The purpose of this study is to present ways to provide more precise patient-oriented services by presenting implications and promoting a better understanding of exercise constraints. This study used questionnaire survey as measurement tool for 196 hospital inpatients in 5 general hospitals in the metropolitan area (Seoul, Gyeonggi, and Incheon). The collected data were analyzed using frequency analysis, exploratory factor analysis, reliability analysis, correlation analysis, and hierarchical regression analysis using IBM SPSS Statistics ver. 23.0. The following results were obtained. First, physical activity level and health condition on their physical constraints showed that their health condition factors such as pain/discomfort and anxiety/depression had greater effects on physical constraints than other factors. Second, physical activity level, and health condition on their psychological constraints showed that health condition factors had major effects on patients’ psychological constraints. Thirdly, physical activity level, and health condition on their sociocultural constraints found that anxiety/depression appeared as the key influence factor in physical and psychological constraints.
According to a report by Statics Korea, Korea has already become an aging society with the population over 65 years of age already accounting for 11.3% of total population as of 2010, and based on this trend, it is expected to become an aged society by 2019 and a super-aged society by 2026 (
Generally, physical activities are method of disease control and treatment for patients (
Therefore, this study conducted an empirical analysis of physical activity and factors that are related to insufficient inpatient physical activity based on a survey of adult patients hospitalized in 5 general hospitals in the metropolitan area (Seoul, Gyeonggi, and Incheon). It aims to present ways to provide more precise patient-oriented services by presenting implications and promoting a better understanding of exercise constraints.
Subjects were adult male and female patients over 20 years of age admitted to 5 general hospitals in the metropolitan area (Seoul, Gyeonggi, and Incheon). Written consent was obtained from 250 admitted patients selected through purposive sampling, and a survey was conducted to collect data. The survey period was from April to June 2017, and data from 196 subjects was used for the final analysis with data from 54 subjects who submitted unreliable responses excluded. The general characteristics of study subjects were as seen in
Data was collected via a survey containing questions about sex, age, educational background, income, and marital status to ascertain the general characteristics of subjects. The survey of personal exercise constraint factors used in a study by
The data collected in this study was tested for validity using confirmatory factor analysis. Principal component analysis was used to extract components, and varimax was adopted to simplify factor loadings. The Kaiser–Meyer–Olkin (KMO) Test was used as the reference in selecting variables for factor analysis. Bartlett sphericity test value (
In exploratory factor analysis, personal exercise constraints included 3 questions regarding physical constraints, 4 regarding psychological constraints, and 4 regarding sociocultural constraints. Specifically, personal exercise constraints resulted in KMO=0.818,
The purpose of this study was to examine the effects of hospital inpatients’ health factors, physical activity level, and health condition on their personal exercise constraints. For this, the researcher and assistant researcher visited hospitals and explained the purpose and goals of the survey after obtaining the hospital’s cooperation. Patients completed the survey by self-reporting. Surveys with low reliability, double entries, and no entries were excluded from the analysis, and the remaining data was individually coded and used for frequency analysis, exploratory factor analysis, reliability analysis, correlation analysis, and hierarchical regression analysis using IBM SPSS Statistics ver. 23.0 (IBM Co., Armonk, NY, USA).
Prior to verifying the relationship between variables set in this study, a correlation analysis was performed to examine the correlation among the subvariables and their multicollinearity. These variables showed a correlation of (
Residual analysis using the regression model was performed prior to hierarchical regression analysis for the effects of inpatients’ physical factors, physical activity level, and health condition on their personal exercise constraints, and no outliers were found. Furthermore, there was no deviation from normality, homoscedasticity, and linearity. As seen in
The results of hierarchical regression analysis to explain the effects of hospital inpatients’ health factors, physical activity level, and health condition on their physical constraints were as seen in
The result of hierarchical regression analysis to explain the hospital inpatients’ health factors, physical activity level, and health condition on their psychological constraints was as seen in
The result of hierarchical regression analysis to explain the hospital inpatients’ health factors, physical activity level, and health condition on their sociocultural constraints was as seen in
The purpose of this study was to empirically examine the factors that affect hospital inpatients’ personal exercise constraints and to analyze the effects of inpatients’ health factors, physical activity level, and health condition on their personal exercise constraints; the following discussion can be made based on the data obtained from study results.
First, hierarchical regression analysis of the effects of hospital inpatients’ health factors, physical activity level and health condition on their physical constraints showed that their health condition factors such as pain/discomfort and anxiety/depression had greater effects on physical constraints than other factors. Generally, patients tend to refrain from physical activities due to pain that arises from postoperative recovery and treatment, frustration that they cannot move freely during the treatment period, and fear of recurrence. With regard to this, a previous study also reported that negative emotions such as anxiety or depression after feeling greater pain than expected restrict physical activities (
Second, hierarchical regression analysis on the effects of hospital inpatients’ health factors, physical activity level, and health condition on their psychological constraints showed that health condition factors had major effects on patients’ psychological constraints. In particular, anxiety surrounding the possibility of recovery, negative emotions about the situation that the patient is in, and pain/discomfort acted as constraints in deciding on and implementing exercise participation. This means that anxiety/depression and pain/discomfort act as serious psychological factors in participating in exercise, which is supported by the results of a previous study that found osteoarthritis patients tend to avoid exercise due to the fear that it worsens symptoms (
Thirdly, hierarchical regression analysis on the effects of hospital inpatients’ health factors, physical activity level, and health condition on their sociocultural constraints found that anxiety/depression appeared as the key influence factor in physical and psychological constraints. Generally, it is not easy for inpatients to find inner peace and get back on life during treatment and recovery. These results from various factors such as recovery status or treatment stability, and with patients becoming mentally unstable, this negative emotional state may prevent them from accepting the help or exercise information needed for recovery. Furthermore, it is not easy for hospitalized patients to accept being diagnosed with disease and perform appropriate exercise at the same time. A relevant previous study reported that hemodialysis patients with terminal renal disease were affected in terms of physical constraints by social/environmental disability factors such as unwillingness to exercise, lack of time, and lack of exercise partner (
Therefore, considering that pain, anxiety, or depression arising from the treatment process affect patients’ personal exercise constraints, programs and education that can manage such pain, anxiety, and depression need to be provided. Moreover, a medical service environment where admitted patients can voluntarily participate in exercise should be established.
This study would like to make the following proposals based on these results. This study focused on the individual aspect of inpatients’ exercise constraints. Therefore, follow-up studies should categorize social and environmental characteristics as well as individual exercise constraints in more depth to analyze inpatients’ exercise constraints from different angles. This is because the exercise constraints of hospital inpatients may vary due to personal or other environmental factors. Psychological constraints in particular were not thoroughly examined through in-depth patient interviews and observation. Therefore, follow-up studies are needed to categorize hospital inpatients’ exercise constraint factors based on various inpatient groups to perform a qualitative study that can analyze why physical exercise is so difficult in hospital environments. This is because such exercise is significantly related to the improvement of services at medical institutions as well as patients’ fast recovery.
No potential conflict of interest relevant to this article was reported.
This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2016S1A5B6913737).
Demographic characteristics (n=196)
Variable | No. of cases (%) |
---|---|
Sex | |
Male | 97 (49.5) |
Female | 99 (50.5) |
| |
Age (yr) | |
Below 40 | 55 (28.1) |
40s | 24 (12.2) |
50s | 53 (27.0) |
60s | 37 (18.9) |
Over 70 | 27 (13.7) |
| |
Education | |
Middle school or below | 46 (23.5) |
High school | 75 (38.3) |
University | 63 (32.1) |
Higher than bachelor's degree | 12 (6.1) |
| |
Income (KRW) | |
Below 2 million | 85 (43.4) |
2 million–4 million | 55 (28.1) |
4 million–6 million | 37 (18.9) |
Over 6 million | 19 (9.6) |
| |
Marital status | |
Married | 140 (71.4) |
Single | 44 (22.4) |
Other | 12 (6.2) |
KRW, Korean won.
Correlation analysis
a | b | c | d | e | f | g | h | i | j | k | l | m | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
a | 1 | ||||||||||||
b | 0.044 | 1 | |||||||||||
c | −0.022 | −0.016 | 1 | ||||||||||
d | −0.099 | 0.109 | 0.018 | 1 | |||||||||
e | −0.089 | −0.067 | 0.007 | 0.271 |
1 | ||||||||
f | 0.347 |
−0.046 | 0.023 | −0.129 |
−0.064 | 1 | |||||||
g | 0.260 |
−0.006 | −0.067 | −0.018 | −0.031 | 0.679 |
1 | ||||||
h | 0.336 |
0.061 | 0.027 | −0.104 | −0.163 |
0.739 |
0.782 |
1 | |||||
i | 0.279 |
0.056 | 0.081 | −0.032 | −0.094 | 0.514 |
0.555 |
0.726 |
1 | ||||
j | 0.162 |
0.001 | −0.094 | 0.044 | −0.066 | 0.339 |
0.511 |
0.415 |
0.383 |
1 | |||
k | 0.185 |
−0.123 |
0.060 | 0.048 | 0.076 | 0.350 |
0.399 |
0.422 |
0.447 |
0.395 |
1 | ||
l | −0.124 |
−0.349 |
−0.088 | 0.083 | 0.233 |
−0.029 | 0.099 | −0.024 | −0.061 | 0.214 |
0.319 |
1 | |
m | 0.041 | −0.112 | −0.074 | 0.113 | 0.116 | −0.094 | −0.088 | −0.119 |
−0.089 | 0.166 |
0.151 |
0.426 |
1 |
a, history of surgery; b, exercise experience; c, hours seated; d, daily routine time; e, active time; f, physical ability; g, self-management; h, daily activities; i, pain/discomfort; j, anxiety/depression; k, physical constraints; l, psychological constraints; m, sociocultural constraints.
Effects of health factors, physical activity level, and health condition on physical constraints
Variable | Model 1 | Model 2 | Model 3 | ||||||
---|---|---|---|---|---|---|---|---|---|
|
|
| |||||||
SE | SE | SE | |||||||
History of surgery | 0.118 | 0.191 | 2.717 |
0.119 | 0.204 | 2.891 |
0.111 | 0.044 | 0.670 |
| |||||||||
Exercise experience | 0.113 | −0.132 | −1.877 | 0.115 | −0.134 | −1.884 | 0.101 | −0.142 | −2.281 |
| |||||||||
Hours seated | - | - | - | 0.060 | 0.060 | 0.859 | 0.053 | 0.056 | 0.901 |
| |||||||||
Daily routine hours | - | - | - | 0.059 | 0.063 | 0.861 | 0.052 | 0.050 | 0.768 |
| |||||||||
Active hours | - | - | - | 0.046 | 0.068 | 0.923 | 0.041 | 0.118 | 1.810 |
| |||||||||
Physical ability | - | - | - | - | - | - | 0.061 | 0.027 | 0.281 |
| |||||||||
Self-management | - | - | - | - | - | - | 0.065 | 0.023 | 0.207 |
| |||||||||
Daily activity | - | - | - | - | - | - | 0.087 | 0.129 | 0.961 |
| |||||||||
Pain/discomfort | - | - | - | - | - | - | 0.062 | 0.242 | 2.679 |
| |||||||||
Anxiety/depression | - | - | - | - | - | - | 0.053 | 0.232 | 3.198 |
| |||||||||
Statistics |
SE, standard error.
Effects of health factors, physical activity level, and health condition on psychological constraints
Variable | Model 1 | Model 2 | Model 3 | ||||||
---|---|---|---|---|---|---|---|---|---|
|
|
| |||||||
SE | SE | SE | |||||||
History of surgery | 0.110 | −0.109 | −1.624 | 0.108 | −0.088 | −1.339 | 0.113 | −0.099 | −1.441 |
| |||||||||
Exercise experience | 0.106 | −0.345 | −5.140 |
0.104 | −0.342 | −5.158 |
0.102 | −0.340 | −5.246 |
| |||||||||
Sitting hours | - | - | - | 0.054 | −0.098 | −1.339 | 0.054 | −0.056 | −0.873 |
| |||||||||
Daily life maintenance hours | - | - | - | 0.054 | 0.063 | 0.914 | 0.053 | 0.033 | 0.491 |
| |||||||||
Intentional moving hours | - | - | - | 0.042 | 0.186 | 2.717 |
0.041 | 0.205 | 3.030 |
| |||||||||
Physical ability | - | - | - | - | - | - | 0.061 | −0.139 | −1.399 |
| |||||||||
Self-management | - | - | - | - | - | - | 0.066 | 0.099 | 0.872 |
| |||||||||
Daily activity | - | - | - | - | - | - | 0.088 | 0.085 | 0.611 |
| |||||||||
Pain/discomfort | - | - | - | - | - | - | 0.063 | −0.129 | −1.374 |
| |||||||||
Anxiety/depression | - | - | - | - | - | - | 0.054 | 0.248 | 3.293 |
| |||||||||
Statistics |
SE, standard error.
Effects of health factors, physical activity level, and health condition on sociocultural constraints
Variable | Model 1 | Model 2 | Model 3 | ||||||
---|---|---|---|---|---|---|---|---|---|
|
|
| |||||||
SE | SE | SE | |||||||
History of surgery | 0.132 | 0.046 | 0.643 | 0.132 | 0.063 | 0.883 | 0.138 | 0.102 | 1.369 |
| |||||||||
Exercise experience | 0.126 | −0.114 | −1.597 | 0.127 | −0.123 | −1.709 | 0.125 | −0.119 | −1.686 |
| |||||||||
Hours seated | - | - | - | 0.066 | −0.077 | −1.709 | 0.066 | −0.053 | −0.754 |
| |||||||||
Daily routine hours | - | - | - | 0.066 | 0.111 | 1.490 | 0.065 | 0.085 | 1.161 |
| |||||||||
Active hours | - | - | - | 0.051 | 0.084 | 1.126 | 0.050 | 0.096 | 1.302 |
| |||||||||
Physical ability | - | - | - | - | - | - | 0.075 | −0.046 | −0.421 |
| |||||||||
Self-management | - | - | - | - | - | - | 0.081 | −0.182 | −1.471 |
| |||||||||
Daily activity | - | - | - | - | - | - | 0.108 | −0.009 | −0.060 |
| |||||||||
Pain/discomfort | - | - | - | - | - | - | 0.077 | −0.074 | −0.724 |
| |||||||||
Anxiety/depression | - | - | - | - | - | - | 0.066 | 0.289 | 3.518 |
| |||||||||
Statistics |
SE, standard error.