Previous studies suggest a myriad of factors prevent individuals from engaging in physical activity; however, less is known about barriers faced by individuals with multiple chronic conditions, such as peripheral artery disease (PAD) and type 2 diabetes, and how these barriers may impact engagement in physical activity. To date, there are no studies that integrate simultaneous assessment of perceived barriers to physical activity and engagement in physical activity in older adults with PAD and diabetes. This integration is key to understanding the implications of barriers to physical activity and to developing strategies to address those barriers. Therefore, this study investigated the unique physical activity experiences of older adults with PAD and diabetes. This study used a concurrent mixed methods design. Ten adults aged 65 years and older with PAD and diabetes completed semistructured interviews about experiences with physical activity, self-reported questionnaires assessing quality of life and fear of falling, and measures of physical function (eg, 6-minute walk test, chair stand, gait speed). Physical activity was measured objectively with accelerometry. Inductive content analysis was used to identify themes, and integrated analysis was performed to evaluate patterns among qualitative and quantitative variables. On average, participants were 74 years old and spent 10% of their time in moderate or vigorous physical activity (range: 3%–18%); 80% of participants were men. Barriers to physical activity identified through qualitative interviews included lack of accessibility, lack of enjoyment of activity, lack of motivation, and pain and physical health. Facilitators to physical activity were social support, accessibility and convenience, and enjoyment of the activity. Participants with more sedentary time and less moderate or vigorous physical activity tended to report greater fear of falling and greater barriers to physical activity and achieved lower distances in 6-minute walk tests. This research provides insight into both the nature of perceived barriers to physical activity and engagement in physical activity among older adults with PAD and diabetes. The integration of self-reported measures and objective measures facilitates our understanding of the lived experiences of individuals with these conditions. Study findings can be used to support further investigation into factors that influence engagement in physical activity in individuals with PAD and diabetes and to assist in the development of strategies to address identified barriers.
Bibliographical noteFunding Information:
The authors would like to thank Dr Barbara McMorris for her valuable assistance in the development of this article. Ms Whipple was a 2015-2017 National Hartford Center of Gerontological Nursing Excellence (NHCGNE) Patricia G. Archbold Scholar. The Patricia G. Archbold Scholar program is supported by a grant to the Gerontological Society of America (GSA)/NHCGNE from the John A. Hartford Foundation. This publication was made possible by the National Institutes of Health under a Ruth L. Kirschstein National Research Service Award (F31NR016614, PI Whipple) from the National Institute of Nursing Research and by UL1TR002494 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Portions of the results reported in this article were presented as a poster at the Society for Vascular Nursing 2017 Annual Meeting in Nashville, TN, and the 2018 Annual Meeting in Boston, MA.
© 2019 Society for Vascular Nursing
Copyright 2019 Elsevier B.V., All rights reserved.