Attitudes and Expectations Regarding Exercise in the Hospital of Hospitalized Older Adults: A Qualitative Study

Abstract

Objectives: To describe expectations of, and perceived motivators and barriers to, in‐hospital exercise of hospitalized older adults. Design: Qualitative study using the framework theory. Setting: Public hospital general medical wards. Participants: Twenty‐eight English‐ or Spanish‐speaking inpatients aged 65 to 103 . Measurements: Semistructured interviews were conducted at the bedside. Questions explored attitudes and expectations regarding in‐hospital exercise. Interviews were tape recorded and transcribed, and content analysis was performed to identify major themes. Results: For most participants (71%), exercise in the hospital meant walking. Only 29% of participants expected to be exercising in the hospital, although three‐quarters perceived it to be appropriate. Major themes included motivating factors and barriers to in‐hospital exercise. Motivating factors included avoiding the negative effects of prolonged bed rest, promoting a sense of well‐being, promoting functional recovery, and being asked to exercise. Barriers included symptoms related to one's illness, institutional barriers, and fear of injury. Most respondents (85%) felt that if the physician suggested exercise, it would influence their decision to do so, yet few (27%) reported that they had spoken to their physician about exercise. Conclusion: Hospitalized older adults have positive perceptions about in‐hospital exercise, although they must overcome significant barriers to do so. Medical professionals have a strong influence over the exercise behavior of elderly adults in the hospital yet infrequently address the issue. Incorporating motivating factors and removing barriers may increase the effectiveness of in‐hospital exercise programs.