Health Qigong engagement scale and wellbeing in Chinese older adults

China's population is aging. Psychological wellbeing describes positive psychological functioning, including self-acceptance, purpose in life, personal growth, positive relationships, autonomy, and the ability to manage daily life. Health Qigong is a traditional Chinese mind-body exercise that combines movement, breathing, and mental focus. However, no specific tool is available to assess how regularly, attentively, and independently older adults engage in Health Qigong. This study developed such a tool and examined its associations with resilience, perceived social support, and psychological wellbeing.

Guided by self-determination theory, which explains how autonomy, competence, and social connection support sustained behavior, we developed the Health Qigong Engagement Scale through interviews with older practitioners, expert review, and tests of reliability and validity. We then examined data from 1,173 older Health Qigong practitioners in six Chinese cities. The analysis evaluated the scale and examined the cross-sectional associations among engagement, resilience, perceived social support, and psychological wellbeing.

The 18-item scale included three dimensions: continuous behavioral engagement, normative focused engagement, and autonomous persistent engagement. It showed satisfactory reliability and validity. Greater Health Qigong engagement was associated with higher resilience, perceived social support, and psychological wellbeing. The indirect association through resilience accounted for 27.97% of the total association between engagement and psychological wellbeing. The association between engagement and resilience was stronger at higher levels of perceived social support.

The scale provides a practical tool for assessing Health Qigong engagement among Chinese older adults. Greater engagement was associated with better psychological wellbeing, and resilience and perceived social support may help explain this pattern.