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1.文献信息:
Title:Barriers and facilitators to exercise adherence in community-dwelling older adults: A mixed-methods systematic review using the COM-B model and Theoretical Domains Framework.
社区老年人锻炼依从性的阻碍和促进因素:使用COM-B模型和理论领域框架的混合方法系统综述。
Journal:International Journal of Nursing Studies .
IF//JCR分区: 7.5/Q1.
Keyword:Adherence ; Community-dwelling older adults ; Barriers ; PFacilitators.
依从性;社区老年人;阻碍;促进。
Design:A cross-sectional study.
横断面研究。
2. 摘要 Abstract:
(译文仅供参考)
Background: Although the health benefits of exercise for older adults are widely recognized, physical inactivity is still common among older adults. Further clarification of the factors affecting exercise adherence is needed to develop more effective exercise interventions in community-dwelling older adults.
背景:尽管运动对老年人的健康益处已得到广泛认可,但老年人缺乏体育锻炼的现象仍然很普遍。需要进一步证明影响运动坚持的因素,以制定更有效的社区老年人运动干预措施。
Objective: The purposes of this study were to identify (1) barriers and facilitators of exercise adherence in community-dwelling older adults and (2) behavior change techniques (BCTs) and implementation strategies that are potentially effective in improving adherence.
目的:本研究的目的是确定(1)社区居住老年人坚持运动的阻碍和促进因素;(2)行为改变技术和实施策略,这些技术和实施策略可能有效地提高坚持运动的程度。
Methods: A total of eight databases were searched: PubMed, Web of Science, EMBASE, CENTRAL, PsycINFO, SPORTDiscus, MEDLINE, and Scopus. Studies published from database inception to April 2023 were searched. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Capabilities, Opportunities, Motivations, Behavior (COM-B) model and the Theoretical Domain Framework (TDF) were used to identify potential barriers and facilitators. The BCTs were used to identify potential intervention implementation strategies.
方法:检索PubMed、Web of Science、EMBASE、CENTRAL、PsycINFO、SPORTDiscus、MEDLINE、Scopus等8个数据库。检索了从数据库建立到2023年4月发表的研究。使用混合方法评估工具(MMAT)评估纳入研究的质量。使用能力、机会、动机、行为(COM-B)模型和理论领域框架(TDF)来识别潜在的障碍和促进因素。bct用于确定潜在的干预实施策略。
Results: A total of 64 studies were included, including 30 qualitative studies, 12 randomized controlled trials, 12 mixed methods studies, 6 quantitative descriptive studies, and 5 non-randomized trials. 54 factors influencing adherence and 38 potentially effective BCTs were identified from the included studies. The 38 BCTs were further categorized into 8 areas of implementation strategies (tailored exercise program, appropriate exercise environment, multidimensional social support, monitoring and feedback, managing emotional experiences and issues, participants education, enhancing self-efficacy, and exerting participants' autonomy).
结果:共纳入64项研究,其中定性研究30项,随机对照试验12项,混合方法研究12项,定量描述性研究6项,非随机试验5项。从纳入的研究中确定了54个影响依从性的因素和38个潜在有效的行为改变技术。38个行为改变技术被进一步划分为8个实施策略领域(量身定制的运动计划、适当的运动环境、多维社会支持、监测和反馈、管理情绪体验和问题、参与者教育、提高自我效能感和发挥参与者自主权)。
Conclusion: This study identified 54 influential factors affecting exercise adherence and identified 8 areas of intervention strategies (containing 38 BCTs). Further refinement, evaluation, and validation of these factors and strategies are needed in future studies.
结论:本研究确定了54个影响运动依从性的因素,并确定了8个领域的干预策略(包含38个行为改变技术)。在未来的研究中,需要进一步细化、评估和验证这些因素和策略。
3.文献新知扩展:
①COM-B模型是什么
COM-B模型是一个行为改变的理论模型,它提供了一个框架来分析和理解影响个体行为的因素。COM-B代表三个核心组成部分:能力(Capability)、机会(Opportunity)和动机(Motivation)。这三个组成部分相互作用,共同决定了个体的行为(Behavior)。能力指的是个体执行行为所需的心理和物理能力;机会涉及外部环境因素,如社会和物理环境,这些因素可以促进或阻碍行为的发生;动机则包括自动的心理过程(如习惯和情绪)和反思的过程(如信念和目标),这些过程激发或抑制行为。
②理论领域框架(TDF)是什么
理论领域框架(Theoretical Domains Framework,TDF)是一个更广泛的理论框架,它扩展了COM-B模型,提供了一个详细的理论结构来分析行为改变的潜在障碍和促进因素。TDF整合了多个健康心理学和行为科学理论中的概念,形成了14个理论域,这些域包括知识、技能、社会/专业角色和身份、信念关于能力、信念关于后果、动机和行为、记忆、注意力和行为控制、环境结构、社会影响、情绪、行为规范、强化和激励。TDF可以帮助研究者和实践者识别在特定情境中影响行为的关键因素,并设计有效的干预措施来促进行为改变。
③行为改变技术(BCTs)是什么
行为改变技术(Behavior Change Techniques,简称BCTs)是指在各种干预措施中用来促进行为改变的具体方法或策略。这些技术是干预的“活性成分”,它们通过直接作用于目标行为来产生效果。BCTs通常具有标准化的定义,这有助于清晰地评估、复制和报告干预措施的效果。
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