Physical activity perceptions, barriers, and needs among nursing home residents: an explanatory sequential mixed-methods study.

Residents living in larger nursing home facilities were less likely to engage in physical activity.

• Residents in facilities with 30 or more beds were less likely to engage in physical activity compared to those in smaller facilities.
• Study enrolled 254 residents across 20 nursing homes in Korea.
• Facility size was identified as a significant factor through hierarchical logistic regression analyses.
• Data were collected from September to December 2024.

Higher program frequency was positively associated with physical activity participation among nursing home residents.

• Program frequency was one of five variables significantly associated with physical activity in hierarchical logistic regression analyses.
• The quantitative phase used structured questionnaires assessing physical activity frequency, fall efficacy, outcome expectations, and social support.
• Sample consisted of 254 nursing home residents across 20 facilities in Korea.

Program sessions lasting 30 minutes or longer were negatively associated with physical activity participation.

• Longer program duration (30 minutes or more per session) was associated with lower likelihood of physical activity participation.
• This finding suggests that shorter session durations may be more conducive to engagement in this population.
• Duration was identified as a significant predictor via hierarchical logistic regression.

Greater perceived social support was associated with higher physical activity participation among nursing home residents.

• Social support was measured using structured questionnaires and identified as a significant predictor in hierarchical logistic regression.
• Social support was one of five variables significantly associated with physical activity participation.
• Qualitative findings also underscored the role of interpersonal relationships in shaping engagement.

Residents with a middle school education or higher were more likely to engage in physical activity.

• Education level was significantly associated with physical activity participation in hierarchical logistic regression analyses.
• Residents with at least a middle school education had higher odds of physical activity participation compared to those with lower education levels.
• Education level was one of five significant factors identified in the quantitative phase.

Qualitative analysis identified five themes explaining the contextual influences on physical activity among nursing home residents.

• Twelve residents participated in in-depth interviews analyzed using reflexive thematic analysis.
• The five themes were: meanings shaped by past experiences; physical activity as restoration; motivating forces amid decline; multilayered barriers; and expectations for improved opportunities.
• Themes were derived from the qualitative phase, which followed and elaborated on the quantitative phase in an explanatory sequential mixed-methods design.

Integration of quantitative and qualitative findings revealed that personal meaning, interpersonal relationships, and institutional contexts dynamically interact to shape physical activity engagement.

• Findings from both phases were integrated to provide a comprehensive interpretation of contextual influences on physical activity.
• The mixed-methods integration highlighted that individual experiences, social support, and environmental conditions operate together rather than independently.
• The authors concluded that strategies should 'adopt a holistic and context-sensitive approach.'