Exposure to Transtheoretical Model-based exercise associated with higher physical activity levels among type 2 diabetes mellitus patients at Dr. Oen Hospital, Surakarta
DOI:
https://doi.org/10.53638/phpma.2025.v13.i2.p04Keywords:
Physical activity, T2DM, physical activity recommendations, Transtheoretical ModelAbstract
Background and purpose: Many people with type 2 diabetes mellitus (T2DM) do not do physical activity and those who have started doing physical activity often stop within 3-6 months. The main difficulty faced by individuals with T2DM is psychological, primarily due to low self-confidence to engage in regular physical activity. It is necessary to provide IEC or physical activity recommendations using behavior change strategies to encourage compliance of individuals with T2DM in carrying out physical activity, one of which is using the transtheoretical model (TTM). This research aims to find the association between giving physical activity recommendations based on TTM and the level of physical activity in individuals suffering from T2DM.
Methods: This research is a cross sectional analytic carried out at Dr. Oen Kandang Sapi Hospital Surakarta in February 2024. This research involved 91 respondents selected through consecutive sampling. Data collection was carried out using questionnaires. The available data was analyzed by univariate analysis and bivariate analysis using the Chi-square test.
Results: Most of the physical activity levels of T2DM patients were low (58.2%) and the majority of physical activity behavior change stages were in the preparation stage (51.6%). Meanwhile, 67% of T2DM patients did not carry out physical activity according to recommendations and as many as 71.4% did not receive physical activity recommendations based on TTM. The results of the Chi-square test between physical activity recommendations based on TTM and physical activity levels obtained p value= 0.015.
Conclusion: There is a significant relationship between the provision of physical activity recommendations based on TTM and the physical activity level of T2DM patients at Dr. Oen Kandang Sapi Hospital Surakarta.
References
International Diabetes Federation. IDF Diabetes Atlas 2021 [Internet]. IDF Diabetes Atlas. 2021. Available from: https://diabetesatlas.org/atlas/tenth-edition/
Khan MA, Hashim MJ, King J, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends. J Epidemiol Glob Health. 2020 Mar 10;10(1):107–11.
American Diabetes Association. Standards of Medical Care in Diabetes—2019 Abridged for Primary Care Providers. Clin Diabetes. 2019 Dec 17;37(1):11–34.
Perkumpulan Endokrinologi Indonesia. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia. PB Perkeni. 2021.
Beverly EA, Wray LA. The role of collective efficacy in exercise adherence: a qualitative study of spousal support and type 2 diabetes management. Health Educ Res. 2010 Apr 1;25(2):211-23.
Putri M, Persariningrat RT, Surialaga S, Syamsunarno MR. Physical activities decrease fasting blood glucose level in diabetes mellitus type 2 patients: use of International Physical Activity Questionnaire (IPAQ) in rural area. Maj Kedokt Bandung. 2019 Dec 30;51(4):201-5.
Thomas N, Alder E, Leese GP. Barriers to physical activity in patients with diabetes. Postgrad Med J. 2004 May;80(943):287-91.
Jiménez-Zazo F, Romero-Blanco C, Castro-Lemus N, Dorado-Suárez A, Aznar S. Transtheoretical model for physical activity in older adults: Systematic review. Int J Environ Res Public Health. 2020 Dec;17(24):9262.
Prochaska JO, Redding CA, Evers KE. The transtheoretical model and stages of change. Health behavior and health education: Theory, research, and practice. 2008:97-121.
Giacobbi Jr PR. Theoretical, critical, and practical reflections on the long-term maintenance of health behavior change. Am J Lifestyle Med. 2016 Nov;10(6):377-80.
Hasler TD, Fisher BM, MacIntyre PD, Mutrie N. Exercise consultation and physical activity in patients with type 1 diabetes. Pract Diabetes Int. 2000 Mar;17(2):44-8.
Siregar R, Harefa K, Hasibuan EK. The effect of exercise consultation program on exercise behavioral changes in patients of T2DM with overweight: transtheoretical model approach. Indonesian Nurs J Educ Clin. 2016 Sep 24;1(1):24-33.
Nurayati L, Adriani M. Association between physical activity and fasting blood glucose among type 2 diabetes mellitus patients. Amerta Nutr. 2017;1(2):80-7.
Kennerly AM, Kirk A. Physical activity and sedentary behaviour of adults with type 2 diabetes: a systematic review. Pract Diabetes. 2018 May;35(3):86-9.
Ramadhan BJ, Alramadan MJ, Alhassan RE, Almajed HA, Khamseen MA, Billah B. Adherence to the recommended physical activity duration among Saudis with type 2 diabetes mellitus. J Family Med Prim Care. 2019 Nov 1;8(11):3668-77.
Lidegaard LP, Schwennesen N, Willaing I, Færch K. Barriers to and motivators for physical activity among people with Type 2 diabetes: patients' perspectives. Diabet Med. 2016 Dec;33(12):1677-85.
Kirk AF, Barnett J, Mutrie N. Physical activity consultation for people with Type 2 diabetes. Evidence and guidelines. Diabet Med. 2007 Aug;24(8):809-16.
Jackson R, Asimakopoulou K, Scammell A. Assessment of the transtheoretical model as used by dietitians in promoting physical activity in people with type 2 diabetes. J Hum Nutr Diet. 2007 Feb;20(1):27-36.
Kirk AF, Mutrie N, MacIntyre PD, Fisher MB. Promoting and maintaining physical activity in people with type 2 diabetes. Am J Prev Med. 2004 Nov 1;27(4):289-96.
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