الفهرس 
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Abstract
Physical mobility and regular exercise improve overall health; reduces weight; lowers cholesterol levels; protects against stroke, heart disease, and high blood pressure; increases immune health; and reduces stress (Tanimura et al., 2018). Regular physical activity helps to improve physical and mental functions as well as reverse some effects of chronic disease to keep older people mobile and independent. Despite the highly publicized benefits of physical activity, the overwhelming majority of older people do not meet the minimum physical activity levels needed to maintain health (Landi et al., 2018).
Aim of the Study:
This study aimed to assess the effect of physical mobility on the life style of older adults through:
1- Assessing the older adults’ knowledge about physical mobility.
2-Assessing the older adult’s observed and reported practices related to physical mobility.
3- Assessing the older adult’s physical mobility regarding to the Elderly Mobility Scale (EMS).
4- Assessing the geriatrics homes environment.
Research Questions:
1- What’s the older adult’s knowledge about physical mobility?
2- What’s the older adult’s practice related to physical mobility?
3- What’s the geriatrics homes environment effect of physical mobility?
4- Is there a relation of physical mobility on the life style of older adults?
Subjects and Methods:
Research design:
A descriptive research design was used to conduct this study.
Inclusion criteria:
The older adults aging 60 years and over, both males and females and free any disability.
Setting:
This study was conducted at four geriatric homes at Cairo governorate, including: Elderly hotel honored at Maser Elgdeda it contains 100 elderly, Dar al-Hady al-Islami at Nasr City it contains 12 elderly, Family home at Nasr City it contains 65 elderly and Dar Al Nasr Islamic House at Elkhalfawy it contains 56 elderly. They were the homes who have given permission to enter according to the location policy due to the Corona disease.
Study Subjects:
Sampling type: A Convenience sample was used.
Size of study subjects:
This study included 233 older adults representing the total residence from the previously mentioned settings.
Tools of the study:
Four tools were used in this study;
First tool: Structured interview questionnaire for older adult’s clients was prepared by the investigator based on reviewing the recent related literature written in the simple Arabic language that included four parts.
Part 1: The demographic characteristics of older adults such as gender, age, educational level, previous occupation, monthly income. Questions No 1 - 5.
Part 2: The medical history for older adults such as: chronic illness, pervious accident and history of fall, surgical history. Questions No 6 - 16.
Part 3: The older adults’ knowledge about physical mobility such definition of physical mobility, importance of movement for the elderly, causes for immobility for an elderly, signs that indicate a movement problem for the elderly, disadvantages of inactivity for the elderly and precautions needed for the elderly when moving. Healthy lifestyle. Questions No 17 - 26.
Part 4: The older adults’ reported practices related to physical mobility such as walking and exercise, eating habits, rest and sleep. Questions No 27 - 44.
Second tool:
The Elderly Mobility Scale (EMS) adopted from (Dokken et al., 2020) and modified by investigator. It assessed mobility in frail elderly based on 6 functional tests from gait to reach. Lying to sitting included 3 statements, sitting to lying included 3 statements, sit to stand included 3 statements, stand to sit included 2 statements, walk included 4 statements and down and up the stairs included 5 statements. Questions No 45-64
Third tool:
Lifestyle questionnaire was adapted from (Brojen et al., 2019) and was modified by the researcher; it includes many items such as Activity of daily living that included 11 questions, nutrition habits 7 questions, physical exercises and leisure activities 8 questions and rest and sleep 5 questions. Questions No 65 - 92.
Fourth tool:
The geriatric home assessment to assess the environmental safety adapted from (Tawfiek, 2016) and modified by the investigator to assess safety related to geriatric home in some areas such as Ventilation at home 3 questions, Drinking water 3 questions, Illumination 3 questions, Cleanliness in the house 5 questions, Furniture 4 questions, Toilet or bathroom 9 questions, Ladder and roads 3 questions and Bedroom 5 questions.
Tools validity:
Testing validity of the proposed tools by Content validity was conducted to determine the appropriateness & relevance of each item to be included in questionnaire. After the construction of data collection tools (questionnaire sheets), the content validity of the tools was judged three jury members having experience in nursing community health Faculty of Nursing, Ain Shams University. Based on their recommendation corrections, addition and / or omission of some items were done.
Tools reliability:
Testing reliability of the proposed tools was done with the Cronbach’s Alpha test. The result was:
Scales Cronbach’s Alpha
Elderly mobility scale 0.752
Life style scale 0.760
Environment safety 0 .960
II. Operational Design:
The operational design for this study included three phases namely: preparatory phase, pilot study and field work.
A-Preparatory phase:
During this phase reviewed the previous and current available related literature to be acquainted with the subject. Also, local and international related literature and knowledge aspects of the study using books, articles. Magazines and internet to modify tools for data collection for preparation of tools and the theoretical part.
B-Pilot study:
Pilot study was conducted on 10% of the elderly persons represented 24 older adults of the main study subjects and before starting fieldwork and data collection. A pilot study was done for testing feasibility and the clarity of questionnaire sheets, and their relevance to study. It also helped to estimate the time needed to complete the data collection forms. It took around 15-30 minutes to fill in the sheets. Those pilot study respondents were included in the main study sample as no modifications were done.
C-Field work:
• The field work of the study extended through 6 months.
• Data collection was carried out in the period from the beginning of March 2020 and was completed by the end of September 2020. After securing the official approval for conducting the study.
• The researcher met the directors of the geriatric homes to determine the suitable time for data collection and seek their support.
• The researcher introduced herself to elderly adults ’in their geriatric homes, the researcher collected data three days per week, which are (Tuesday, Wednesday and Thursday) from 9.00am to 1.00pm.
• The researcher distributed the tools to participants and asked them to fill after clarifying the aim of the study and its implication.
• Data was collected through using the study tool by the researcher; clarifications were given whenever it was needed with reassurance about confidentiality of any obtained information.
• The researcher checked each filled questionnaire to ensure its completeness.
Ethical consideration:
Prior to the actual work of research study, ethical approval was obtained from the scientific research ethical committee at faculty of nursing, Ain Shams University In addition, an written consent was obtained of older adults to participate in the study after explaining the aim of the study, Privacy and confidentiality were assured. Also, Ethics, values, cultural and beliefs was respected and the subjects were informed about their right to withdraw at any time without giving any reason and that the collected data will be kept confidential.
III. Administrative Design:
Before starting on the study, official and formal letters were issued from the Faculty of Nursing, Ain Shams University to the Directors of the study settings, explaining the aim of the work, and the expected benefits. Ensuring confidentiality of the information obtained. Individual oral consent was also obtained from each participant in the study.
IV. Statistical Design:
Data entry and statistical analysis were done using SPSS 22 statistical software package. Data were presented using descriptive statistics in the form of frequencies and percentages for qualitative variables, and means, standard deviations and medians for quantitative variables. Cronbach alpha coefficient was calculated to assess the reliability of the tools through their internal consistency. Qualitative categorical variables were compared using chi-square test. Statistical significance was considered at p- value p ≤ 0.05, and considered highly statistically significance at p - value p ≤ 0.001.
Results:
The findings of the current study can be summarized as:
• According to socio-demographic data of the older adults, the older adults aged 65-<70 years were less than half (41.6%) with the Mean ± SD = 1.92 ± 0.762, more than half (51.9%) of them were male. Also, more than one quarter (30%) of them were not read and don’t write, with the mean educational level 2.42 ± 1.157. Also, more than one-third (37.3%) of them worked in governmental occupation. While, the minority (15.9%) of them were housewives. The majority (83.7%) had sufficient income.
• According to current medical history, more than three quarters (78.1%) of studied older adults suffering from chronic diseases, as regarding the chronic diseases, the minority and one-quarter (17.6% & 24.7%) respectively.
• According to older adults’ knowledge about physical mobility, less than two-thirds (63.5%) of the studied older adult had unsatisfactory level of knowledge; while, slightly more than one-third (36.5%) of them had satisfactory level of knowledge as regarding the total score level of knowledge.
• According to older adults’ reported practices related to physical mobility, more than half (55.8%) of the studied sample had health reported practices compared to less than half (44.2%) of them had unhealthy reported practices.
• Regarding to total physical mobility score level, more than half (59.2%) of studied older adults were total independent, and less than half (41.8%) of them were dependent in their physical mobility.
• According to total Lifestyle score level, more than half (59.6%) of the total older adult’s life style were healthy, and less than half (40.4%) of them were unhealthy life style.
• According to total environmental safety at geriatric homes, less than two thirds (64.4%) of the total environment were safe at geriatric home, and more than one-third (35.6%) of the total environment were unsafe at geriatric homes.
• According to the relation between demographic characteristics of the studied older adult and their total knowledge, there was no statistically significant relation between total score of older adults’ knowledge and their age (P > 0.05). However, there were statistically significant relation between total level of older adults’ knowledge and their educational level, previous occupation and monthly income (P< 0.05).
• According to the relation between total older adult physical mobility and total safety environment, there was a statistically significant relation between total level of older adults’ physical mobility and their Geriatric home environment (P< 0.05).
• Related to the relation between total older adults’ life style and physical mobility, there was a statistically significant relation between total level of older adults’ physical mobility and their life style (P< 0.05).
• Related to the correlation between older adult’ knowledge, practices and safety environment, there was a positive correlation between total older adults’ knowledge, practices and safety environment scores regarding their life style.