Difficulties and motivations for physical exercise in women older than 65 years. A qualitative study.

OBJECTIVE: to identify difficulties and motivations for the practice of physical exercise in women older than 65 years. METHOD: qualitative study based on the phenomenological theory, with focus groups and in-depth interviews. The nursing staff selected 15 women by intentional sampling using the following criteria: age, time dedicated to physical exercise, independence, and absence of cognitive impairment and contraindication for this activity. Two focus groups were formed (one of them did physical exercise for less than 150 minutes per week and the other at least 150 minutes per week) in addition to conducting five in-depth interviews. Qualitative analysis of the data was performed through transcription, coding, categorization, and verification of results. RESULTS: the difficulties to start and develop physical exercise were circumscribed to the perception of poor health and lack of free time; both circumstances result from care obligation, being represented as a gender imposition. However, the motivations are related to perception of strength, need for socialization, and perception of autonomy and freedom. CONCLUSIONS: the ideological representation of gender determines the women's decision to exercise. Knowing the meaning and significance that women give to health and their role in the socio-family environment allows nurses to develop relationships and interventions to encourage the practice of physical exercise.

Difficulties and motivations for physical exercise in women older than 65 years. A qualitative study / Dificuldades e motivações para o exercício físico em mulheres idosas. Um estudo qualitativo / Dificultades y motivaciones para el ejercicio físico en mujeres mayores de 65 años. Un estudio cualitativo

ABSTRACT Objective: to identify difficulties and motivations for the practice of physical exercise in women older than 65 years. Method: qualitative study based on the phenomenological theory, with focus groups and in-depth interviews. The nursing staff selected 15 women by intentional sampling using the following criteria: age, time dedicated to physical exercise, independence, and absence of cognitive impairment and contraindication for this activity. Two focus groups were formed (one of them did physical exercise for less than 150 minutes per week and the other at least 150 minutes per week) in addition to conducting five in-depth interviews. Qualitative analysis of the data was performed through transcription, coding, categorization, and verification of results. Results: the difficulties to start and develop physical exercise were circumscribed to the perception of poor health and lack of free time; both circumstances result from care obligation, being represented as a gender imposition. However, the motivations are related to perception of strength, need for socialization, and perception of autonomy and freedom. Conclusions: the ideological representation of gender determines the women's decision to exercise. Knowing the meaning and significance that women give to health and their role in the socio-family environment allows nurses to develop relationships and interventions to encourage the practice of physical exercise.

RESUMO Objetivo: identificar dificuldades e motivações para a prática de exercício físico em mulheres com mais de 65 anos. Método: estudo qualitativo baseado na teoria fenomenológica com grupos focais e entrevistas em profundidade. A enfermagem selecionou 15 mulheres por amostragem intencional com critérios de idade, tempo dedicado ao exercício físico, independentes, sem deterioração cognitiva e sem contra-indicação para a atividade. Foram estudados dois grupos focais (um realizava menos de 150 minutos semanais de exercício físico e outro no mínimo 150 minutos semanais), além de cinco entrevistas em profundidade. Análise qualitativa dos dados mediante transcrição, codificação, categorização e verificação dos resultados. Resultados: as dificuldades para o início e desenvolvimento do exercício físico ficam circunscritas à percepção de má saúde e à falta de tempo livre, resultado da obrigação do cuidado, representado como um mandato de gênero. Porém, as motivações estão relacionadas à percepção de fortaleza, necessidade de socialização, percepção de autonomia e liberdade. Conclusões: a representação ideológica do gênero determina a decisão para realizar exercício. Conhecer o sentido e o significado que as mulheres dão à saúde e ao seu papel no âmbito sócio familiar, permite que as enfermeiras desenvolvam relações e intervenções para a prática do exercício físico.

RESUMEN Objetivo: Identificar dificultades y motivaciones para la práctica de ejercicio físico en mujeres mayores de 65 años. Método: estudio cualitativo basado en la teoría fenomenológica con grupos focales y entrevistas en profundidad. La enfermería seleccionó 15 mujeres por muestreo intencional utilizando criterios de: edad, tiempo dedicado al ejercicio físico, independencia, sin deterioro cognitivo y sin contraindicación para esta actividad. Se formaron dos grupos focales (uno realizaba menos de 150 minutos semanales de ejercicio físico y el otro al menos 150 minutos semanales) además de realizar cinco entrevistas en profundidad. Análisis cualitativo de los datos mediante transcripción, codificación, categorización y verificación de resultados. Resultados: las dificultades para el inicio y desarrollo del ejercicio físico quedan circunscritas a la percepción de mala salud y falta de tiempo libre; que es resultado de la obligación de cuidar, representado como una imposición de género. Sin embargo, las motivaciones están relacionadas con percepción de fortaleza, necesidad de socialización, percepción de autonomía y libertad. Conclusiones: la representación ideológica de género determina la decisión para realizar ejercicio. Conocer el sentido y significado que las mujeres dan a la salud y su papel en el ámbito socio familiar permite a las enfermeras desarrollar relaciones e intervenciones para incentivar la práctica del ejercicio físico.

Eficacia de una intervención educativa en el manejo de dispositivos de inhalación / Efficacy of an educational intervention in the use of inhalation devices

OBJETIVO: evaluar el efecto de la intervención educativa enfermera en el manejo de dispositivos de inhalación. MÉTODO: ensayo controlado y aleatorizado en el Centro de Salud de Vistabella (Murcia) (70 sujetos en el grupo control (GC) y 69 en el grupo intervención (GI)) sobre pacientes con enfermedad respiratoria que cursa con obstrucción crónica del flujo aéreo. En el GI se realizó un adiestramiento hasta que el paciente lo hizo de forma correcta, y posteriormente se le entregó material escrito de apoyo; en el GC solo se les dio la información escrita. A los tres meses se efectuó la medición de evaluación. Se consideró como técnica inhalatoria aceptable realizar una inspiración profunda y apnea de 10 segundos. En el tratamiento y análisis de los datos se empleó el test de McNemar para datos apareados (antes y después de la intervención) y Chi-cuadrado en el contraste de hipótesis de datos apareados (medición postintervención). RESULTADOS: el porcentaje de realización aceptable de la técnica con el inhalador presurizado fue el que tuvo un mayor incremento entre antes y después de la intervención (antes: 13,5%, después: 703%; p = 0,001), aunque también se produjo un incremento significativo (p < 0,05) en el Turbuhaler® y Accuhaler®. En la comparación postintervención, en el grupo control un 49,1% (n= 27) realizaba la técnica de forma aceptable, y en el grupo intervención, un 93,3% (n= 56), siendo una diferencia estadísticamente significativa (p< 0,05). CONCLUSIÓN: el adiestramiento en el manejo de dispositivos de inhalación, junto con información escrita de apoyo, mejora la técnica empleada por el paciente, frente a entregar solo información escrita

OBJECTIVE: to assess the effect of educational intervention on the use of inhalation devices, METHOD: a controlled and randomized clinical trial at the Vistabella (Murcia) Health Centre, on patients with respiratory disease presenting a chronic obstruction in air flow (70 patients in the Control Arm (CA) and 69 in the Intervention Arm (AI)). The patients in the IA received training until they could do it adequately, and subsequently they were provided with support written materials; patients in the CA only received written information. At three months, the assessment measurement was conducted. A deep inhalation and 10-second apnea was considered an acceptable inhalation technique. For data treatment and analysis, McNemar Test for paired data was used (before and after the intervention), and Chi-Square Test was used for hypothesis contrast (post-intervention measurement). RESULTS: the proportion of acceptable use of the technique with the pressurized inhaler was the one with a higher increase after the intervention (before: 13.5%, after: 703%; p= 0.001), though there was also a significant increase (p< 0.05) for the Turbuhaler and Accuhaler. In the post-intervention comparison, 49.1% (n= 27) of patients in the control arm conducted the technique in an acceptable manner, vs. 93.3% (n= 56) in the intervention group; and this represented a statistically significant difference (p< 0.05). CONCLUSION: training in the use of inhalation devices, together with support written information, will improve the technique used by the patient, vs. only providing written information