Transforming Motivation for Exercise in a Safe and Kind Environment—A Qualitative Study of Experiences among Individuals with Type 2 Diabetes

Abstract

Exercise is a cornerstone in diabetes care; however, adherence is low and sustaining physical activity remains a challenge. Patient-centered diabetes self-management education and support are recommended; however, sparse literature exists on how to design exercise interventions that improve self-management in individuals with complications of type 2 diabetes mellitus (T2D). We aimed to gain insights into needs, barriers, and motivation based on experiences with exercise participation among individuals with T2D and complications to adjust and develop new types of tailored, supervised exercise classes in specialized care at three hospitals in Denmark. In keeping with a constructivist research paradigm, a qualitative hermeneutic approach using focus group interviews was applied to explore perspectives among different participants in terms of disease severity. Seven interviews with 30 participants (aged 49–88) representing seven different exercise classes, were conducted over three years. Reflective thematic analysis was used. Four themes were generated: People like us, Getting started with exercise, Game changers, and Moving forward. An overarching theme ‘The transformation of motivation when exercising in a safe and kind environment’ links the themes together, resembling the participants’ development of physical literacy encompassing motivation, confidence, physical competence as well as an ability to value physical activity. Supportive patient-centered exercise classes promoted a transformation of motivation grounded in the development of physical literacy among participants in specialized diabetes care. However, participants were concerned with continuing to exercise on their own after the intervention, as they experienced a lack of continuous, supervised exercise opportunities in local communities.

Successful Practices in Performing and Maintaining Physical Activity in Adults with Type 2 Diabetes Mellitus: A Qualitative Study

“…Most authors agree that lack of willpower and motivation to adopt lifetime habits is an important barrier for the treatment of the conditions related to lifestyle [ 31 ]. It should also be pointed out that studies including interventions to increase PA have determined that the participants were worried about continuing physical exercise alone after the interventions, as they did not find supervised long-term programmes in their communities [ 38 ] his was not the case with our sample, as the patients engaged in PA individually or in reduced groups and adhered well to these practices. This highlights the importance of interventions aimed at encouraging autonomous motivation and correct adherence to PA once they are no longer supervised by healthcare professionals.…”

The social and organisational factors shaping acceptability of a self-management education and exercise intervention for people with hip or knee osteoarthritis in Greenland

“…As a result, adaptations must be made to ensure that everyone feels motivated in group-based exercise sessions. In the OA School intervention, this could be done by splitting the group-based exercise based on age, gender, or capabilities to make peers more comfortable in an exercise situation, as seen in an intervention for people with type 2 diabetes in Denmark [ 46 ].…”

Comparisons and Associations between Hip-Joint Position Sense and Glycosylated Hemoglobin in Elderly Subjects with Type 2 Diabetes Mellitus—A Cross-Sectional Study

“…In addition, the effect of age on central mechanics and changes in the peripheral somatosensory system may contribute to JPS impairments in older individuals with T2DM [ 29 , 47 ]. According to studies examining the benefits of proprioceptive exercise regimens on patients with diabetes, balance and postural stability can be improved, most likely by an increase in peripheral inference, resulting in decreased falls caused by sensory deficiencies [ 48 , 49 , 50 ].…”