Type 2 Diabetes Patients’ Need for Physical Activity Programming: A Qualitative Study at a Yogyakarta Hospital Clini

Novita Intan Arovah, Bernadeta Wara Kushartanti, Tracy L Washington, Kristiann C Heesch

Abstract


Physical activity programs offered in Indonesian hospitals are often inadequate to help type 2 diabetes (T2D) patients meet international physical activity recommendations. This study aimed to identify T2D patients’ physical activity enablers and barriers, their preferences for, and experiences with, physical activity programming, with a view to developing future programs that are suited to these patients’ needs and preferences. Four focus groups were conducted with 28 patients (50% female) of the T2D clinic at the Local General Hospital of Yogyakarta.  Discussions were thematically analysed in NVivo 10. The most reported types of physical activity were walking and participation in the hospital-based exercise program. Participants were motivated to be physically active for the health benefits and for social interactions. The main barriers to physical activity were a lack of enjoyment, the absence of knowledge about appropriate activities for T2D patients, and a shortage of time due to social and family obligations. Based on study participants’ preferences, future physical activity programs need to include educational components, regular clinical evaluations, consultations with health educators, and efforts to increase the reach of the programs. This study provides practical suggestions for physical activity programming that meet the needs of T2D patients in Indonesia.

Keywords


diabetes; exercise; health promotion; physical activity; qualitative

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References


 1. International Diabetes Federation. IDF diabetes atlas seventh edition. 2015.

 2. Soewondo P, Ferrario A, Tahapary DL. Challenges in diabetes management in Indonesia: a literature review. Globalization and Health. 2013; 9(1): 63.

 3. Soewondo P, Soegondo S, Suastika K, Pranoto A, Soeatmadji DW, Tjokroprawiro A. The DiabCare Asia 2008 study: outcomes on control and complications of type 2 diabetic patients in Indonesia. Medical Journal of Indonesia. 2010; 19(4): 235-44.

 4. Indonesian Ministry of Health. Riset kesehatan dasar (RISKESDAS) 2013. In: Kesehatan BPdP, editor. Jakarta: Kemenkes RI; 2013.

 5. Kaizu S, Kishimoto H, Iwase M, Fujii H, Ohkuma T, Ide H, et al. Impact of leisure-time physical activity on glycemic control and cardiovascular risk factors in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. PloS One. 2014; 9(6): e98768.

 6. Umpierre D, Ribeiro PA, Kramer CK, Leitão CB, Zucatti AT, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. 2011; 305(17): 1790-9.

 7. Fagour C, Gonzalez C, Pezzino S, Florenty S, Rosette-Narece M, Gin H, et al. Low physical activity in patients with type 2 diabetes: the role of obesity. Diabetes and Metabolism. 2013; 39(1): 85-7.

 8. Fritz T, Caidahl K, Krook A, Lundström P, Mashili F, Osler M, et al. Effects of nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance. Diabetes Metabolism Research and Reviews. 2013; 29(1): 25-32.

 9. Jennersjö P, Ludvigsson J, Länne T, Nystrom F, Ernerudh J, Östgren CJ. Pedometer determined physical activity is linked to low systemic inflammation and low arterial stiffness in type 2 diabetes. Diabetic Medicine. 2012; 29(9): 1119-25.

 10. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes the American College of Sports Medicine and the American Diabetes Association: Joint position statement. Diabetes Care. 2010; 33(12): e147-e67.

 11. Ahmad B, Ramadas A, Kia Fatt Q, Md Zain AZ. A pilot study: the development of a culturally tailored Malaysian Diabetes Education Module (MY-DEMO) based on the Health Belief Model. BMC Endocrine Disorders. 2014;14.

 12.Hallgren EA, McElfish PA, Rubon-Chutaro J. Barriers and Opportunities: A Community-Based Participatory Research Study of Health Beliefs Related to Diabetes in a US Marshallese Community. The Diabetes educator. 2015; 41(1).

 13. World Health Organization. Global recommendation on physical activity for health. Geneva Switzerland: WHO Press; 2010.  14. Ayele K, Tesfa B, Abebe L. Self care behavior among patients with diabetes in Harari, Eastern Ethiopia: The health belief model perspective. PloS One. 2012;7(4):e35515.

 15. Avery L, Flynn D, van Wersch A, Sniehotta FF, Trenell MI. Changing physical activity behavior in type 2 diabetes: A systematic review and meta-analysis of behavioral interventions. Diabetes Care. 2012; 35(12): 2681-9.

 16. Dutton GR, Tan F, Provost BC, Sorenson JL, Allen B, Smith D. Relationship between self-efficacy and physical activity among patients with type 2 diabetes. Journal of Behavioral Medicine. 2009; 32(3): 2707.

 17. Rochmawati DH, Hamid AYS, Helena N. Makna kehidupan klien dengan diabetes melitus kronis di kelurahan Bandarharjo Semarang: sebuah studi fenomologi. Jurnal Keperawatan Jiwa. 2013; 1(1).

 18. Plotnikoff, Karunamuni N, Courneya K, Sigal R, Johnson J, Johnson S. The Alberta diabetes and physical activity trial (adapt): a randomized trial evaluating theory-based interventions to increase physical activity in adults with type 2 diabetes. Annals of Behavioral Medicine. 2012; 45(1): 45-56.

 19. Australian Bureau of Statistics. Physical activity in Australia: a snapshot, 2004-05. Australian Bureau Statistics: ABS Canberra, Australia; 2011.

 20. Berrigan D, Carroll DD, Fulton JE, Galuska DA, Brown DR, Dorn JM, et al. Vital signs: walking among adults-United States, 2005 and 2010. Morbidity and Mortality Weekly Report. 2012; 61(31): 595-601.

 21. Mathews E, Lakshmi J, Ravindran TS, Pratt M, Thankappan K. Perceptions of barriers and facilitators in physical activity participation among women in Thiruvananthapuram City, India. Global Health Promotion. 2015; 23(4): 27-36.

 22. Pew Research Centre. Emerging nations embrace internet, mobile technology: cell phones nearly ubiquitous in many countries. Washington DC: Pew Research Center; 2014. Available from: (www.pewglobal.org/2014/02/13/emerging-nations-embrace-internetmobile-technology/).

 23. Fukuoka Y, Komatsu J, Suarez L, Vittinghoff E, Haskell W, Noorishad T, et al. The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol. BMC Public Health. 2011;11(1):933.

 24. Fjeldsoe BS, Miller YD, Marshall AL. MobileMums: a randomized controlled trial of an SMS-based physical activity intervention. Annals of Behavioral Medicine. 2010;39(2):101-11.  25. Thompson D, Cantu D, Bhatt R, Baranowski T, Rodgers W, Jago R, et al. Texting to increase physical activity among teenagers (TXT Me!): Rationale, design, and methods proposal. JMIR Research Protocols. 2014;3(1).




DOI: http://dx.doi.org/10.21109/kesmas.v13i4.1942

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