HRQL 3 Flashcards
Exercise and HRQL – Factors to Consider
* Purpose of an …
* People who exercise for …., vs. …., show largest gains in HRQL
* Adherence factor:
* Those with disease may not be able to … – more barriers – and thus….
* Those with disease may be …. motivated to achieve gains
* Those with disease may not …. benefits they consider important
* Those with healthy may not … benefits – already doing ‘ok’ – and thus don’t adhere/maintain
- Other interventions
- Exercise most effective when combined with standard treatments (e.g., drug
therapy, psychotherapy) for certain populations - Exercise may provide benefits beyond achievable by standard treatment alone
- EXERCISE AS ADJUNCT TO OTHER THERAPIES
- Purpose of an intervention
- People who exercise for health promotion or disease prevention, vs. rehabilitation / disease management, show largest gains in HRQL
- Adherence factor:
- Those with disease may not be able to adhere – more barriers – and thus less beneficial impacts
- Those with disease may be MORE motivated to achieve gains
- Those with disease may not perceive benefits they consider important
- Those with healthy may not perceive benefits – already doing ‘ok’ – and thus don’t adhere/maintain
Mechanisms of Change*
* … changes in health and fitness status
* Person does NOT need to experience significant changes in (BP, glucose, strength, aerobic fitness, body
composition) to derive HRQL benefits
* HRQL reflects … about health and
function, subjective responses are more critical than
the …. changes*
* Changes in self-efficacy
* Low HRQL is reported in those who believe they have
little control over illness and their lives
* Exercise can improve HRQL by enhancing self-efficacy to control their health
- Objective changes in health and fitness status
- Person does NOT need to experience significant changes in (BP, glucose, strength, aerobic fitness, body
composition) to derive HRQL benefits - HRQL reflects PERCEPTIONS about health and
function, subjective responses are more critical than
the ACTUAL changes*** - Changes in self-efficacy
- Low HRQL is reported in those who believe they have
little control over illness and their lives - Exercise can improve HRQL by enhancing self-efficacy to control their health
Practical Recommendations
* People must be able to perceive improvements in their level of functioning
- Interventionists can help make people more aware of functional gains by:
Changes in perceived difficulty with which tasks are performed or amount of help required can be recorded throughout exercise intervention and brought to the participant’s attention
*
People must realize the value of exercise to their HRQL
* E.g.,
*
People should be encouraged to engage in various different types of PA
*
* E.g.,
Performing unstructured PA can increase beliefs about level of control a person has over his or her life
*
- Interventionists can help make people more aware of functional gains by:
- Asking about level of functioning in ADL
- Periodically testing ability to perform ADL
- Changes in perceived difficulty with which tasks are performed or amount of help required can be recorded throughout exercise intervention and brought to the participant’s attention
- People often don’t realize they have made progress unless given opportunity to see how far they have come
- People must realize the value of exercise to their HRQL
- E.g., why should older adults in a fitness class strengthen biceps and triceps?
- Relates to performance of ADL’s – carry laundry, lift self out of tub
- People should be encouraged to engage in various different types of PA
- Some types of PA may affect certain components of HRQL more than others
- E.g., strength training
→ physical functioning - Performing unstructured PA can increase beliefs about level of control a person has over his or her life
- Improved control beliefs might lead to increased perceptions of HRQL
Social Support
* Defined as: perceived ???? , and information person receives from others
* Two approaches have been used to define and measure social support among exercisers:
1. ???? of social network
2. ???? of support provided
Social Support
* Defined as: perceived comfort, caring, assistance, and information a person receives from others.
* Two approaches have been used to define and measure social support among exercisers:
Size of social network
- * Measured as number of groups or individuals an exerciser can turn to for support
* Relationship to PA Participation:
* Those who have more available support sources report greater levels of physical exertion during PA
* People who have many significant others to exercise with are more likely to exercise at
recommended levels
amount and Type of support provided
1. TANGIBLE
1. Provide tangible, practical assistance
2.EMOTIONAL
1. Express encouragement, caring, empathy, and concern
3. INFORMATIONAL
1. Give direction, advice, or suggestions about exercise
4. SOCIAL
1. People with whom one can exercise
5. ESTEEM
* Comparing oneself with others to gauge progress
- As exercisers’ needs and coping abilities fluctuate over time, so do their social support
requirements: - Most effective type of support depends on …… at any given point in time
- Needs may vary as function of changes in the exerciser’s psychology, physiology, or
stage of development
- As exercisers’ needs and coping abilities fluctuate over time, so do their social support
requirements: - Most effective type of support depends on exercisers’needs at any given point in time
- Needs may vary as function of changes in the exerciser’s psychology, physiology, or
stage of development
Four sources/categories of support persons:
Family (spouse, parents, siblings)
Important others (friends, coworkers, physicians, trainers)
Exercise professionals (coaches, instructors, personal trainers)
Other exercise participants (workout partners, teammates, group members)
FAMILY social support
advantages?
they provide…
and serve as…
children compliance increases when…
Limitations?
behavioural reactance?
overproctiveness?
- Positive effects of supportive spouse or partner on
exercise behavior consistently demonstrated - People who exercise with spouses have greater
emotional support, higher attendance and lower
drop-out rates - Parents provide multiple types of social support
- Serve as role models and establish PA norms
- Children’s compliance is best when parents take part in exercise interventions with them
- When family members pressure loved ones to exercise, the person may resist or withdraw
- Behavioral reactance – Response in the opposite direction of what is being advocated
- May occur when individuals perceive significant others exerting social control rather than social support
- Overprotectiveness – Going to extremes in trying to protect another person from harm
- Can be intrusive, controlling, and undermine self-efficacy
IMPORTANT OTHER SOCIAL SUPPORT
from health professionals
from the physician
- Health professionals are an important source of support for people wishing to become active
- There is an increasing number of health professionals who discuss PA with clients and work with fitness professionals
- PA counseling from a health professional leads to increased motivation and adherence to exercise
- Health professionals also serve as role models
PHYSICIAN
- Source of information for those starting out
- But activity counseling occurs during less than half of all patient visits
- More than half of the physicians trained in the US received no formal education in P
Exercise Professionals
* Exercise professionals are cited as the ???? of an
exerciser’s continued participation in exercise program
* Exercise professionals are able to provide ???? of
social support
2 LEADERSHIP STYLES
people who experience social supportive leadership get
- Characteristics that instill confidence:
- C
- C
- Exercise professionals are cited as the most important determinant of an exerciser’s continued participation in an exercise program
- Exercise professionals are able to provide multiple types of social support
Socially supportive leadership style
* Encouragement, verbal reinforcement, interactive
Autocratic leadership style
* Un-encouraging, critical, non-interactive
- People who experience socially supportive leadership:
- Greater self-efficacy
- More energy & enthusiasm
- Less post-exercise fatigue
- Less self-conscious
- More class enjoyment
- Stronger intentions to exercise
- Characteristics that instill confidence:
- Communication skills (informational support)
- Challenging workout (instrumental support)
- Other Exercise Participants
* Exercise groups can serve to ???? or ???? exercise behavior
* Three aspects of an exercise group:
A. ????
B. ????
C. ????
Three aspects of an exercise group:
A. Group Size
B. Group Cohesion
- As the number of people increases, perceptions of group cohesion and satisfaction decrease due to crowding, fewer interactions, and less enjoyment (though this depends on the environment!)
- The group’s perceptions of the instructor can be affected by group size. Discrepancies can arise between the approach expected by participants and the approach used by the instructor
MORE COHESIVE ENVN ENHANCES EXERCISE ADHERENCE AND PURSUIT OF A COMMON GOAL
C. Group Composition
- Characteristics of people who make up the group can affect responses to the exercise experience
E.g., sex ratio, similarity of members (age or level of fitness), group member enthusiasm (encouragement and attention from other group members)
Enhancing Group Cohesion
Five principles to increase group cohesion:
Enhancing Group Cohesion
Five principles to increase group cohesion:
- Create group environment
* Create sense of “we” - Create group structure
* Assign individual and group roles - Establish group norms
* Adopt a common goal - Individual sacrifices
* Changing exercise choices, helping the group - Interaction and communication
* Partner and group activities, post-class social
