Development of an Evaluation Scale for Self-Management Behavior Related to Physical Activity of Type 2 Diabetic Patients

Abstract

OBJECTIVE -The aim of this study was to assess the reliability and validity of an evaluation scale for self-management behavior related to physical activity of type 2 diabetic patients (ES-SMBPA-2D).RESEARCH DESIGN AND METHODS -Outpatients with type 2 diabetes (n ϭ 146) completed a self-administered questionnaire supported by a semistructured interview based on a literature review. The content, factor, and concurrent validity and internal consistency and reproducibility of the scale were analyzed. Pearson's correlation coefficients for the ES-SMBPA-2D and International Physical Activity Questionnaire (IPAQ) subscale scores were calculated to evaluate the concurrent validity.RESULTS -The ES-SMBPA-2D was divided into two parts, the first dealing with selfmanagement behavior to enhance physical activity in daily life and the second with behavior to maintain the level of physical activity. Factor analysis showed that the first part comprised four factors and the second five. The ES-SMBPA-2D correlated with the IPAQ subscales. Cronbach's ␣ coefficient was between 0.56 and 0.90, and the intraclass test-retest correlation coefficient of the subscales was between 0.60 and 0.88.CONCLUSIONS -The ES-SMBPA-2D is reasonably reliable and valid and is expected to prove useful for the assessment of patients' self-management behavior and for individualized instruction. Diabetes Care 30:2843-2848, 2007R egular physical activity is recommended for type 2 diabetic patients, as it is commonly known to improve metabolic disorders and prevent complications such as cardiovascular disease (1). Even moderately intense physical activity through daily activities is beneficial for management of this condition (2,3). However, many patients fail to achieve the recommended level of physical activity (4) because of barriers such as the commonly given reason of "perceived difficulty in exercising" (5). The aim of self-management education is to enable patients to acquire knowledge and skills to improve their diabetic state, identify barriers that hinder improvement, and attain problem-solving and coping skills to achieve effective self-care behavior (6). Thus, medical personnel need to provide patients with strategies to enhance and maintain the required level of physical activity.Self-management education also involves individualized instruction, based on assessment of patients' psychosocial factors and self-management skills and behaviors (7) and strategies to enhance and maintain the required level of physical activity. Most scales designed for this purpose evaluate environmental and psychosocial factors (8 -11), the frequency of diabetes self-care behaviors (12), and perceived adherence to patients' self-care recommendations (13). No tools exist, however, to evaluate self-management behavior related to patients' physical activity. Therefore, the aim of this study was to develop an evaluation scale for selfmanagement behavior related to physical activity of type 2 diabetic patients (ES-SMBPA-2D). RESEARCH DESIGN AND METHODS -The EthicsCommitt...

Physical activity among adults with diabetes mellitus in Rwanda

“…Physical activity has the potential to provide several benefits for the diabetic individual which may include: possible improvement in blood glucose control, improvement of insulin sensitivity thus requiring less medication, reduction in body fat, cardiovascular benefits and stress reduction. Similarly, regular physical activity is often recommended for individuals with diabetes in view of its beneficial effects on the metabolic risk factors often associated with diabetes complications (Nakawatase et al, 2007). All levels of physical activity, including leisure activities, recreational sports, and competitive professional performance can be performed by people with diabetes who do not have complications and have good glucose control (American Diabetes Association, 2003).…”

“…However, despite these and other benefits, many individuals with diabetes do not include regular physical activity as a part of their diabetes care (Chau & Edelman, 2001). Despite the fact that the importance of exercise and physical activity is probably stressed more to diabetics compared with non-diabetics, diabetic individuals are less likely to exercise than non-diabetic individuals (Nakawatase et al, 2007). Individuals with chronic illness often avoid exercise for fear of making their condition worse or overexerting themselves, yet these patients are the ones that stand to benefit most from a regular exercise programme (Kolt & Snyder-Mackler, 2003).…”

Measuring Self-Care in Persons With Type 2 Diabetes

“…The Evaluation Scale for Self-Management Behavior Related to Physical Activity of Type 2 Diabetic Patients (ES-SMBPA-2D) was developed based on one of the key behaviors to diabetes self-management (i.e., physical activity) and its measurement defined as core measures of outcomes performance by the American Association of Diabetes Educators and semi-structured interviews of persons with T2DM in Japan (Nakawatase et al, 2007). Respondents were asked to report the frequency of self-care behavior related to the enhancement (e.g., spending a large amount of time on shopping) and maintenance (e.g., making time to enjoy favorite physical activities) of daily physical activity, using a 5-point Likert-type scale from 1 ( never ) to 5 ( always ).…”

“…The Cronbach’s α was generally satisfactory. The test–retest reliability coefficients ranged from .60 to .88 (Nakawatase et al, 2007). Although evaluated thoroughly, the inadequate psychometric properties and limitation of validation sample warrant further rigorous testing and application in other ethnic populations before being used widely.…”

Randomized Controlled Trial of the Effectiveness of Genetic Counseling and a Distance, Computer-Based, Lifestyle Intervention Program for Adult Offspring of Patients with Type 2 Diabetes: Background, Study Protocol, and Baseline Patient Characteristics

“…Current lifestyle behaviors will be assessed using a self-administered questionnaire. The questionnaire is based on two measurement scales: evaluation scale for self-management behavior related to physical activity of type 2 diabetic patients (ES-SMBPA-2D) [54] and Dietary Self-Management Behavior Questionnaire (DSBQ) [55]; which were developed by the authors. These scales measure dietary and PA self-management behaviors in diabetic patients and consist of 32 and 91 items, respectively.…”