Abstract
The purpose of this study was to investigate whether self-efficacy for exercise decreased 12 weeks after educational intervention in diabetic patients and whether this had an effect on glycemic control. Thirty-eight diabetic patients underwent a 2-week educational program and were then followed for 12 weeks after discharge. The intervention program was delivered by several types of medical professionals. Lectures on exercise were given by a physical therapist, who tailored exercise instructions for individual patients. The assessment of self-efficacy for exercise was performed using a scale from a previous study, modified for Japanese people. The scale consisted of four sub-items: physical fatigue, mental stress, lack of time, and poor weather. Measurements were performed at the time of discharge and 12 weeks after discharge. Glycated hemoglobin (HbA1c) levels were assessed as an index of glycemic control, and diabetic status and social status factors were recorded. The physical fatigue and lack of time components of the self-efficacy for exercise scale were significantly decreased 12 weeks after discharge. Positive correlations were found between HbA1c levels at 12 weeks and duration of diabetes, number of educational admissions, and presence of diabetic retinopathy. The results suggest that the factors that are difficult to reproduce during hospital education (physical fatigue and lack of time) are the ones that decrease after discharge. To clarify the relationship between changes in self-efficacy for exercise and glycemic control, further studies with an extended follow-up period (24 weeks or 48 weeks) are needed.
Highlights
Self-efficacy is the belief of an individual in his/her ability to perform a particular activity and influence the level of effort and perseverance in spite of difficulties
The purpose of this study was to investigate whether self-efficacy for exercise decreased 12 weeks after educational intervention in diabetic patients and whether this had an effect on glycemic control
The results suggest that the factors that are difficult to reproduce during hospital education are the ones that decrease after discharge
Summary
Self-efficacy is the belief of an individual in his/her ability to perform a particular activity and influence the level of effort and perseverance in spite of difficulties. In the prestigious work of Bandura, self-efficacy is a psychological factor affecting behavioral change [1]. Social cognitive theory (SCT), which is based on self-efficacy, can contribute to changes in lifestyle and weight loss in obesity [2]. A few studies have suggested that interventions based on SCT increase self-care levels and improve glycemic control [3] [4]. Self-efficacy for exercise has been shown to increase physical activity (PA) levels in diabetic patients [5]. Interventions to reinforce self-efficacy for exercise play an important role in exercise therapy for diabetic patients. There are few studies investigating the relationship between changes in self-efficacy for exercise and glycemic control. This study may contribute to the construction of exercise therapy programs for diabetic patients by incorporating socio-psychological factors
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