Abstract:

Objective To systematically evaluate and integrate qualitative studies on perception of exercise behaviors in community-dwelling older adults with frailty，and to provide references for clinical development of targeted exercise intervention strategies. Methods A systematic search of PubMed，Medline，Embase，PsycINFO，the Cochrane Library，SinoMed，Wanfang Database，CNKI，and VIP Database for qualitative studies on perception of exercise behaviors in older adults with frailty in the community was conducted from the inception of the databases to June 2024. Literature quality was evaluated using the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research（2016 edition），and Meta-synthesis was performed using the theme synthesis method. Results A total of 10 papers were included，grouped into 10 categories and integrated into the 3 domains of the capability，opportunity，and motivation-behavior model（COM-B model），i.e. Preparation for exercise behavior is influenced by capability factors（physical reserve，knowledge reserve，psychological preparation）；stage-specific motivational evolution promotes the internalization of exercise behavior（guiding，focusing，stimulating，and maintaining）；external conditions provide opportunities for exercise behavior（individual interaction，community environment，and social support）. Conclusion Perceptions of exercise behavior among community-dwelling older adults with frailty or are complex and influenced by a variety of factors. Future exercise intervention strategies should consider modifiable factors，enhance knowledge education，stimulate intrinsic motivation，and solidify external conditions，while also accommodating individual differences and preferences，so as to promote exercise participation and health enhancement in this group.

Key words: Frailty, Exercise, Aged, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

摘要：

目的 系统整合社区衰弱老年人运动行为认知的质性研究，为临床制订针对性的运动干预策略提供参考。 方法 系统检索PubMed、Medline、Embase、PsycINFO、Cochrane Library、中国生物医学文献数据库、万方数据库、中国知网和维普数据库中关于社区衰弱老年人运动行为认知的质性研究，检索时限为建库至2024年6月。根据澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准（2016版）评价文献质量，由2名研究者采用主题综合法进行Meta整合。 结果 共纳入10篇文献，归纳为10个类别，并整合到能力、机会、动机-行为模型的3个领域，即运动行为准备受能力因素影响（身体贮备、知识储备、心理准备）、阶段性动机演变促进运动行为内化（导进、聚焦、激发、维持）、外部条件为运动行为提供机会（个体互动、社区环境和社会支持）。结论 社区衰弱老年人在运动行为上的认知具有复杂性，并受到多种因素的影响。未来的运动干预策略需依据可改变因素，强化知识教育、激发内在动机和巩固外部条件，充分考虑个体差异和偏好，从而促进该群体运动参与及健康水平的提升。

关键词: 衰弱, 运动, 老年人, 质性研究, Meta整合, 循证护理学