Increased self-efficacy: The experience of high-intensity exercise of nursing home residents with dementia - A qualitative study
Journal article, Peer reviewed
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Original versionOlsen, C. F., Telenius, E. W., Engedal, K., & Bergland, A. (2015). Increased self-efficacy: the experience of high-intensity exercise of nursing home residents with dementia–a qualitative study. BMC health services research, 15(1), 1. http://dx.doi.org/10.1186/s12913-015-1041-7
Background:There has been increasing interest in the use of non-pharmacological interventions, such as physicalexercise, to improve the well-being of nursing home residents with dementia. For reasons regarding diseasesymptoms, persons with dementia might find it difficult to participate in exercise programs. Therefore, it isimportant to find ways to successfully promote regular exercise for patients in residential care. Several quantitativestudies have established the positive effects of exercise on biopsychosocial factors, such as self-efficacy in olderpeople; however, little is known regarding the qualitative aspects of participating in an exercise program amongolder people with dementia. From the perspective of residents, we explored the experiences of participating in ahigh-intensity functional exercise program among nursing home residents with dementia.Methods:The participants were eight elderly people with mild-to-moderate dementia. We conducted semi-structured interviews one week after they had finished a 10-week supervised high-intensity exercise program. Weanalyzed the data using an inductive content analysis.Results:Five overreaching and interrelated themes emerged from the interviews:“Pushing the limits,”“Beinginvested in,”“Relationships facilitate exercise participation,”“Exercise revives the body, increases independence andimproves self-esteem”and“Physical activity is a basic human necessity—use it or lose it!”The results wereinterpreted in light of Bandura’s self-efficacy theory. The exercise program seemed to improve self-efficacy throughseveral mechanisms. By being involved,“being invested in”and having something expected of them, theparticipants gained a sense of empowerment in their everyday lives. The importance of social influences related tothe exercise instructor and the exercise group was accentuated by the participants.Conclusions:The nursing home residents had, for the most part, positive experiences with regard to participatingin the exercise program. The program seemed to increase their self-efficacy through several mechanisms. Theinstructor competence emerged as an important facilitating factor. The participants emphasized the importance ofphysical activity in the nursing home.