Health  Vol.9 No.4 , April 2017
Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients
The purpose of this study was to investigate whether self-efficacy for exercise decreased 12 weeks after educational intervention in diabetic patients and whether this had an effect on glycemic control. Thirty-eight diabetic patients underwent a 2-week educational program and were then followed for 12 weeks after discharge. The intervention program was delivered by several types of medical professionals. Lectures on exercise were given by a physical therapist, who tailored exercise instructions for individual patients. The assessment of self-efficacy for exercise was performed using a scale from a previous study, modified for Japanese people. The scale consisted of four sub-items: physical fatigue, mental stress, lack of time, and poor weather. Measurements were performed at the time of discharge and 12 weeks after discharge. Glycated hemoglobin (HbA1c) levels were assessed as an index of glycemic control, and diabetic status and social status factors were recorded. The physical fatigue and lack of time components of the self-efficacy for exercise scale were significantly decreased 12 weeks after discharge. Positive correlations were found between HbA1c levels at 12 weeks and duration of diabetes, number of educational admissions, and presence of diabetic retinopathy. The results suggest that the factors that are difficult to reproduce during hospital education (physical fatigue and lack of time) are the ones that decrease after discharge. To clarify the relationship between changes in self-efficacy for exercise and glycemic control, further studies with an extended follow-up period (24 weeks or 48 weeks) are needed.
Cite this paper: Matsui, N. , Washida, K. , Shoji, M. , Nakaizumi, D. , Kitagawa, T. , Terada, S. and Uchiyama, K. (2017) Decrease in Self-Efficacy for Exercise at 12 Weeks after Exercise Education in Diabetic Patients. Health, 9, 649-656. doi: 10.4236/health.2017.94046.

[1]   Bandura, A.S. and Adams, N.E. (1977) Analysis of Self-Efficacy Theory of Behavioral Change. Cognitive Therapy and Research, 1, 287-310.

[2]   Teixeira, P.J., Carraça, E.V., Marques, M.M., Rutter, H., Oppert J.M., De Bourdeaudhuij, I., et al. (2015) Successful Behavior Change in Obesity Interventions in Adults: A Systematic Review of Self-Regulation Mediators. BMC Medicine, 13, 84.

[3]   Norris, S.L., Lau, J., Smith, S.J., Schmid, C.H. and Engelgau, M.M. (2002) Self-Management Education for Adults with Type 2 Diabetes: A Meta-Analysis of the Effect on Glycemic Control. Diabetes Care, 25, 1159-1171.

[4]   Ismail, K., Winkley, K. and Rabe-Hesketh, S. (2004) Systematic Review and Meta-Analysis of Randomised Controlled Trials of Psychological Interventions to Improve Glycaemic Control in Patients with Type 2 Diabetes. The Lancet (London, England), 363, 1589-1597.

[5]   Dutton, G.R., Tan, F., Provost, B.C., Sorenson, J.L., Allen, B. and Smith, D. (2009) Relationship between Self-Efficacy and Physical Activity among Patients with Type 2 Diabetes. Journal of Behavioral Medicine, 32, 270-277.

[6]   Andersen, E., Burton, N.W. and Anderssen, S.A. (2012) Physical Activity Levels Six Months after a Randomised Controlled Physical Activity Intervention for Pakistani Immigrant Men Living in Norway. International Journal of Behavioral Nutrition and Physical Activity, 9, 47.

[7]   Umpierre, D., Ribeiro, P.A.B., Schaan, B.D. and Ribeiro, J.P. (2013) Volume of Supervised Exercise Training Impacts Glycaemic Control in Patients with Type 2 Diabetes: A Systematic Review with Meta-Regression Analysis. Diabetologia, 56, 242-251.

[8]   Marcus, B.H., Selby, V.C., Niaura, R.S. and Rossi, J.S. (1992) Self-Efficacy and the Stages of Exercise Behavior Change. Research Quarterly for Exercise and Sport, 63, 60-66.

[9]   Oka, K. (2003) [Stages of Change for Exercise Behavior and Self-Efficacy for Exercise among Middle-Aged Adults]. Japanese Journal of Public Health, 50, 208-215.

[10]   Grace, S.L., Barry-Bianchi, S., Stewart, D.E., Rukholm, E. and Nolan, R.P. (2007) Physical Activity Behavior, Motivational Readiness and Self-Efficacy among Ontarians with Cardiovascular Disease and Diabetes. Journal of Behavioral Medicine, 30, 21-29.

[11]   Mansyur, C.L., Pavlik, V.N., Hyman, D.J., Taylor, W.C. and Goodrick, G.K. (2013) Self-Efficacy and Barriers to Multiple Behavior Change in Low-Income African Americans with Hypertension. Journal of Behavioral Medicine, 36, 75-85.

[12]   Nies, M.A. and Motyka, C.L. (2006) Factors Contributing to Women’s Ability to Maintain a Walking Program. Journal of Holistic Nursing, 24, 7-14.

[13]   Focht, B.C., Knapp, D.J., Gavin, T.P., Raedeke, T.D. and Hickner, R.C. (2007) Affective and Self-Efficacy Responses to Acute Aerobic Exercise in Sedentary Older and Younger Adults. Journal of Aging and Physical Activity, 15, 123-138.

[14]   Wenthe, P.J., Janz, K.F. and Levy, S.M. (2009) Gender Similarities and Differences in Factors Associated with Adolescent Moderate-Vigorous Physical Activity. Pediatric Exercise Science, 21, 291-304.

[15]   Tucker, P. and Gilliland, J. (2007) The Effect of Season and Weather on Physical Activity: A Systematic Review. Public Health, 121, 909-922.

[16]   Cleland, V.J., Ball, K., Salmon, J., Timperio, A.F. and Crawford, D.A. (2010) Personal, Social and Environmental Correlates of Resilience to Physical Inactivity among Women from Socio-Economically Disadvantaged Backgrounds. Health Education Research, 25, 268-281.

[17]   Delahanty, L.M., Conroy, M.B., Nathan, D.M. and Diabetes Prevention Program Research Group (2006) Psychological Predictors of Physical Activity in the Diabetes Prevention Program. Journal of the American Dietetic Association, 106, 698-705.

[18]   Walraven, I., Mast, M.R., Hoekstra, T., Jansen, A.P., van der Heijden, A.A., Rauh S.P., et al. (2015) Distinct HbA1c Trajectories in a Type 2 Diabetes Cohort. Acta Diabetologica, 52, 267-275.

[19]   Sartore, G., Chilelli, N.C., Burlina, S., Di Stefano, P., Piarulli, F., Fedele, D., et al. (2012) The Importance of HbA1c and Glucose Variability in Patients with Type 1 and Type 2 Diabetes: Outcome of Continuous Glucose Monitoring (CGM). Acta Diabetologica, 49, 153-160.

[20]   Kavanagh, D.J., Gooley, S. and Wilson, P.H. (1993) Prediction of Adherence and Control in Diabetes. Journal of Behavioral Medicine, 16, 509-522.

[21]   Talbot, F., Nouwen, A., Gingras, J., Gosselin, M. and Audet, J. (1997) The Assessment of Diabetes-Related Cognitive and Social Factors: The Multidimensional Diabetes Questionnaire. Journal of Behavioral Medicine, 20, 291-312.

[22]   Torimoto, K., Okada, Y., Sugino, S. and Tanaka, Y. (2016) Determinants of Hemoglobin A1c Level in Patients with Type 2 Diabetes after In-Hospital Diabetes Education: A Study Based on Continuous Glucose Monitoring. Journal of Diabetes Investigation, early view.