| ObjectiveTo explore the current situation of sedentary behavior of the elderly in the community and analyze its influencing factors,to deeply understand the experience and views of the elderly in the community on sedentary behavior,and to analyze the correlation between sedentary behavior and frailty of the elderly in the community,to explore the best critical time value of sedentary behavior in the screening of the elderly frailty,so as to lay a foundation for the elderly care workers in the community to formulate targeted sedentary behavior intervention measures,It provides valuable reference for the management and intervention of senile frailty.MethodsThe research methods of phenomenology in cross-sectional and qualitative research are applied.By using the general information questionnaire,Mini-Mental State Examination,Activity of Daily Living Scale,International Physical Activity Questionnaire(since the fill type long),Frailty Phenotype,10 communities in the Middle District,Lixia District and Huaiyin District of Jinan City,Shandong Province were selected as the research sites.264 community elders who met the exclusion criteria were investigated and effective questions were collected The effective recovery was 94.70%.The data base was established and SPSS21.0 software was used for statistical analysis to explore the influencing factors of sedentary behavior of the elderly in the communi ty and the correlation between sedentary behavior and elderly frailty.Using the maximum difference sampling strategy in the objective sampling method,14 senior citizens who met the inclusion criteria were interviewed semi-structured from the senior citizens who participated in the first stage of the quantitative survey,and the influencing factors of the sedentary behavior of the senior citizens in the community were further explored to supplement the factors that could not be obtained in the quantitative study.The interview data was analyzed in7 steps of the Colaizzi phenomenological research method Analysis methodResults1.The average time of sedentary behavior was 6.90±1.60 hours/day.The average time of sedentary behavior of the elderly by means of transport is 0.67±0.81 hours/day;the average time of sedentary behavior of working days is 6.25±1.59 hours/day;the average time of sedentary behavior of rest days is 6.25±1.61 hours/day.The time of sedentary behavior of 250 old people is more than 4 hours,of which 84 people have sedentary behavior for 4-6 hours a day,accounting for 33.6%of the total;84 people have sedentary behavior for 6-8 hours a day,accounting for 33.6%of the total 82 people have sedentary behavior for more than or equal to 8 hours a day,accounting for 32.8%of the total.2.The results of single factor analysis showed that there were significant differences in sedentary time among the elderly in different gender,age,occupation,marital status,education level,monthly income status,medical insurance,employment status,self-assessment of health,number of disease types and ADL(P<0.05).The results of multiple regression analysis showed that gender and education had a significant negative impact on sedentary behavior of the elderly in the community(P<0.01,P<0.01),and age,employment status,health self-assessment,ADL had a significant positive impact on sedentary behavior of the elderly in the community(P<0.01,P<0.05,P<0.05,P<0.01).3.Through qualitative research,we further explored the influencing factors of sedentary behavior of the elderly in the community,the results of qualitative interviews show that some elderly people in some communities think that living alone can lead to the increase of sedentary behavior.Some elderly people think that the individual factors of static hobbies,inherent habits,inertia,lack of motivation,and lack of cognition can lead to the increase of sedentary behavior.Some elderly people think that the physical health factors of their poor health status and decreased physical function can lead to sedentary behavior with the increase of behavior,some old people think that cognitive function decline can lead to the increase of sedentary behavior.Some old people think that people’s stereotype,social needs,social support and family role commitment are reduced in the social environment.In the physical environment,the weather and environment are not suitable,and the restrictions of policy environment can lead to the increase of sedentary behavior people think that psychological factors such as psychological emptiness and loneliness can lead to the increase of sedentary behavior.4.The prevalence of frailty was 13.6%and the incidence of pre-frailty was 40.8%.The incidence of frailty was as follows:low grip strength(36.4%),low physical activity(31.2%),fatigue(22.8%),slow pace(19.2%),and body mass decline(3.0%).The results of single factor analysis showed that compared with the non-frail group(5.48±1.10 hours/day)and the pre-frailty group(7.56±0.86 hours/day),the time of sedentary behavior in the frailty group(9.39±1.01hours/day)was significantly longer(P<0.01).Pearson’s correlation analysis showed that there was a significant positive correlation between the time level of sedentary behavior and the state of frailty and the scores of four indicators of weakness,such as self feeling fatigue,grip strength reduction,slow walking and low physical activity(r=0.803,P<0.01;r=0.440,P<0.01;r=0.579,P<0.01;r=0.495,P<0.01;r=0.688,P<0.01).The results of regression analysis showed that sedentary behavior time was the risk factor of the state of frailty and four indexes of frailty,such as self feeling fatigue,grip strength reduction,slow walking speed and low physical activity(P<0.01).ROC curve analysis shows that the time of sedentary behavior can be used as a potential indicator to screen whether the elderly in the community are frail or not.The area under the curve shows that sedentary 6.5 hours/day is the best critical time to identify whether the elderly in the community are frail.Its sensitivity is 90%and specificity is 69%.Conclusion1.At present,the sedentary behavior of the elderly in the community is more common,and the sedentary situation is more severe.The average time of sedentary behavior of the elderly in the community is 6.90±1.60 hours/day,and most of them are more than 4 hours per day.2.In the single factor analysis,there are significant differences in the time of sedentary behavior among the elderly in different gender,age,occupation,marital status,education level,monthly income status,medical insurance,employment status,self-assessment of health,number of disease types and ADL.In the multi factor analysis,gender,age,education level,employment status,self-assessment of health andability of daily living(ADL)are the influencing factors that leadtothe increase of sedentary behavior of the elderly in the community.That is to say,the more serious the male,low education level,old age,non employment status,poor self-assessment of health and ADL barrierwill promote the increase of sedentary behavior of the elderly in thecommunity.3.Through qualitative research,we find that the sedentary behavior of the elderly in the community is also affected by the elderly living alone,individual factors,physical health factors,cognitive function,environmental factors and psychological factors.4.The incidence of frailty was 13.6%and the incidence of pre-frail was 40.8%.Compared with the non-frail group and the pre-frail group,the sedentary behavior time of the frailty group was significantly longer.There was a significant positive correlation between sedentary behavior and frailty status of the elderly in the community and the four indicators of frailty(self feeling fatigue,grip strength reduction,slow pace,low physical activity).Sedentary behavior is a risk factor for frailty condition and four frailty indexes(self-reported fatigue,decreased grip strength,slow walking speed,and low physical activity).Sedentary behavior can be used asasign of the elderly debilitating screening.The best critical time of sedentary behavior screening is 6.5 hours/day. |
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