How motivated are patients with type 2 diabetes to change their lifestyle? A survey among patients and healthcare professionals

Linmans, Joris; Knottnerus, J. André; Spigt, Mark

doi:10.1016/j.pcd.2015.02.001

Cited by 22 publications

(11 citation statements)

References 39 publications

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“…The findings of this study suggest that to achieve the patient empowerment aspirations of current national health care plans [ 1 ], clinicians would do well to consider the quality not just quantity of their patients’ motivation. Research suggests that physicians may not know whether their T2DM patients are motivated to change or not and recommend the regular measurement of patient motivation [ 14 ]. While our findings support a greater focus on patient motivation, we would argue that considering the quality of motivation is of primary importance.…”

Section: Discussionmentioning

confidence: 99%

“…Self-determination theory (SDT) [ 7 ] is a psychological framework of motivational self-regulation that has been extensively applied to physical activity [ 8 ], diet [ 9 ], medication adherence [ 10 ] and diabetes control interventions [ 11 – 13 ]. Rather than considering only the quantity of people’s motivation (i.e., motivated vs. not motivated) as in previous work with patients with T2DM [ 14 ], within SDT, the quality of motivation is considered based on the extent to which it is self-regulated [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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“I’ve made this my lifestyle now”: a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus

et al. 2018

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BackgroundDiagnosis with Type 2 Diabetes is an opportunity for individuals to change their physical activity and dietary behaviours. Diabetes treatment guidelines recommend theory-based, patient-centred care and advocate the provision of support for patient motivation but the motivational experiences of people newly diagnosed with diabetes have not been well studied. Framed in self-determination theory, this study aimed to qualitatively explore how this patient group articulate and experience different types of motivation when attempting lifestyle change.MethodsA secondary analysis of semi-structured interview data collected with 30 (n female = 18, n male = 12) adults who had been newly diagnosed with type two diabetes and were participants in the Early ACTID trial was undertaken. Deductive directed content analysis was performed using NVivo V10 and researcher triangulation to identify and describe patient experiences and narratives that reflected the motivation types outlined in self-determination theory and if/how these changed over time.ResultsThe findings revealed the diversity in motivation quality both between and within individuals over time and that patients with newly-diagnosed diabetes have multifaceted often competing motivations for lifestyle behaviour change. Applying self-determination theory, we identified that many participants reported relatively dominant controlled motivation to comply with lifestyle recommendations, avoid their non-compliance being “found out” or supress guilt following lapses in behaviour change attempts. Such narratives were accompanied by experiences of frustrating slow behaviour change progress. More autonomous motivation was expressed as something often achieved over time and reflected goals to improve health, quality of life or family time. Motivational internalisation was evident and some participants had integrated their behaviour change to a new way of life which they found resilient to common barriers.ConclusionsMotivation for lifestyle change following diagnosis with type two diabetes is complex and can be relatively low in self-determination. To achieve the patient empowerment aspirations of current national health care plans, intervention developers, and clinicians would do well to consider the quality not just quantity of their patients’ motivation.Trial registrationISRCTN ISRCTN92162869. Retrospectively registered

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“I’ve made this my lifestyle now”: a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus

et al. 2018

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“…Avramopoulos et al showed that in Greek population 79.7% of the patients exerted none or light physical activity [ 14 ]; however, only less than quarter of studied group was treated with insulin. Linmans et al also reported that a large part of the T2DM patients reported having a deficient physical activity level (35% according to patients, 47% according to healthcare professionals) [ 15 ]; however, again, minority of them only were insulin-treated. Preiss et al indicated further decrease in physical activity in individuals relatively inactive at baseline after the diagnosis of type 2 diabetes [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…One may speculate, for instance, that sex differences in a declared level of physical activity could be related to difference in being ready to admit a low physical activity between man and women rather than actual frequency of exercise. It was shown that T2DM patients tend to overestimate their physical activity and there may be sex differences in this field [ 12 , 15 ]. Additionally, it should be underlined that due to the nature of recruitment protocol the study population may not be fully representative for the participating centers.…”

Section: Discussionmentioning

confidence: 99%

Diet-Related Knowledge and Physical Activity in a Large Cohort of Insulin-Treated Type 2 Diabetes Patients: PROGENS ARENA Study

Klupa

Możdżan

Kokoszka‐Paszkot

et al. 2016

International Journal of Endocrinology

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There is no doubt that behavioral intervention is crucial for type 2 diabetes mellitus (T2DM) prevention and management. We aimed to estimate dietary habits and diet-oriented knowledge as well as the level of physical activity in 2500 insulin-treated Polish type 2 diabetes mellitus (T2DM) patients (55.4% women). The mean age of the study participants was 64.9 ± 9.3 years, mean BMI was 31.4 kg/m2 ± 4.5, mean diabetes duration was 12.4 ± 6.9 years, and mean baseline HbA1c was 8.5% ± 1.2. At the study onset, all the patients completed a questionnaire concerning health-oriented behavior. Results showed a significant lack of diet-related knowledge. For example, only 37.5% recognized that buckwheat contains carbohydrates; the percentage of correct answers in questions about fruit drinks and pasta was 56.4% and 61.2%, respectively. As for the physical activity, only 57.4% of examined T2DM patients declared any form of deliberate physical activity. To conclude, the cohort of poorly controlled insulin-treated T2DM patients studied by us is characterized by insufficient diet-related knowledge and by a very low level of physical activity. Further studies on other populations of insulin-treated T2DM patients are required to confirm these findings.

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“… 11 Ways to encourage and empower patients with T2DM to increase their DRSCA levels through the provision of support information have therefore been receiving increasing attention. 12 – 16 …”

Section: Introductionmentioning

confidence: 99%

The association of diabetes-related self-care activities with perceived stress, anxiety, and fatigue: a cross-sectional study

Zhao¹,

Suhonen²,

Katajisto³

et al. 2018

PPA

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PurposeMany people with type 2 diabetes (T2DM) do not sustain sufficient diabetes-related self-care activities (DRSCA) in their daily lives. To provide additional information about the positive influence of DRSCA, this study was conducted to examine whether DRSCA were associated with reduced perceived stress, anxiety, and fatigue among people with T2DM and to explore the level of DRSCA, perceived stress, anxiety, and fatigue and their association with background information.Patients and methodsThis study was a cross-sectional survey including 251 participants aged 18 years and older recruited from two hospitals in the eastern part of China. The study utilized self-report questionnaires that consisted of background information, DRSCA, perceived stress, anxiety, and fatigue. Hierarchical multiple regression analysis was conducted to explore the association of DRSCA with perceived stress, anxiety, and fatigue while adjusting for background information.ResultsThe results indicated that the level of self-care activities, stress, and fatigue was around middle level. The prevalence of anxiety was 19%. A high level of DRSCA was likely to reduce perceived stress but was not linked to anxiety and fatigue. Women were more susceptible to stress and anxiety, and people who had diabetes for >5 years were more likely to have anxiety. The background information included diabetes duration, standardized diabetes education, and high social support, all of which are factors that may influence DRSCA.ConclusionThe findings suggest that improving the level of DRSCA might effectively reduce perceived stress. The potential benefits of DRSCA can provide both motivational and evaluative data for self-care programs. In addition, the findings show that DRSCA were not linked to anxiety and fatigue, which implies that their positive influence on anxiety and fatigue may be offset by the load of frequent DRSCA. It is suggested that helping patients to make tailored plans to integrate DRSCA into their daily lives is needed. Meanwhile, in the background information, it is suggested that standardized diabetes education and high social support can benefit DRSCA; in improving psychological health, more attention should be paid to women and patients with diabetes duration <5 years.

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How motivated are patients with type 2 diabetes to change their lifestyle? A survey among patients and healthcare professionals

Cited by 22 publications

References 39 publications

“I’ve made this my lifestyle now”: a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus

“I’ve made this my lifestyle now”: a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus

Diet-Related Knowledge and Physical Activity in a Large Cohort of Insulin-Treated Type 2 Diabetes Patients: PROGENS ARENA Study

The association of diabetes-related self-care activities with perceived stress, anxiety, and fatigue: a cross-sectional study

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