将身体活动评估和行为改变技术纳入老年医学

Mariana Wingood DPT, PhD, MPH , Jonathan F. Bean MD, MPH , Amy M. Linsky MD, MSc
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引用次数: 0

摘要

在 65 岁及以上的成年人中,有 91% 的人没有进行建议水平的体育锻炼(PA),导致残疾、发病和死亡风险增加。尽管人们知道体育锻炼的益处,也认识到评估和解决体育锻炼不足问题的重要性,但仍有 50%-75% 的医疗服务提供者没有将行为改变技术纳入临床实践。造成这种临床差距的原因可能是缺乏以下方面的知识或信心:(1)评估 PA 水平;(2)解决 PA 水平不足的问题;(3)证明在临床实践中使用这些技术所需的时间是合理的。在这篇特别通讯中,我们针对这一不足,提供了一个基于理论的三步临床决策路径,指导医疗服务提供者如何识别PA水平不足的老年人,确定他们是否准备好增加PA,并授权专利制定行动计划以提高他们的PA水平。我们还提供了一个概念模型,通过将 PA 与年龄友好健康系统的 4Ms(即对老年人重要的事情、指导、行动能力和药物)联系起来,支持使用评估和解决 PA 不足的技术。
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Incorporating Physical Activity Assessments and Behavior Change Techniques Into Geriatrics

Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What Matters to the older adult, Mentation, Mobility, and Medications).

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