| Summary: | 博士 === 慈濟大學 === 醫學科學研究所 === 101 === Engaging in exercise is an important health behavior to prevent or delay type 2 diabetes for people with pre-diabetes. However, many people with pre-diabetes fail to develop and maintain a regular exercise regime. There are no exercsie behavior relevant theories interpreting entirely the opinions, the feelings, mood change, and the meaningful actions of the exercise behavior for the population with prediabetes, even though there have been many exercsie behavior-related theories trying to explain their exercise behavior from different aspects. Therefore, research is needed into the exercise beliefs, experiences and process of change of people with pre-diabetes to explore. It will provides useful information to help practitioners designing the prompt, appropriate, effective exercise intervention strategies which fit the needs of people with pre-diabetes.
This study used a grounded theory approach to develop a descriptive theory to understand the experience of the entire process of implementing exercise for people with pre-diabetes. There are twenty participants with impaired fasting glucose (IFG) from a medical center in Taiwan were enrolled in this study for in-depth open and semi-structured interviews. The same interviewer interviewed all the participants and interviews were conducted in places that were convenient and private for the participants. Each participant was interviewed at least once for between 40-70 minutes. The interviews were audio-recorded and the participants' responds of emotions and behaviors were recorded. The interview guide included the following questions: (1)How about your experiences and feelings of implementation of exercise? (2)What motivates you to start taking exercise? (3)What kinds of obstacles have you encountered during exercise? and how do you overcome the obstacles? (4)What motivates you to continue the exercise behavior? The data were entered into NVivo 8.0 qualitative data management software after transcription, then analyzed into coding and categorized by constant comparative method of the step of grounded theory until no new themes or categories were identified (i.e., saturation was achieved).
This study developed a model of the process of people with pre-diabetes implementing exercise behavior. Comprising four stages: developing awareness, creating and practicing the health blueprint, action cycle of struggle and developing spontaneous regular exercise. Developing awareness was the starting point for the process of implementing exercise, including being aware of health crises, perceiving that exercise is beneficial to health and their own duty for health, and receiving external incentives. Once the people were aware of the importance of exercise, they started to create a health blueprint and attempted to integrate exercise into daily life. After they started to exercise, they would experience the action cycle of struggle - represented by the core category. All the participants experienced this stage of the cycle that mentioned exercise behavior will either be continued or discontinued secondary to driving and resistive forces. They had to be encouraged to make efforts to develop exercise habits. Once the motivator disappeared or they encountered obstacles, their exercise behaviors reduced or ceased. However, for some who overcame these obstacles, they entered the highest level of the exercise process – that of spontaneous regular exercise. The participants would spontaneously engage in regular exercise without being forced to when the implementation of exercise became an indispensable enjoyment in their life and made them feel physically and psychologically relaxed.
It is not easy for people with pre-diabetes to develop a regular exercise regime. Therefore, before providing people with pre-diabetes with relevant exercise interventions, professionals should first assess carefully their psychological needs at various stages of awareness and behavior change. The primary goal should be to improve the intrinsic motivation to spontaneously engage in exercise, so as to assist them in going through the action cycle of struggle and achieve the ideal goals of continuing to exercise and prevent diabetes.
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