Development and validation of a physical activity barrier assessment scale for older patients with chronic diseases

Implementing effective physical activity interventions remains challenging due to insufficient physical activity levels among hospitalized older adults with chronic diseases and the complex array of barriers they face. Existing interventions frequently fail to address the unique needs of this demographic. While research increasingly focuses on patient-related activity barriers, no standardized instrument exists to assess these factors in older chronic disease patients. This study aimed to develop and validate a Physical Activity Barrier Assessment Scale for this population.

Guided by the socio-ecological model, we employed literature review, semi-structured interviews, Delphi expert consultation, and pilot testing to develop scale items. Between March and September 2023, 523 hospitalized older adults with chronic diseases from a tertiary hospital in Zhejiang Province completed the scale. Psychometric evaluation included item analysis, exploratory factor analysis, confirmatory factor analysis, and reliability testing.

The final 29-item scale comprises three domains: individual (health status, psychological factors), interpersonal (caregiver/staff support), and organizational (environmental barriers). EFA revealed four components explaining 74.14% variance. CFA indicated an acceptable model fit (RMSEA = 0.062; CFI = 0.834). The scale demonstrated excellent internal consistency (Cronbach's α = 0.863). Content validity index reached 0.931.

The scale demonstrates robust psychometric properties for identifying physical activity barriers in hospitalized older adults with chronic diseases. This instrument enables healthcare providers to develop targeted activity interventions, potentially improving clinical outcomes in this vulnerable population.