratio [OR] =.61; 95% confidence interval [CI],.48.78; P<.001), if exercise was recommended by the hospital physiotherapist (OR=1.93; 95% CI, 1.033.59; P=.04), and if they lived with a partner (OR=1.97; 95% CI, 1.183.28; P=.009). Barriers to exercise identified by 168 participants (55%) included low self-efficacy, low motivation, medical problems such as pain, and impediments to program delivery. Conclusions: Older patients have low levels of engagement in exercise after hospital discharge. Researchers should design exercise programs that address identified barriers and facilitators, and provide education to enhance motivation and self-efficacy to exercise in this population.

Original languageEnglish
Pages (from-to)1395-1403
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume92
Issue number9
DOIs
Publication statusPublished - Sep 2011

Fingerprint

Patient Participation
Exercise
Odds Ratio
Self Efficacy
Confidence Intervals
Motivation
Physical Therapists
Urban Hospitals
Telephone
General Hospitals
Observational Studies
Rehabilitation
Logistic Models
Regression Analysis
Research Personnel
Outcome Assessment (Health Care)
Prospective Studies
Education
Pain

Cite this

Hill, Anne Marie ; Hoffmann, Tammy ; McPhail, Steven ; Beer, Christopher ; Hill, Keith D. ; Brauer, Sandra G. ; Haines, Terrence P. / Factors associated with older patients' engagement in exercise after hospital discharge. In: Archives of Physical Medicine and Rehabilitation. 2011 ; Vol. 92, No. 9. pp. 1395-1403.
@article{6fbe4b8100f34ddf98ac2d079e7d6efb,
title = "Factors associated with older patients' engagement in exercise after hospital discharge",
abstract = "Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge. Design: A prospective observational study using qualitative and quantitative evaluation. Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital. Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge. Interventions: Not applicable. Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and self-reported barriers to engagement in exercise measured at 6 months after discharge using a telephone survey. Results: Six months after discharge, 305 participants remained in the study, of whom 109 (35.7{\%}) were engaging in a structured exercise program. Multivariable logistic regression analysis demonstrated participants were more likely to be engaging in exercise if they perceived they were at risk of serious injury from a fall (odds ratio [OR] =.61; 95{\%} confidence interval [CI],.48.78; P<.001), if exercise was recommended by the hospital physiotherapist (OR=1.93; 95{\%} CI, 1.033.59; P=.04), and if they lived with a partner (OR=1.97; 95{\%} CI, 1.183.28; P=.009). Barriers to exercise identified by 168 participants (55{\%}) included low self-efficacy, low motivation, medical problems such as pain, and impediments to program delivery. Conclusions: Older patients have low levels of engagement in exercise after hospital discharge. Researchers should design exercise programs that address identified barriers and facilitators, and provide education to enhance motivation and self-efficacy to exercise in this population.",
author = "Hill, {Anne Marie} and Tammy Hoffmann and Steven McPhail and Christopher Beer and Hill, {Keith D.} and Brauer, {Sandra G.} and Haines, {Terrence P.}",
year = "2011",
month = "9",
doi = "10.1016/j.apmr.2011.04.009",
language = "English",
volume = "92",
pages = "1395--1403",
journal = "Archives of physical medicine",
issn = "0003-9993",
publisher = "Elsevier",
number = "9",

}

Factors associated with older patients' engagement in exercise after hospital discharge. / Hill, Anne Marie; Hoffmann, Tammy; McPhail, Steven; Beer, Christopher; Hill, Keith D.; Brauer, Sandra G.; Haines, Terrence P.

In: Archives of Physical Medicine and Rehabilitation, Vol. 92, No. 9, 09.2011, p. 1395-1403.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Factors associated with older patients' engagement in exercise after hospital discharge

AU - Hill, Anne Marie

AU - Hoffmann, Tammy

AU - McPhail, Steven

AU - Beer, Christopher

AU - Hill, Keith D.

AU - Brauer, Sandra G.

AU - Haines, Terrence P.

PY - 2011/9

Y1 - 2011/9

N2 - Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge. Design: A prospective observational study using qualitative and quantitative evaluation. Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital. Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge. Interventions: Not applicable. Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and self-reported barriers to engagement in exercise measured at 6 months after discharge using a telephone survey. Results: Six months after discharge, 305 participants remained in the study, of whom 109 (35.7%) were engaging in a structured exercise program. Multivariable logistic regression analysis demonstrated participants were more likely to be engaging in exercise if they perceived they were at risk of serious injury from a fall (odds ratio [OR] =.61; 95% confidence interval [CI],.48.78; P<.001), if exercise was recommended by the hospital physiotherapist (OR=1.93; 95% CI, 1.033.59; P=.04), and if they lived with a partner (OR=1.97; 95% CI, 1.183.28; P=.009). Barriers to exercise identified by 168 participants (55%) included low self-efficacy, low motivation, medical problems such as pain, and impediments to program delivery. Conclusions: Older patients have low levels of engagement in exercise after hospital discharge. Researchers should design exercise programs that address identified barriers and facilitators, and provide education to enhance motivation and self-efficacy to exercise in this population.

AB - Objectives: To identify factors that are associated with older patients' engagement in exercise in the 6 months after hospital discharge. Design: A prospective observational study using qualitative and quantitative evaluation. Setting: Follow-up of hospital patients in their home setting after discharge from a metropolitan general hospital. Participants: Participants (N=343) were older patients (mean age ± SD, 79.4±8.5y) discharged from medical, surgical, and rehabilitation wards and followed up for 6 months after discharge. Interventions: Not applicable. Main Outcome Measures: Self-perceived awareness and risk of falls measured at discharge with a survey that addressed elements of the Health Belief Model. Engagement and self-reported barriers to engagement in exercise measured at 6 months after discharge using a telephone survey. Results: Six months after discharge, 305 participants remained in the study, of whom 109 (35.7%) were engaging in a structured exercise program. Multivariable logistic regression analysis demonstrated participants were more likely to be engaging in exercise if they perceived they were at risk of serious injury from a fall (odds ratio [OR] =.61; 95% confidence interval [CI],.48.78; P<.001), if exercise was recommended by the hospital physiotherapist (OR=1.93; 95% CI, 1.033.59; P=.04), and if they lived with a partner (OR=1.97; 95% CI, 1.183.28; P=.009). Barriers to exercise identified by 168 participants (55%) included low self-efficacy, low motivation, medical problems such as pain, and impediments to program delivery. Conclusions: Older patients have low levels of engagement in exercise after hospital discharge. Researchers should design exercise programs that address identified barriers and facilitators, and provide education to enhance motivation and self-efficacy to exercise in this population.

UR - http://www.scopus.com/inward/record.url?scp=80052194365&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2011.04.009

DO - 10.1016/j.apmr.2011.04.009

M3 - Article

VL - 92

SP - 1395

EP - 1403

JO - Archives of physical medicine

JF - Archives of physical medicine

SN - 0003-9993

IS - 9

ER -