Background
Methods
Mixed-method design
Study outline
Questionnaire | Variable | Scoring range | |
---|---|---|---|
Frändin-Grimby Activity Scale (FGAS) [16] | Measure of habitual physical activity over a whole year. | Estimates physical activity summer and winter using 6 fixed respond alternatives describing different levels of physical activity. | 1-6a |
EuroQol (EQ-5D, EQ-VAS) [18] | Measure of health status. | Five dimensions rated on a 5-point scale using fixed respond alternatives. One question rated on a VAS scale ranging from 0–100. | 1-5a |
0-100a | |||
Health Index (HI) [19] | Measure of general wellbeing, rated on nine questions about energy, temper, fatigue, loneliness, sleep, dizziness, bowel function, pain and mobility. | Nine questions rated on a 4-point scale using fixed respond alternatives. | 9-36a |
Gastrointestinal Symptoms Rating Scale (GSRS) [20] | Measure of gastrointestinal health, constructed by five domains: diarrhea, indigestion, constipation, abdominal pain and reflux. | Fifteen questions rated on a 7-point scale using fixed respond alternatives. | 1-7b |
Hospital Anxiety and Depression Scale (HADS) [21] | Measure of psychological distress divided into two subscales: depression and anxiety. | Fourteen questions (7 questions per subscale) rated on a 4-point scale using fixed respond alternatives. | 0-42b |
Study participants and inclusion criteria
O-Ringen orienteering athletes (OR) | Local orienteering athletes (LO) | Mann Whitney | |
---|---|---|---|
(n = 122) | (n = 14) | p-value | |
Sex, n (%) | |||
Female | 41 (33.6) | 7 (50) | |
Male | 81 (66.4) | 7 (50) | |
Age, median (IQR) | 69 (66–71) | 70 (68–72) | 0.08 |
Educationa, n (%) | |||
Lower | 51 (41.8) | 6 (42.9) | >0.9 |
Higher | 71 (58.2) | 8 (57.1) | >0.9 |
Missing | 6 (4.8) | ||
Medicinesb, n (%) | |||
BP | 23 (18.9) | 4 (28.6) | 0.48 |
PPI | 8 (6.6) | 0 (0) | 0.6 |
Opi | 2 (1.6) | 0 (0) | >0.9 |
NSAID | 4 (3.3) | 0 (0) | >0.9 |
Yrs of orienteering, | |||
median (IQR) | 36.5 (30–50) | 45.5 (31.5-57) | 0.12 |
Smoking, n (%) | |||
yes | 0 (0) | 0 (0) | |
no | 122 (100) | 14 (100) |
Recruitment of study populations
OR (n = 122, median age = 69 (66–71) years)
LO (n = 14, median age = 70 (68–72) years)
Free-living older adults (n = 238, median age = 72.9 (68–75)
Data collection
Demographic data
Medications
Quantitative data–phase 1: OR
Qualitative data–phase 2: LO
Follow-up question–phase 3
Data analysis
Quantitative data
Questionnaire | OR | Free-living older adults | Mann Whitney |
---|---|---|---|
n = 122, age: 69 ± 5 yrs | n = 238, age: 72.9 ± 6.5 yrs | p-value | |
FGAS | 5 (4–5) | 3.5 (3–4) | <0.0001 |
EQ-5D index | 0.86 (0.8-1) | 0.86 (0.8-1) | 0.0015 |
EQ-VAS | 90 (85–95) | 80 (75–90) | <0.0001 |
HI | 31 (29–33) | 29 (26–31) | <0.0001 |
GSRS | 1.3 (1.1-1.7) | 1.8 (1.3-2.4) | <0.0001 |
HADS | 4 (2–7.3) | 4 (3–8) | 0.1852 |
Depression
|
2 (1–3)
|
2 (1–3)
| |
Anxiety
|
2.5 (1–5)
|
3 (1–5)
|
Qualitative data
Results
Background information
Quantitative findings–phase 1:OR
Physical activity level
Health status
Gut health
Psychological distress
Qualitative findings–phase 2: LO
Main categories | Generic categories | Sub-categories |
---|---|---|
Body-related factors | Basic hygiene |
Basic hygiene
|
Good gut health |
Getting along with your gut
| |
Good gut health
| ||
Live the life you desire |
Being able to do the same things as you used to do
| |
Being able to do what ever you want
| ||
Being able to go outside
| ||
Being able to live the life you used to
| ||
Being able to move
| ||
Being able to run
| ||
Being able to walk
| ||
Physical activity |
Everyday exercise
| |
Keep Moving
| ||
Not being still (not sitting at home)
| ||
Physical Activity
| ||
To be physically strong
| ||
Prevention and treating of body-related issues |
Regular health check-ups
| |
To take care of physically related issues
| ||
Self-related factors | Feeling mentally strong |
Feeling mentally stronger than others
|
Having a good time |
Having a good time
| |
Keep the brain active |
Keep the brain active
| |
To educate oneself
| ||
Staying positive to life |
Feeling desire towards moving
| |
Feeling desire towards eating
| ||
Keep a positive attitude towards life
| ||
Staying positive towards life
| ||
Wanting to do things
| ||
External factors | Avoiding un-healthy environments and habits |
Avoiding un-healthy environments (e.g. barrooms) and habits (e.g. drinking, smoking)
|
Being Outdoors |
Being in the forest
| |
Being outdoors
| ||
Being outdoors and moving (engaging in physical activity)
| ||
Enjoying nature
| ||
Enjoying the fresh air
| ||
Exercising outdoors
| ||
Fresh air and sunshine
| ||
Picking berries and mushrooms (in the forest)
| ||
Spending a lot of time outdoors
| ||
Walking outdoors
| ||
Cultural engagement |
Experiencing culture
| |
To be a part of the cultural community
| ||
To go to the theatre and cinema
| ||
To keep up with news
| ||
To read books
| ||
To read magazines
| ||
To travel
| ||
Healthy diet |
Important to eat well (healthy)
| |
Low fat diet
| ||
Making sure that you eat everything that is needed
| ||
Not a lot of sugar and cream
| ||
Not to be careless with your diet
| ||
To think about what you eat
| ||
Social engagement |
Feelings of kinship
| |
Important to have social exchange
| ||
Meeting others
| ||
Regular social activities
| ||
Social activity without physical activity (going shopping)
| ||
Social engagements with the opportunity to exercise
| ||
To meet
| ||
To socialize
| ||
To spend time with friends and family (acquaintances)
| ||
Social network |
Having a social network
| |
To build a network (of people) for the future
| ||
Good-tasting food | Good-tasting food |
Main categories | Generic categories | Sub-categories |
---|---|---|
Body-related factors | Feeling better than others |
Profit from the physical activity
|
To feel better than others (physically)
| ||
To feel stronger than your peers
| ||
Good genes |
Good genes (genetic inheritance)
| |
Self-related factors | Competitiveness |
Being competitive
|
Being successful
| ||
Competing with your self
| ||
Orienteering as a sport
| ||
Interest in sports |
Interest in sports
| |
Feeling privileged |
Feeling privileged
| |
Feeling talented |
Feeling talented
| |
Having fun |
It is like a party
| |
It is fun
| ||
To be happy (by physical activity)
| ||
Passion |
Not a must (driven by will/desire)
| |
Receiving energy (by physical activity)
| ||
To cope (i.e. to have endurance) |
To keep going (with life)
| |
To keep up a good mood
| ||
External factors | Being outdoors |
Fresh air and sunshine
|
Near nature and going outdoors
| ||
Community |
Being part of a community
| |
Lifelong sport |
A type of sports that you can be part of for as long as you live
| |
Routine |
Getting used to being active
| |
The need to go outdoors for fresh air
| ||
The need to move after being still
| ||
Supportive environment |
Brothers and sisters
| |
Childhood support (family/social)
| ||
Childhood sports
| ||
Friends
| ||
Good PE teachers
| ||
Not so many other options (in your youth)
| ||
Parents have an important part
| ||
Unofficial competitions
| ||
Social interaction |
Sharing the same interest as your children/partner
| |
Social interaction over generations (lots of different ages)
| ||
To socialize
|
Factors contributing to the experience and maintenance of health
Body-related factors
“I take medications… and apparently I have high levels [of cholesterols] but I’m physically strong. I did two Vasalopp [a 90 km long cross-county skiing race] during the same year, that is Sunday and Sunday [a week between his races], running in orienteering, folk dancing, playing floor hockey and doing core workouts… so I just seem to have high levels [of cholesterols]” (The male focus group)
“you can see it on anyone that the gut matters, because you don’t have any power and you cant manage anything [if you have a bad gut].” (The male focus group)
Self-related factors
“one can endure when others get fed up, ‘What are you whining about?’ It is just pushing forward, and then you just keep on pushing” (The male focus group)
“being able to move and walk outside, do whatever you want to do, to wake up and feel ‘oh how nice that it’s a new day’ and you want to do things and you have a positive view of life-that is health to me.” (The female focus group)
External factors
“we are calling it ‘social engagement with the opportunity to exercise [referring to their way of performing physical exercise]’”(The female focus group)
“getting out into the forest, that is absolutely necessary. When you get out into that really nice pine forest where it is green on the ground as well and the silence-it is so incredibly fantastic I think, it feels so good”(The female focus group)
Factors contributing to continuous engagement in physical activity
Body-related factors
“when you are at a party you feel stronger than the others [peers attending the party] because they never move [aren’t physically active], they just sit and fall a sleep.” (The male group)
Self-related factors
“when you get tired… you can stand still and read the map I think that is the best, as soon as you get tired you can stop and with clean conscious read the map, if you’d run on a court you’d get beheaded or yelled at.” (The male group)
“you feel privileged to be able to do this [practicing orienteering] since you know how fast life can change” (The female group)
External factors
“my father took time off from work when we had the February holiday and then you had to be outside skiing and you had to bring cousins and such, whose parents weren’t as interested, because it was important first and foremost to be outside skiing and moving” (The female group)
“especially if you have been sitting in the car for a while, you almost have to go out and move-(perform exercise), it becomes a need” [another woman continues] “I believe you’ve gotten used to it, you get abstinence problems if you can’t move [exercise]” (The female group)
“I often think when I talk to and meet [people] at orienteering competitions, and it doesn’t even need to be at orienteering events, it can be wherever, when you meet someone and then I remember after a while-oh god this is not really my friend its her parents that are my friends and this could be someone that is forty years old or something and then I realize that we had just as much fun when we stood there talking, because we have lots to talk about and then you forget about age” (The female group)
“As an 80 year old, you feel almost the same age as a 10 year old because you can do the same things [referring to orienteering]” (The male group)