Understanding what motivates older adults to exercise.

The purposes of this study were to explore the factors that influenced adherence to an exercise program for older adults, and compare differences in motivation, efficacy expectations, health status, age, functional performance, and falls between adherers and nonadherers. A combined qualitative and quantitative design was used. Participants included 23 of the 24 members of an existing walking group, with an average age of 81 +/- 7.2 years. Fourteen (60%) participants did not adhere to walking, while 9 (40%) adhered. Those that adhered had fewer functional limitations due to their health, (F = 7.7, p < .05), better functional performance (F = 4.0, p < .05), stronger self-efficacy expectations related to exercise (F = 4.3, p < .05), and fewer falls (F = 4.4, p < .05). Six major themes were identified that impacted adherence: a) beliefs about exercise; b) benefits of exercise; c) past experiences with exercise; d) goals; e) personality; and f) unpleasant sensations associated with exercise. Interventions that focus on teaching older adults about the benefits of exercise, establishing appropriate goals, and decreasing unpleasant and increasing pleasant sensations associated with exercise may be useful to improve adherence to a regular exercise program.

Path analysis of efficacy expectations and exercise behaviour in older adults.

The benefits of regular exercise for older adults are well documented and include improvements in physical, functional, as well as psychological, health. The purpose of this descriptive study was to test a theoretically and empirically based model describing the factors that influence exercise behaviour of older adults in the United States of America. The hypothesized model suggested that age, gender, and mental and physical health have an effect on self-efficacy and outcome expectations, and that all these variables influence exercise behaviour. Exercise behaviour was hypothesized to have a reciprocal relationship with self-efficacy expectations and mental and physical health. The convenience sample was 187 older adults living in a continuing care retirement community (CCRC) in Baltimore, Maryland. A one-time health interview was conducted which included a measure of self-efficacy and outcome expectations related to exercise, a measure of health status (SF-12), and gathering of information from participants about their actual exercise behaviour. Of the 187, 71 (38%) reported participating in 20 minutes of continuous aerobic exercise at least three times per week over the previous 3 months. Six hypothesized paths were significant. The model fitted the data and accounted for 32% of the variance in exercise behaviour. Interventions that focus on strengthening self-efficacy and outcome expectations can improve exercise behaviour in older adults.

Implementing strategies to decrease risk of falls in older women.

1. Seventy-three percent of older women attending a fall prevention program made at least one low cost change in either their personal behavior or living environment to decrease their likelihood of falls. 2. Older women educated in small group sessions made more fall prevention changes than those educated individually. 3. When conducting a fall prevention program, having examples of safety devices available for participants to examine enhances the presentation.

Nursing's role in health promotion. An overview.

This article presents health promotion as a basic concept for nursing practice. Since the era of Nightingale, health promotion has continued to be a major focus for nursing as is reflected in the American Nurses' Association (ANA) Social Policy Statement. The major focus of this article is nursing's role in health promotion in such areas as assessment, advocacy, case management, promotion of self-care, and client education. Major societal changes that are expected to have an impact on health promotion in the near future are also presented.