540102 research-article2014
WJNXXX10.1177/0193945914540102Western Journal of Nursing Research
Midwest Nursing Research Society PhD Student Award Abstract
Self-Concepts of Exercise in Frail Older Adults With Heart Failure: A Literature Review
Western Journal of Nursing Research 2014, Vol. 36(10) 1378–1379 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0193945914540102 wjn.sagepub.com
Approximately 40% of older adults age >65 with heart failure (HF) experience concurrent frailty. This co-occurrence can adversely affect the ability of older adults to engage in self-care management behaviors, which may alter self-concepts and decrease quality of life. Little is known about how frailty and HF influence older adults’ self-concepts or how these self-concepts affect exercise behaviors. The purposes of this systematic review were to identify the self-concepts of older frail adults with HF and how these self-concepts affect their exercise behaviors. Guided by the components of the Schema Model of Self-Concept, literature published before April 2013 was searched using the PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science databases. We included studies that examined the impact of the self-concepts of older adults (>65 years) with HF and/or frailty on exercise behavior and were written in English. Excluded were studies that examined exercise as an antecedent to establish a self-concept and full-text studies that were not available online or via interlibrary loan. Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) rating scale was used to appraise the levels of evidence. We initially identified 610 articles. After deleting duplications and evaluating articles based on the inclusion/exclusion criteria, six articles were included: three qualitative studies, two cross-sectional design, and one secondary data analysis. Studies were primarily conducted in Western countries with small sample sizes. All had Level III evidence with good quality. Half of articles focused on frailty and half on HF. No study specifically examined the selfconcepts of frail older adults with HF. The self-concepts of older adults with HF and/or frailty were multifaceted and included both cognitive resources (facilitating exercise) and cognitive liabilities (hindering exercise). Cognitive resources included exerciser self-schema, possible selves, perceived health, self-perception of HF regimens as a challenge, and self-perception of exercise. Cognitive liabilities included perceived frailty and self-perception of HF regimens as a threat. Nurses must be aware of older adults’ cognitive resources and liabilities to facilitate exercise engagement. Studies are needed
Xie and Arslanian-Engoren
1379
to determine how these self-concepts impact exercise behaviors in frail older adults with HF, using larger sample sizes and culturally and ethnically diverse samples. Boqin Xie, MS, RN, PhD candidate Cynthia Arslanian-Engoren, PhD, RN, FAHA, FAAN University of Michigan School of Nursing, Ann Arbor, USA
WJNXXX10.1177/0193945914540102Western Journal of Nursing Research
Midwest Nursing Research Society PhD Student Award Abstract
Self-Concepts of Exercise in Frail Older Adults With Heart Failure: A Literature Review
Western Journal of Nursing Research 2014, Vol. 36(10) 1378–1379 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0193945914540102 wjn.sagepub.com
Approximately 40% of older adults age >65 with heart failure (HF) experience concurrent frailty. This co-occurrence can adversely affect the ability of older adults to engage in self-care management behaviors, which may alter self-concepts and decrease quality of life. Little is known about how frailty and HF influence older adults’ self-concepts or how these self-concepts affect exercise behaviors. The purposes of this systematic review were to identify the self-concepts of older frail adults with HF and how these self-concepts affect their exercise behaviors. Guided by the components of the Schema Model of Self-Concept, literature published before April 2013 was searched using the PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science databases. We included studies that examined the impact of the self-concepts of older adults (>65 years) with HF and/or frailty on exercise behavior and were written in English. Excluded were studies that examined exercise as an antecedent to establish a self-concept and full-text studies that were not available online or via interlibrary loan. Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) rating scale was used to appraise the levels of evidence. We initially identified 610 articles. After deleting duplications and evaluating articles based on the inclusion/exclusion criteria, six articles were included: three qualitative studies, two cross-sectional design, and one secondary data analysis. Studies were primarily conducted in Western countries with small sample sizes. All had Level III evidence with good quality. Half of articles focused on frailty and half on HF. No study specifically examined the selfconcepts of frail older adults with HF. The self-concepts of older adults with HF and/or frailty were multifaceted and included both cognitive resources (facilitating exercise) and cognitive liabilities (hindering exercise). Cognitive resources included exerciser self-schema, possible selves, perceived health, self-perception of HF regimens as a challenge, and self-perception of exercise. Cognitive liabilities included perceived frailty and self-perception of HF regimens as a threat. Nurses must be aware of older adults’ cognitive resources and liabilities to facilitate exercise engagement. Studies are needed
Xie and Arslanian-Engoren
1379
to determine how these self-concepts impact exercise behaviors in frail older adults with HF, using larger sample sizes and culturally and ethnically diverse samples. Boqin Xie, MS, RN, PhD candidate Cynthia Arslanian-Engoren, PhD, RN, FAHA, FAAN University of Michigan School of Nursing, Ann Arbor, USA
