Abstract:

Objective To systematically evaluate the factors that promote and hinder exercise in frail older adults，and to provide references for the formulation of exercise intervention programs. Methods We searched PubMed，Web of Science，Embase，CINAHL，Cochrane library，CNKI，Wanfang，VIP database，and China Biomedical Literature Database for qualitative studies on exercise facilitators and hindrances in frail older adults，and the search time period was from the establishment of the databases to September 1，2024. The quality of the literature was evaluated using the Joanna Brigg Institute Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research（2016），and the results were integrated by integrating methods. Results A total of 18 studies were included，and 72 research results were extracted，and 10 categories were summarized. The final synthesis included 2 integrated results：the facilitators included personal exercise motivation，physical and psychological benefits，positive interpersonal interactions，multiple social support systems and person-centred exercise programme；the impediments included underlying diseases and somatic functional limitations，negative psychological status，low health literacy，family role conflicts and limits of the environment. Conclusion Exercise for frail older adults is affected by a variety of factors. Healthcare professionals should improve the positive perception of exercise for frail older people and help them overcome psychological barriers；establish an all-round support system to enhance the sense of social contact of the frail elderly；formulate a personalised exercise programme with a human-centred approach to enhance the motivation of the frail elderly.

Key words: Frailty, Aged, Exercise, Promoting and Hindering Factors, Qualitative Research, Meta Synthesis, Evidence-Based Nursing

摘要：

目的 系统整合影响衰弱老年人运动锻炼的促进与阻碍因素，为制订相关运动干预方案提供参考。方法 计算机检索PubMed、Web of Science、Embase、CINAHL、Cochrane Library、中国知网、万方数据库、维普数据库和中国生物医学文献数据库等中英文数据库中关于衰弱老年人运动促进与阻碍因素的质性研究，检索时限为建库至2024年9月1日。文献质量评价采用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），采用汇集性整合方法对结果进行整合。结果 共纳入18篇文献，提炼出72个研究结果，最终归纳为10个类别，综合为2个整合结果：促进因素包括个人运动动机、感知身心获益、人际间积极互动、多元的社会支持系统及以人为本的运动方案；阻碍因素包括基础疾病及躯体功能限制、消极心理状态、低健康素养、家庭角色冲突及环境的限制。结论 衰弱老年人运动锻炼受多方面因素的影响，医护人员应提高衰弱老年人运动的积极认知，帮助其克服心理障碍；建立全方位支持系统，增强衰弱老年人社会联络感；制订以人为本的个性化运动方案，提高衰弱老年人的运动积极性。

关键词: 衰弱, 老年人, 运动, 促进与阻碍因素, 质性研究, Meta整合, 循证护理学