Older women are most likely to sustain hip fractures and least likely to exercise. Understanding factors related to exercise behavior will guide the development of relevant nursing interventions to increase long-term adherence to regular exercise which may improve their recovery.

Purpose

The purpose of this study was to test a hypothesized model of exercise behavior in older women post hip fracture who participated in the Exercise Plus Program.

Methods

A descriptive, correlational study was conducted on a convenience sample of 101 older women age 65 and older who was 1 to 4 years post-hip fracture and consented to a one time telephone follow-up interview.

Results

Majority was white, mean age of 80(7.6), widowed, and had high school education. Path analysis revealed 8 of 32 paths were statistically significant and 32% of the variance in exercise behavior was explained by variables in hypothesized model. Self-efficacy, pain, and social support had direct effects on exercise behavior. Education, fear of falling, and resilience had indirect effects on exercise behavior and stage of change through self-efficacy. All 8 paths remained statistically significant and 26% of the variance in exercise behavior was explained by variables in trimmed model. Model comparison showed no improvement in model fit. Chi-square/df ratio for the hypothesized model was 1.4 and for the trimmed model, 1.2. Both models indicated good fit with X2 diff of 1.6, CFI >.9 and RMSEA < .06.

Conclusions

This study supports the growing evidence that self-efficacy expectations exert an influence on older adults' exercise behavior. Limitations of the study were it was descriptive, used a convenience sample, and obtained self-report measures. Further research focusing on interventions that increase self-efficacy expectations, resilience, and social support; decrease pain and fear of falling; and provide pertinent education related to exercise after hip fracture needs to be developed.