Journal of Cardiovascular Nursing
Vol. 32, No. 4, pp 321Y330 x Copyright B 2017 Wolters Kluwer Health, Inc. All rights reserved.
Influence of Socioeconomic Status and
Perceived Barriers on Physical Activity Among
Taiwanese Middle-Aged and Older Women
Chia-Huei Lin, PhD, RN; Shang-Lin Chiang, MD, PhD; Patsy Yates, PhD; Wen-Chii Tzeng, PhD;
Meei-Shyuan Lee, PhD; Li-Chi Chiang, PhD
Background: Physical activity (PA) is associated with cardiovascular health in general populations, particularly in
women. Middle-aged and older women are at high risk of less engagement in PA for unknown and complicated
reasons. Objectives: The aim of this study was to investigate whether PA was positively associated with socioeconomic
status and psychosocial correlates of PA (self-efficacy and perceived benefits) but inversely correlated with perceived
barriers in women (age 940 years). Methods: A cross-sectional survey of 326 community-dwelling women was
conducted. Data on socioeconomic status, PA, and its psychosocial correlates (ie, perceived benefits/barriers and
self-efficacy) were collected using self-report questionnaires. Analyses were performed by multiple linear
regressions. Results: Monthly income (" = .35, P = .015), employment status (" = .32, P G .001), and perceived
barriers to PA (" = j.19, P = .008) were significantly associated with PA. More highly educated women participated
in more (" = .13, P = .033) vigorous PA, women with fewer perceived barriers participated in more (" = j.14, P = .047)
moderate-intensity PA, and employed women participated in more (" = .35, P G .001) walking. Significantly higher
scores of perceived barriers, including ‘‘no trainer,’’ ‘‘feeling exhausted,’’ ‘‘lack of motivation,’’ and ‘‘lack of guidance,’’
were identified in women with low PA compared with those with moderate PA. Conclusion: Socioeconomic status
and perceived barriers are associated with PA and its intensity level. Some specific barriers provide insights into the key
factors that contribute to low PA in middle-aged and older women. These findings can be considered in future
interventions to design PA promotion programs for this population to protect against cardiovascular diseases.
KEY WORDS: perceived barriers, physical activity, socioeconomic status, women
R
egular physical activity (PA) has been associated
with a wide array of physical, psychological, and
social benefits.
1Y3
However, middle-aged and older
women participate in less PA compared with men of
the same age, particularly Asian women (eg, Taiwanese
women).
4,5
Many middle-aged and older women tend to have
sedentary lifestyles,
5
particularly as age increases.
4
In
addition to age and sedentary lifestyle, menopause is
another challenge faced by this population, as it is
associated with a higher risk of cardiovascular disease
and a higher risk of mortality.
6,7
Performing regular
PA protects postmenopausal women against develop-
ing cardiovascular diseases. A previous study demon-
strated that middle-aged and older individuals who
participated in greater PA reported a lower death rate
than did those who engaged in less PA.
8
Promoting
PA for this population is therefore important.
Various models, including the health belief model, the
transtheoretical model, and the self-determination model,
propose that PA participation is influenced by physio-
logical factors, behavioral factors, and psychological con-
siderations.
9Y12
For example, to increase PA, Pender’s
Health Promotion Model, a nursing middle-range theory
321
Chia-Huei Lin, PhD, RN
Assistant Professor, School of Nursing, National Defense Medical
Center, and Supervisor, Department of Nursing, Tri-Service General
Hospital, Taipei, Taiwan, ROC.
Shang-Lin Chiang, MD, PhD
Lecturer, School of Medicine, National Defense Medical Center, and
Attending Physician, Department of Physical Medicine and
Rehabilitation, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Patsy Yates, PhD
Professor and Head of School Faculty of Health, School of Nursing,
and Director, Centre for Palliative Care Research and Education,
Queensland University of Technology, Australia.
Wen-Chii Tzeng, PhD
Associate Professor, School of Nursing, National Defense Medical
Center, Taipei, Taiwan, ROC.
Meei-Shyuan Lee, PhD
Professor, School of Public Health & Graduated Institute of Medical
Science, National Defense Medical Center, Taipei, Taiwan, ROC.
Li-Chi Chiang, PhD
Professor, School of Nursing & Graduated Institute of Medical Science,
National Defense Medical Center & China Medical University, Taipei &
Taichung, Taiwan, ROC.
This study was supported by grants from the Tri-Service General
Hospital research project (TSGH-C101-175) in northern Taiwan.
The authors have no conflicts of interest to disclose.
Correspondence
Li-Chi Chiang, PhD, 161 Sec. 6 Mingchuan E Rd, Neihu 114, Taipei,
Taiwan, ROC 115 (lichichiang@gmail.com).
DOI: 10.1097/JCN.0000000000000354
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.