Bekken Tina, Ottesen Nina, Glenton Claire, Nordheim Lena Victoria
Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
PLoS One. 2025 Sep 18;20(9):e0332276. doi: 10.1371/journal.pone.0332276. eCollection 2025.
People with type 2 diabetes often find recommended lifestyle changes difficult to achieve and can find it particularly difficult to maintain these changes. It is therefore useful to explore their views and experiences about what influences them when attempting to achieve these goals.
To identify, appraise and synthesise qualitative studies that explore what motivates people with type 2 diabetes to maintain lifestyle changes over time and the challenges they experience.
We included qualitative studies and mixed methods studies with a qualitative component, in any language, of adults who had type 2 diabetes and who had maintained lifestyle changes for a minimum of twelve months. We searched MEDLINE, CINAHL, PsycINFO and EMBASE from inception to 4th November 2024. We extracted data using a pre-designed form and assessed methodological limitations using predefined criteria. We used a thematic synthesis approach to analyse the data. We assessed our confidence in the review findings using the GRADE-CERQual approach. Finally, we used our findings to develop a model using the locus of control theory and to develop implications for practice.
We included twelve studies from Europe, USA, Canada, South-Africa, Australia and New Zealand. Participants described several factors that motivated them to maintain lifestyle changes, including getting support from others, seeing results from their lifestyle changes, walking as an activity, being physically active with others, fearing the consequences of type 2 diabetes, and taking control. Factors that they viewed as challenging included mental, physical, practical, and social challenges around exercise, and lack of follow-up from healthcare professionals.
Our review identified several factors that may influence maintenance of lifestyle changes in type 2 diabetes. Based on these findings, we have developed a series of questions to help people with type 2 diabetes and their healthcare providers think about how best to maintain lifestyle choices over time.
2型糖尿病患者往往觉得难以实现推荐的生活方式改变，而且很难维持这些改变。因此，探索他们在尝试实现这些目标时，关于影响他们的因素的观点和经历是很有用的。
识别、评估和综合定性研究，以探究是什么促使2型糖尿病患者长期维持生活方式的改变以及他们所经历的挑战。
我们纳入了定性研究以及包含定性部分的混合方法研究，研究对象为任何语言的成年2型糖尿病患者，且他们已维持生活方式改变至少十二个月。我们检索了MEDLINE、CINAHL、PsycINFO和EMBASE数据库，检索时间从建库至2024年11月4日。我们使用预先设计的表格提取数据，并使用预定义的标准评估方法学局限性。我们采用主题综合法来分析数据。我们使用GRADE-CERQual方法评估我们对综述结果的信心。最后，我们利用研究结果，运用控制点理论建立一个模型，并得出实践启示。
我们纳入了来自欧洲、美国、加拿大、南非、澳大利亚和新西兰的12项研究。参与者描述了几个促使他们维持生活方式改变的因素，包括获得他人的支持、看到生活方式改变带来的结果、将散步作为一项活动、与他人一起进行体育锻炼、害怕2型糖尿病的后果以及掌控局面。他们认为具有挑战性的因素包括围绕运动的心理、身体、实际和社会挑战，以及医疗保健专业人员缺乏随访。
我们的综述确定了几个可能影响2型糖尿病患者维持生活方式改变的因素。基于这些发现，我们提出了一系列问题，以帮助2型糖尿病患者及其医疗保健提供者思考如何随着时间的推移最好地维持生活方式的选择。
