Exploring the Significance of Physical Activity and Quality of Life Among Hemiplegic Elderly: A Novel Approach Using Mixed-Methods Grounded Theory

Background Elderly stroke survivors commonly live a sedentary life with some degree of physical disability despite their independent functional ability in performing activities of daily living (ADL) and ambulation. The perception and meanings given to physical activity (PA) play a significant role in promoting active aging for better Quality of life (QoL). This study aims to explore the QoL-related meanings of PA given by hemiplegic older adults living in Thailand's rural community to construct an explorative theoretical model. Methods A mixed-methods grounded theory (MM-GT) embedded research design. In-depth interviews collected the qualitative data from twenty samples of community-dwelling elderlies who were hemiplegic stroke survivors for more than one year. Quantifying the PA level of respondents was embedded using Global Physical Activity Questionnaires (GPAQ), whereas WHOQOL-BREF and Stroke Impact Scale (SIS) were used for quantifying QoL. Results The constructive theoretical model displayed three hierarchical meaningful PA categories. Firstly, initial PA refers to activities that positively drive to being more independent in performing ADL and negatively drive to avoid burdening the family. Secondly, identity PA meant what they do regarding the accountabilities to prior family roles, which were commonly viewed negatively instead of living a sedentary, empty life. Thirdly, optimizing PA was denoted as what they do to maintain and balance their existence in the community’s social and physical context. The more meaningful PA was, the more possibility to turn into action and contribute to QoL of elderly hemiplegic stroke survivors. The MM-GT embedded design helped to disclose the multidimensional QoL-related meanings of the PA behavior of older people, while the cognitive theories enhanced learning property and explanatory power. On the other hand, the theory of everything helped to ensure the inclusion of individual and societal perspectives and subjective and objective evidence. Conclusions These findings have significant implications for geriatrics, rehabilitation, and public health, providing insights into the role of PA in the QoL of elderly stroke survivors and suggesting potential strategies for promoting active aging and improving QoL in this population.