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The Chronic Illness Context and Change in Exercise Self-Care Among Older Adults: A Longitudinal Analysis*

Published online by Cambridge University Press:  31 March 2010

Andrew Wister  and
Zan Romeder
Andrew Wister*
Affiliation:
Simon Fraser University
Zan Romeder
Affiliation:
South Granville Seniors Centre, Vancouver, B.C., Canada
*
Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressées à : Andrew Wister, Ph.D., Professor and Associate Director, Gerontology Programs, Simon Fraser University, 15 West Hastings, Vancouver, BCV6B 5K3. (wister@sfu.ca)
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Abstract

This study examines the stages of change in exercise as a form of coping with chronic illness, among a panel of older adults managing arthritis, cardiovascular disease, or hypertension. Hypotheses connected to socio-demographic, exercise-history, cognitive, and illness contexts are explored in order to advance applications of the Transtheoretical Model for exercise self-care. A random sample of 735 individuals aged 51 to 95, who completed interviews at time 1 (1995–96) and time 2 (1996–97), were drawn from the Vancouver North Shore Self Care Study. Bivariate and hierarchical logistic regression analyses were performed on the data. The descriptive analyses supported two patterns: first, older persons with a chronic illness exhibited a propensity either to remain in or move into the extreme exercise stages (pre-contemplation or maintenance) in a non-sequential manner; second, elements of the illness context were primary determinants of stage of exercise change. Illness type, illness duration, activity restriction, and co-morbidity exhibited associations with exercise-stage change in the multivariate analysis. The findings have a number of direct implications for tailoring health promotion programs targetting older adults, especially those who use exercise as a form of self-care.

Résumé

Cette recherche examine les étapes associées à la progression en matière de conditionnement physique lors de l'affrontement de la maladie chronique. Participaient à ce groupe d'études, des personnes âgées souffrant d'arthrite, de maladie cardio-vasculaire et d'hypertension. La recherche examine les hypothèses relatives aux domaines socio-démographiques, des antécédents de conditionnement physique, des contextes cognitifs et de maladies afin de présenter les réalisations du modèle trans-théorique de conditionnement physique et d'auto soins. Un échantillon aléatoire de 735 individus, âgés de 51 à 95 ans, ayant préalablement complétés des entrevues lors de la première (1995–96) et deuxième (1996–97) rencontres, ont été choisis du Vancouver North Shore Self Care Study. Les données ont fait l'objet d'analyse bivariée et d'analyse hiérarchique du modèle de régression logistique. Les analyses descriptives appuient deux dispositions : d'une manière non-séquentielle, les personnes âgées souffrant d'une maladie chronique démontraient une propension à vouloir demeurer dans ou progresser vers des étapes extrêmes de conditionnement physique (pré-recueillement ou entretien) ; certains éléments du contexte maladie étaient des facteurs déterminants primaires de la progression du conditionnement physique. Le genre de maladie, l'étendue de la maladie, les restrictions imposées aux activités et la co-morbidité démontraient tous des liens à la progression du conditionnement physique lors de l'analyse multifactorielle. Les résultats ont des effets immédiats lors de l'adaptation des programmes de sensibilisation de la santé pour les personnes âgées, surtout pour les individus qui se servent du conditionnement physique comme moyen d'auto-santé.

Keywords

agingstages of exercise changechronic illness managementolder adultsvieillissementétapes du changement en matière de conditionnement physiquegestion de la maladie chroniquepersonnes âgées
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 4 , Winter/Hiver 2002 , pp. 521 - 534
Copyright
Copyright © Canadian Association on Gerontology 2002

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Footnotes

*

The data used in this study were collected as part of a grant (#6610–2122–602) funded by the National Health Research and Development Program, Health Canada (Co-PIs: Drs. Larry Green, Andrew Wister, Gloria Gutman & Patrick McGowan). The authors gratefully acknowledge the helpful comments made by Dr. Tom Prohaska and the reviewers.

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