Psychological Needs as Mediators? The Relationship Between Leisure-Time Physical Activity and Well Being in People Diagnosed With Osteoporosis

Osteoporosis is a skeletal disease characterized by reduced bone mass and microarchitectural deterioration of bone tissue resulting in compromised bone strength, increased fracture risk, and reduced well being (World Health Organization, 1994). With evidence attesting to the positive effects of leisure-time physical activity (LTPA) on biomedical health in people with osteoporosis (Johnell & Hertzman, 2006), there have been calls to broaden the scope of health-related variables that LTPA may influence (Li, Chen, Yang, & Tsauo, 2009). Previous studies examining the link between LTPA and well being in people with osteoporosis have been largely atheoretical (e.g., Papaioannou et al., 2003; Papaioannou et al., 2006), rendering the mechanisms via which LTPA influences well being speculative. Because literature has suggested the association between LTPA and well being may be indirect, as opposed to direct (Chodzko-Zajko et al., 2009; Motl & McAuley, 2009), greater attention to the mechanisms underpinning the LTPA-well being relationship is warranted. One theory that holds promise for explaining well being is Basic Psychological Needs Theory (BPNT; Deci & Ryan, 2002). Central to BPNT are the psychological needs for competence, autonomy, and relatedness that nurture psychological growth, integrity, and well being directly (Deci & Ryan, 2002). Deci and Ryan’s contentions have been largely supported in exercise contexts, given that people who feel competent, autonomous, and related to others report greater well being and less ill-being (c.f., Wilson, Mack, Gunnell, Oster, & Gregson, 2008). While insight has been gained into the LTPA-well being relationship for individuals living with osteoporosis (Papaioannou et al., 2003; Papaioannou et al., 2006), a number of issues warrant further investigation. First, the mechanisms underpinning the LTPA-well being relationship in individuals with a chronic health condition have generally been confined to self-efficacy, social support, and fatigue (McAuley, White, Rogers, Motl, & Courneya, 2010; Motl & McAuley, 2009). Considering additional mechanisms (i.e., psychological need fulfillment) would complement and potentially extend current evidence. Second, within BPNT, Ryan and Deci (2001) differentiated hedonic well being (HWB; maximizing pleasure) from eudaimonic well being (EWB; realizing human potentials). Previous research on individuals with osteoporosis focused primarily on HWB markers (Papaioannou et al., 2003; Papaioannou et al., 2006) despite evidence of distinctions between well being in its hedonic and eudaimonic forms (McGregor & Little, 1998; Ryff et al., 2006). Moreover, EWB has a stronger pattern of association with biomarkers of health than HWB (Ryff et al., 2006). Thus, the primary aim of this investigation was to examine basic psychological needs satisfaction in explaining the LTPA-EWB relationship. Based on BPNT (Deci & Ryan, 2002), we hypothesized that perceived psychological need satisfaction would mediate the LTPA-EWB relationship. Psychological Needs as Mediators? The Relationship Between Leisure-Time Physical Activity and Well Being in People Diagnosed With Osteoporosis