Department of Psychology, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières, QC, G9A 5H7, Canada.
BMC Public Health. 2018 Apr 10;18(1):469. doi: 10.1186/s12889-018-5376-y.
Using self-determination theory, the objective of this study was to examine, over a one-month period, how physical activity (PA) motivation would influence accelerometer-derived PA behavior, and ultimately, acute diabetes-related symptoms burden among adults with type 2 diabetes (T2D adults). Using both a person and variable-centered approach, this objective was attained by means of: 1) investigating the indirect effect of PA participation on the relationship between PA motivation and acute diabetes-related symptom burden and 2) examining whether participants who met PA recommendations (i.e., 150 min of moderate-to-vigorous PA per week) would experience less acute diabetes-related symptom burden over a one-month period.
A two-wave prospective longitudinal design was used. At time 1, participants completed a questionnaire assessing their PA motivation and were asked to wear an ActiGraph GT3x accelerometer for four consecutive weeks. At time 2, they completed a short questionnaire assessing their acute diabetes-related symptoms (i.e., symptoms related to fatigue, cognitive distress, hyperglycemia, and hypoglycemia). The final sample includes 165 adults (89 or 53.61% women) aged from 26 to 75 years (M = 62.05, SD = 8.75) with T2D, which provided at least 21 valid days of accelerometer-derived data.
First, results of a path analysis demonstrated that over a one-month period, the average number of minutes spent practicing moderate to vigorous PA per week mediated the relationship between intrinsic and external PA motivation and the level of burden associated with the following diabetes-related symptoms: fatigue, cognitive distress, and hyperglycemia. In addition, results of covariance analyses showed that participants meeting PA recommendations also reported significantly less burden associated with these three symptoms over a month period. Then, the existence of four motivational profiles (Self-Determined, High Introjected, Low Motivation, and Non-Self-Determined) was confirmed using a k-means analysis. Results of covariance and chi-square analyses further showed, respectively, that compared to other motivational profiles, the Self-Determined profile was associated with a higher score on weekly PA participation and meeting PA recommendations.
The results highlight the importance of promoting autonomous motives for PA participation among T2D adults. They also suggest that T2D adults meeting PA recommendations experience less acute diabetes-related symptoms burden, which further support the importance of their PA motivation.
本研究运用自我决定理论，旨在在一个月的时间内，检验身体活动（PA）动机如何影响加速度计得出的 PA 行为，最终减轻成年 2 型糖尿病（T2D 成人）的急性糖尿病相关症状负担。本研究采用个体和变量为中心的方法，通过以下两种方式实现目标：1）探讨 PA 参与对 PA 动机与急性糖尿病相关症状负担之间关系的间接影响；2）检验是否满足 PA 推荐量（即每周进行 150 分钟的中等到剧烈的 PA）的参与者在一个月内会经历更少的急性糖尿病相关症状负担。
本研究采用两波前瞻性纵向设计。在第 1 时间点，参与者完成了一份评估他们 PA 动机的问卷，并被要求佩戴 ActiGraph GT3x 加速度计连续四周。在第 2 时间点，他们完成了一份关于他们急性糖尿病相关症状（即与疲劳、认知困扰、高血糖和低血糖相关的症状）的简短问卷。最终样本包括 165 名年龄在 26 至 75 岁之间（M = 62.05，SD = 8.75）的成年人，他们患有 2 型糖尿病，至少提供了 21 天有效的加速度计数据。
首先，路径分析的结果表明，在一个月的时间内，每周进行中等到剧烈 PA 的平均分钟数中介了内在和外在 PA 动机与与以下糖尿病相关症状的负担水平之间的关系：疲劳、认知困扰和高血糖。此外，协方差分析的结果表明，满足 PA 推荐量的参与者在一个月内也报告了与这三种症状相关的负担显著减少。然后，使用 k-均值分析确认了存在四种动机特征（自我决定、高内摄、低动机和非自我决定）。协方差和卡方分析的结果进一步表明，与其他动机特征相比，自我决定特征与每周 PA 参与度和满足 PA 推荐量的得分更高相关。
结果强调了在 T2D 成人中促进 PA 参与的自主动机的重要性。它们还表明，满足 PA 推荐量的 T2D 成人经历的急性糖尿病相关症状负担更少，这进一步支持了他们 PA 动机的重要性。
