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Hamidi S, Gholamnezhad Z, Kasraie N, Sahebkar A. The Effects of Self-Efficacy and Physical Activity Improving Methods on the Quality of Life in Patients with Diabetes: A Systematic Review. J Diabetes Res 2022; 2022:2884933. [PMID: 35936392 PMCID: PMC9348907 DOI: 10.1155/2022/2884933] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/15/2022] [Accepted: 07/15/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The purpose of this systematic review is to study the impact of self-efficacy-improving strategies on physical activity-related glycemic control of diabetes. METHOD This systematic review was conducted based on the PRISMA statement. ("Diabetes" OR "glycemic control") AND ("exercise" OR "physical activity") AND "self-efficacy" were searched as keywords in databases including PubMed, Google Scholar, Science Direct, Embase, Cochrane, Web of Science, and Scopus between 2000 and 2019 for relesvant articles. RESULTS Two reviewers independently screened articles (n = 400), and those meeting eligibility criteria (n = 47) were selected for data extraction using a predesigned Excel form and critical appraisal using the "Tool for Quantitative Studies." Different strategies and health promotion programs such as individual or group face-to-face education and multimedia (video conference, video, phone calls, short message service, and Internet-based education) were used in diabetes self-management education programs. The results of different interventions including motivational interviewing (7 studies), exercise (5 studies), multidimensional self-management programs (25 studies), and electronic education (11 studies) had been evaluated. Interventions with more social support, longer duration, combined educative theory-based, and individual education had better outcomes both in postintervention and in follow-up evaluation. CONCLUSION A combination of traditional and virtual long-lasting self-care promoting (motivating) programs is needed to improve patients' self-efficacy for healthy habits like active lifestyle.
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Affiliation(s)
- Sajjad Hamidi
- Department of Psychiatric Nursing, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Gholamnezhad
- Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Kasraie
- Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, Texas, USA
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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Wee PJL, Kwan YH, Loh DHF, Phang JK, Puar TH, Østbye T, Thumboo J, Yoon S, Low LL. Measurement Properties of Patient-Reported Outcome Measures for Diabetes: Systematic Review. J Med Internet Res 2021; 23:e25002. [PMID: 34397387 PMCID: PMC8398743 DOI: 10.2196/25002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/18/2020] [Accepted: 06/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The management of diabetes is complex. There is growing recognition of the use of patient-reported outcome measures (PROMs) as a standardized method of obtaining an outlook on patients' functional status and well-being. However, no systematic reviews have summarized the studies that investigate the measurement properties of diabetes PROMs. OBJECTIVE Our aims were to conduct a systematic review of studies investigating the measurement properties of diabetes PROMs by evaluating the methodological quality and overall level of evidence of these PROMs and to categorize them based on the outcome measures assessed. METHODS This study was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Relevant articles were retrieved from the Embase, PubMed, and PsychINFO databases. The PROMs were evaluated with the COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) guidelines. RESULTS A total of 363 articles evaluating the measurement properties of PROMs for diabetes in the adult population were identified, of which 238 unique PROMs from 248 studies reported in 209 articles were validated in the type 2 diabetes population. PROMs with at least a moderate level of evidence for ≥5 of 9 measurement properties include the Chinese version of the Personal Diabetes Questionnaire (C-PDQ), Diabetes Self-Management Instrument Short Form (DSMI-20), and Insulin Treatment Appraisal Scale in Hong Kong primary care patients (C-ITAS-HK), of which the C-PDQ has a "sufficient (+)" rating for >4 measurement properties. A total of 43 PROMs meet the COSMIN guidelines for recommendation for use. CONCLUSIONS This study identified and synthesized evidence for the measurement properties of 238 unique PROMs for patients with type 2 diabetes and categorized the PROMs according to their outcome measures. These findings may assist clinicians and researchers in selecting appropriate high-quality PROMs for clinical practice and research. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020180978; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020180978.
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Affiliation(s)
| | - Yu Heng Kwan
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Troy H Puar
- Department of Endocrinology, Changi General Hospital, Singapore, Singapore
| | - Truls Østbye
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Julian Thumboo
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sungwon Yoon
- Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Lian Leng Low
- SingHealth Office of Regional Health, Singapore, Singapore
- Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore, Singapore
- Post Acute and Continuing Care, Outram Community Hospital, SingHealth Community Hospitals, Singapore, Singapore
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Ren Z, Zhu H, Zhang T, Hua H, Zhao K, Yang N, Liang H, Xu Q. Effects of a 12-Week Transtheoretical Model-Based Exercise Training Program in Chinese Postoperative Bariatric Patients: a Randomized Controlled Trial. Obes Surg 2021; 31:4436-4451. [PMID: 34373988 DOI: 10.1007/s11695-021-05607-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This study aims to investigate the effectiveness of the transtheoretical model (TTM)-based exercise training on TTM variables, exercise adherence, and physical function in patients in the early stages after bariatric surgery (BS). MATERIALS AND METHODS We conducted a single-blinded, prospective, randomized controlled trial (RCT) to evaluate the effects of TTM-based exercise training on BS patients immediately after surgery. Participants (n = 120) were randomized into a TTM-based exercise training group (n = 60) and a control group (n = 60). Main outcomes included TTM variables (measured by exercise stages of change (ESCs), exercise self-efficacy (ESE), and decisional balance), exercise adherence, and physical function (determined by the 6-min walk distance (6MWD)). Secondary outcomes were physical activity, anthropometrics, and body composition. We performed all analyses in accordance with the intention-to-treat principle. RESULTS Retention rates for the interventions were 91.7% for the intervention group and 90.0% for the control group. Compared with the control group, the 12-week TTM-based intervention significantly helped participants advance through ESCs, demonstrate higher ESE, perceive more benefits and fewer barriers to exercise, and show higher exercise adherence and better physical function afterward (all P < 0.05). However, we observed no statistically significant difference between the two groups in anthropometric parameters or body composition after intervention. CONCLUSION The TTM-based exercise intervention had significant positive effects on the TTM variables, which could further help increase patients' exercise adherence and physical function immediately after BS. TRIAL REGISTRATION This study was retrospectively registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn , registry number: ChiCTR2000039319).
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Affiliation(s)
- Ziqi Ren
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China.,School of Nursing, Fudan University, Shanghai, 200032, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China
| | - Tianzi Zhang
- Department of Nursing, Jiangsu College of Nursing, Huai'an, 223000, Jiangsu, China
| | - Hongxia Hua
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China
| | - Ningli Yang
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Hui Liang
- Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, 818 Tianyuan East Road, Jiangning District, Nanjing, 210029, Jiangsu, China.
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Al-Ghafri TS, Al-Harthi S, Al-Farsi Y, Craigie AM, Bannerman E, Anderson AS. Changes in Self-Efficacy and Social Support after an Intervention to Increase Physical Activity Among Adults with Type 2 Diabetes in Oman: A 12-month follow-up of the MOVEdiabetes trial. Sultan Qaboos Univ Med J 2021; 21:e42-e49. [PMID: 33777422 PMCID: PMC7968896 DOI: 10.18295/squmj.2021.21.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/21/2020] [Accepted: 06/10/2020] [Indexed: 12/05/2022] Open
Abstract
Objectives This study aimed to describe changes in self-efficacy (SE) and social support (SS) 12 months after the MOVEdiabetes trial, an intervention designed to increase physical activity (PA) among adults with type 2 diabetes mellitus in Oman. Methods The original MOVEdiabetes trial was conducted between April 2016 and June 2017 in Muscat, Oman. The intervention group (IG) received personalised PA consultations, pedometers and monthly messages using a web-based application, while the comparison group received usual care. Self-reported SE and SS from family and friends were assessed using validated psychosocial scales. Results Of the 232 original participants in the trial, a total of 174 completed the 12 months follow-up study period (response rate: 75%). However, based on intention-to-treat analysis with several imputation procedures for missing data at 3 and/or 12 months, there was a significant increase in SE scores in the IG (+10.3, 95% confidence interval [CI]: 7.1–13.5; P <0.001); however, the correlation with PA levels was weak (+4.2, 95% CI: 2.7–5.7; P <0.001). Higher SE scores were noted in those without comorbidities (+12.2, 95% CI: 6.8–17.6; P <0.001) and with high income levels (+9.7, 95% CI: 5.2–14.2; P <0.001). Additionally, SS scores increased significantly among those in the IG who received support from friends (+2.3, 95% CI: 1.1–3.7; P <0.001), but not family (+1.2, 95% CI: −0.4–2.8; P = 0.110). The reliability of the scales was acceptable for SE and SS from family, but poor for SS from friends (Cronbach’s alpha coefficients = 0.82, 0.82 and 0.40, respectively). Conclusion The PA intervention was associated with positive changes in SE and SS from friends. However, further tools for assessing psychosocial influences on PA are needed in Arab countries.
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Affiliation(s)
- Thamra S Al-Ghafri
- Department of Planning, Directorate General of Planning & Studies, Ministry of Health, Muscat, Oman
| | - Saud Al-Harthi
- Department of Medicine, Al Nahdha Hospital, Muscat, Oman
| | - Yahya Al-Farsi
- Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Angela M Craigie
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, UK
| | - Elaine Bannerman
- Global Academy of Agriculture & Food Security, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, UK
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Hakim AR, Wang ST, Widiantoro FX, Hannan M, Wang CJ, Fetzer SJ. The Indonesian Version of the Exercise Self-Efficacy Scale: Cross-cultural Adaptation and Psychometric Testing. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 14:300-305. [PMID: 32896667 DOI: 10.1016/j.anr.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/22/2020] [Accepted: 08/26/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSES The study aimed to translate the Exercise Self-Efficacy Scale (ESES) into Indonesian and test the cultural equivalence, reliability, and validity of the new version for university students. METHODS The cross-sectional study recruited 379 Indonesian university students using convenience sampling. Phase 1, a culturally appropriate version of the ESES was developed in the Indonesian language. Phase 2, the psychometric properties were determined through exploratory factor analysis, bootstrap factor analysis, and confirmatory factor analysis. The internal consistency reliability was tested using Cronbach's α, whereas the stability using intraclass correlation coefficient to assess. RESULTS The students' ages ranged from 17 to 39 years, and 65.0% were women. For translation equivalence, the mean item content validity indexes ranged from 3.5 to 4, and all items were understandable. The 16-item scale exhibited cross-cultural appropriateness and readability, with a three-factor model explaining 62.3% of the variance in exercise self-efficacy. A bootstrap analysis using 100 resamples further confirmed the three-factor model. The indices of the good-fit model that used the three-factor by two-stage least squares method were satisfactory, with χ2/df = 3.3, goodness of fit index = .88, and root mean-square error of approximation = .05 (p < .001). The Cronbach's α was .78, .80, and .92 for factors 1, 2, and 3, respectively. The test--retest reliability was demonstrated with an intraclass correlation coefficient of .91, indicating adequate measurement stability. CONCLUSION The 16-item ESES-I has acceptable validity and reliability; however, a broader application of the scale requires further testing in different populations to confirm its external validity.
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Affiliation(s)
- Arif R Hakim
- Department of Nursing, University of Wiraraja, Sumenep, Indonesia
| | - Shan-Tair Wang
- Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chiayi, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | | | - Mujib Hannan
- Department of Nursing, University of Wiraraja, Sumenep, Indonesia
| | - Chi-Jane Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Suzan J Fetzer
- Department of Nursing, University of New Hampshire, Durham, United States
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Albergoni A, Hettinga FJ, Stut W, Sartor F. Factors Influencing Walking and Exercise Adherence in Healthy Older Adults Using Monitoring and Interfacing Technology: Preliminary Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6142. [PMID: 32846988 PMCID: PMC7503601 DOI: 10.3390/ijerph17176142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Monitoring and interfacing technologies may increase physical activity (PA) program adherence in older adults, but they should account for aspects influencing older adults' PA behavior. This study aimed at gathering preliminary wrist-based PA adherence data in free-living and relate these to the influencing factors. METHODS Ten healthy older adults (4 females, aged 70-78 years) provided health, fatigue, activity levels, attitude towards pacing, and self-efficacy information and performed a 6 min-walk test to assess their fitness. After a baseline week they followed a two-week walking and exercise intervention. Participants saw their progress via a purposely designed mobile application. RESULTS Walking and exercise adherence did not increase during the intervention (p = 0.38, p = 0.65). Self-efficacy decreased (p = 0.024). The baseline physical component of the Short Form Health Survey was the most predictive variable of walking adherence. Baseline perceived risk of over-activity and resting heart rate (HRrest) were the most predictive variables of exercise adherence. When the latter two were used to cluster participants according to their exercise adherence, the fitness gap between exercise-adherent and non-adherent increased after the intervention (p = 0.004). CONCLUSIONS Risk of over-activity and HRrest profiled short-term exercise adherence in older adults. If confirmed in a larger and longer study, these could personalize interventions aimed at increasing adherence.
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Affiliation(s)
- Andrea Albergoni
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
- Centro Polifunzionale di Scienze Motorie, University of Genoa, 16132 Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, 16148 Genoa, Italy
- Department of Patient Care and Measurements, Philips Research, 5656AE Eindhoven, The Netherlands
| | - Florentina J. Hettinga
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle NE1 8ST, UK
| | - Wim Stut
- Department of Chronic Disease Management, Philips Research, 5656AE Eindhoven, The Netherlands;
| | - Francesco Sartor
- Department of Patient Care and Measurements, Philips Research, 5656AE Eindhoven, The Netherlands
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester CO4 3WA, UK;
- College of Health and Behavioural Science, Bangor University, Bangor LL57 2EF, UK
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Almutary H, Tayyib N. Factors associated with exercise self-efficacy among people with chronic diseases. Appl Nurs Res 2020; 54:151275. [PMID: 32650891 DOI: 10.1016/j.apnr.2020.151275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 04/07/2020] [Accepted: 04/29/2020] [Indexed: 11/18/2022]
Abstract
AIM The aim of this study is to assess the level of exercise self-efficacy in a population with chronic diseases and identify the factors that could influence exercise self-efficacy. BACKGROUND Performing physical exercise is an important part of self-care in chronic diseases. It is highly influenced by individual's self- efficacy. However, little attention has been given to the identification of the factors that could affect the exercise self-efficacy among people with chronic diseases. METHODS This cross-sectional study was conducted to assess the exercise self-efficacy among people with chronic diseases using the Exercise Self-Efficacy Scale (ESE). Demographic and exercise profiles were also collected. RESULTS A total of eighty-five people with chronic diseases from outpatients' clinics participated in this study. The mean age of the participants was 52 ± 13.92 and more than half of them were females (58.8%). The mean score of exercise self-efficacy was 39 ± 21.55. Education level was the main factor that correlated with lower levels of exercise self-efficacy. CONCLUSIONS This study is first to provide preliminary evidence about levels of exercise self-efficacy and its associated factors among people with chronic diseases in Saudi Arabia. The level of exercise self-efficacy is low in people with chronic diseases and this mainly associated with educational factor. Nurses have an important role to promoting exercise self-efficacy through implementing a comprehensive plan that is patient's centered approach. However, further research is needed to assess perception, detect barriers and conduct intervention that aims to improve exercise Self-efficacy.
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Affiliation(s)
- Hayfa Almutary
- Faculty of Nursing, Medical/Surgical Department, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Nahla Tayyib
- Medical Surgical Nursing Department, Faculty of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia.
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Lee J, Lee EH, Chae D. Self-efficacy instruments for type 2 diabetes self-care: A systematic review of measurement properties. J Adv Nurs 2020. [PMID: 32400902 DOI: 10.1111/jan.14411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/25/2020] [Accepted: 04/21/2020] [Indexed: 11/29/2022]
Abstract
AIMS To identify currently available self-efficacy instruments for type 2 diabetes self-care and to evaluate the evidence for their measurement properties. DESIGN Systematic review of measurement properties. DATA SOURCES The PubMed, Embase and CINAHL databases were searched from their inception to 27 May 2019. REVIEW METHODS The updated COnsensus-based Standards for the selection of health Measurement INstruments methodology were applied. RESULTS Twelve instruments were identified from 3,665 records. Eight instruments were related to self-efficacy in performing a comprehensive set of the tasks/behaviours for diabetes self-care and the other four addressed specific behaviours related to diabetes self-care, such as insulin management. Most of the 12 instruments were developed based on Bandura's self-efficacy theory as their theoretical background. Overall, sufficient high-quality evidence for measurement properties was seldom identified. The Diabetes Management Self-Efficacy Scale is currently the best instrument, with particularly the 4-factor, 16-item version being demonstrated to have sufficient high-quality evidence for structural and internal consistency and sufficient moderate-quality evidence for reliability and convergent validity. CONCLUSIONS None of the instruments evaluated all of the relevant measurement properties. The Diabetes Management Self-Efficacy Scale is currently the most suitable instrument for potential use in practice and research. The measurement invariance across languages, measurement error and responsiveness of this instrument still need be evaluated. IMPACT This systematic review provides clinicians and researchers with a comprehensive list of available instruments for measuring self-efficacy in diabetes self-care, as well as evidence for helping them to select the most appropriate instrument. Using a psychometrically sound instrument will accurately inform practitioners about the levels of self-efficacy in self-care among patients with type 2 diabetes in practice and avoid threatening the credibility of research studies on self-efficacy in diabetes self-care.
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Affiliation(s)
- Jiyeon Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea
| | - Duckhee Chae
- College of Nursing, Chonnam National University, Gwangju, Republic of Korea
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Westland H, Schuurmans MJ, Bos-Touwen ID, de Bruin-van Leersum MA, Monninkhof EM, Schröder CD, de Vette DA, Trappenburg JC. Effectiveness of the nurse-led Activate intervention in patients at risk of cardiovascular disease in primary care: a cluster-randomised controlled trial. Eur J Cardiovasc Nurs 2020; 19:721-731. [PMID: 32375491 PMCID: PMC7817988 DOI: 10.1177/1474515120919547] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background To understand better the success of self-management interventions and to
enable tailoring of such interventions at specific subgroups of patients,
the nurse-led Activate intervention is developed targeting one component of
self-management (physical activity) in a heterogeneous subgroup (patients at
risk of cardiovascular disease) in Dutch primary care. Aim The aim of this study was to evaluate the effectiveness of the Activate
intervention and identifying which patient-related characteristics modify
the effect. Methods A two-armed cluster-randomised controlled trial was conducted comparing the
intervention with care as usual. The intervention consisted of four
nurse-led behaviour change consultations within a 3-month period. Data were
collected at baseline, 3 months and 6 months. Primary outcome was the daily
amount of moderate to vigorous physical activity at 6 months. Secondary
outcomes included sedentary behaviour, self-efficacy for physical activity,
patient activation for self-management and health status. Prespecified
effect modifiers were age, body mass index, level of education, social
support, depression, patient provider relationship and baseline physical
activity. Results Thirty-one general practices (n = 195 patients) were
included (intervention group n = 93; control group
n = 102). No significant between-group difference was
found for physical activity (mean difference 2.49 minutes; 95% confidence
interval -2.1; 7.1; P = 0.28) and secondary outcomes.
Patients with low perceived social support (P = 0.01) and
patients with a low baseline activity level (P = 0.02)
benefitted more from the intervention. Conclusion The Activate intervention did not improve patients’ physical activity and
secondary outcomes in primary care patients at risk of cardiovascular
disease. To understand the results, the intervention fidelity and active
components for effective self-management require further investigation. Trial registration: ClinicalTrials.gov NCT02725203.
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Affiliation(s)
- Heleen Westland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | | | - Irene D Bos-Touwen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | | | - Evelyn M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Carin D Schröder
- Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, The Netherlands
| | - Daphne A de Vette
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
| | - Jaap Ca Trappenburg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands
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Malay Version of Exercise Self-Efficacy: A Confirmatory Analysis among Malaysians with Type 2 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030922. [PMID: 32024257 PMCID: PMC7037020 DOI: 10.3390/ijerph17030922] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/23/2020] [Accepted: 01/25/2020] [Indexed: 11/24/2022]
Abstract
Exercise self-efficacy (ESE) is one of the psychological constructs in the Transtheoretical Model (TTM). The objective of the present study is to assess the validity and reliability of the Malay version of Exercise self-efficacy scale (ESE-M) among Malaysians with type 2 diabetes mellitus (T2DM). A cross-sectional study design with convenience sampling method using a self-administered questionnaire was carried out. Participants were invited to complete the ESE-M with 18 items. Confirmatory factor analysis (CFA) was conducted and composite reliability (CR) was computed using Mplus 8. A total of 331 Malaysians with T2DM with a mean age of 63 years old (Standard Deviation = 0.57) completed the questionnaire. Most of the participants were male (52%) and Malay (89.4%). Two initial CFA models (single factor and three factors) of ESE-M scale were tested and they did not fit to the data well. Several re-specifications of the models were conducted. The final model for the ESE-M showed improvement on the value of model fit indices for the single factor model (comparative fit index (CFI) = 0.952, Tucker and Lewis index (TLI) = 0.938, standardised root mean square (SRMR) = 0.044, root mean square error of approximation (RMSEA) = 0.054) and three factors model (CFI = 0.891, TLI = 0.863, SRMR = 0.049, RMSEA = 0.081). The CR for the self-efficacy factor was 0.921 (single factor), while CR for internal feelings, competing demands and situational (three factors) were 0.762, 0.818 and 0.864, respectively. The final model of single factor ESE-M showed better fit to the data compared to the three factors ESE-M. This indicated that the single factor ESE-M is more suitable to be adopted for future study among Malaysians with T2DM.
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Ting LK, Kuan G, Arifin WN, Cheng KY. Psychometric Properties of the Self-Efficacy Scale among Undergraduate Students in Malaysia. Malays J Med Sci 2019; 26:119-128. [PMID: 31303856 PMCID: PMC6613467 DOI: 10.21315/mjms2019.26.3.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022] Open
Abstract
Background Self-efficacy (SE) is a person's belief in his or her own capability to perform and accomplish a task that could produce a favourable outcome, despite facing obstacles. This study aimed to confirm the validity and reliability of an SE scale among undergraduate students at the Health Campus of the Universiti Sains Malaysia. Methods A cross-sectional study was conducted among the undergraduate students using a self-administered questionnaire. After using a purposive sampling method, 562 students completed the questionnaire. Mplus 8 was employed to conduct the confirmatory factor analysis on the psychometric properties of Bandura's 18-item SE scale with three factors (internal feeling, competing demands and situational). Then, the composite reliability was calculated for each factor. Results Most of the students were Malay (73.3%) females (79.0%) who exercised 2.62 times a week for an average of 43.37 min per session. The final measurement model was obtained after removing six problematic items, and the model was deemed fit based on several indices [Root Mean Square Error of Approximation (RMSEA) = 0.067, Standardised Root Mean Square Residual (SRMR) = 0.004, Comparative Fit Index (CFI) = 0.924]. The composite reliability values of the three factors were acceptable (0.65 to 0.84). Conclusion The simplified 12-item SE scale with three factors displayed good fit indices with regard to the data, and they were considered to be acceptable for the current sample.
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Affiliation(s)
- Liu Kien Ting
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Garry Kuan
- Exercise and Sports Science Programme, School of Health Science, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Wan Nor Arifin
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Kueh Yee Cheng
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Westland H, Bos-Touwen ID, Trappenburg JCA, Schröder CD, de Wit NJ, Schuurmans MJ. Unravelling effectiveness of a nurse-led behaviour change intervention to enhance physical activity in patients at risk for cardiovascular disease in primary care: study protocol for a cluster randomised controlled trial. Trials 2017; 18:79. [PMID: 28228151 PMCID: PMC5322635 DOI: 10.1186/s13063-017-1823-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 02/06/2017] [Indexed: 11/24/2022] Open
Abstract
Background Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease. The aim of this study is to evaluate the effectiveness of the Activate intervention. Methods/design A two-arm cluster randomised controlled trial will be conducted to compare the Activate intervention with care as usual at 31 general practices in the Netherlands. Approximately 279 patients at risk for cardiovascular disease will participate. The Activate intervention is developed using the Behaviour Change Wheel and consists of 4 nurse-led consultations in a 3-month period, integrating 17 behaviour change techniques. The Behaviour Change Wheel was also applied to analyse what behaviour change is needed in nurses to deliver the intervention adequately. This resulted in 1-day training and coaching sessions (including 21 behaviour change techniques). The primary outcome is physical activity, measured as the number of minutes of moderate to vigorous physical activity using an accelerometer. Potential effect modifiers are age, body mass index, level of education, social support, depression, patient-provider relationship and baseline number of minutes of physical activity. Data will be collected at baseline and at 3 months and 6 months of follow-up. A process evaluation will be conducted to evaluate the training of nurses, treatment fidelity, and to identify barriers to and facilitators of implementation as well as to assess participants’ satisfaction. Discussion To increase physical activity in patients and to support nurses in delivering the intervention, behaviour change techniques are applied to change behaviours of the patients and nurses. Evaluation of the effectiveness of the intervention, exploration of which patients benefit most, and evaluation of our theory-based training for primary care nurses will enhance understanding of what works and for whom, which is essential for further implementation of self-management in clinical practice. Trial registration ClinicalTrials.gov identifier: NCT02725203. Registered on 25 March 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1823-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heleen Westland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost STR 6.131, PO Box 85500, Utrecht, GA, 3508, The Netherlands.
| | - Irene D Bos-Touwen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost STR 6.131, PO Box 85500, Utrecht, GA, 3508, The Netherlands
| | - Jaap C A Trappenburg
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost STR 6.131, PO Box 85500, Utrecht, GA, 3508, The Netherlands
| | - Carin D Schröder
- Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Niek J de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost STR 6.131, PO Box 85500, Utrecht, GA, 3508, The Netherlands
| | - Marieke J Schuurmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost STR 6.131, PO Box 85500, Utrecht, GA, 3508, The Netherlands
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Darawad MW, Hamdan-Mansour AM, Khalil AA, Arabiat D, Samarkandi OA, Alhussami M. Exercise Self-Efficacy Scale: Validation of the Arabic Version Among Jordanians With Chronic Diseases. Clin Nurs Res 2016; 27:890-906. [DOI: 10.1177/1054773816683504] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study assessed the psychometric properties of the Arabic version of Exercise Self-Efficacy scale (ESE-A) among Jordanian outpatients with a variety of chronic diseases using descriptive cross-sectional design. Participants’ scores of ESE-A significantly correlated with their reported weekly exercise frequency ( r = .23, p< .001), duration ( r = .31, p< .001), and evaluation of their physical exercise ( r = .39, p< .001). The construct validity was tested using exploratory factor analysis, which retained all items, and the scree plot showed one meaningful factor with an eigenvalue of 10.38 and an explained variance of 57.7%. Furthermore, Cronbach’s alpha was .89 and split-half coefficient was .83 indicating that the ESE-A is a reliable scale. The ESE-A was found to be a robust measure to evaluate exercise self-efficacy among Arabic patients with chronic diseases. Arabic researchers interested in exercise self-efficacy are invited to utilize the ESE-A in their studies to confirm its psychometric properties.
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Affiliation(s)
| | | | | | - Diana Arabiat
- The University of Jordan, Amman, Jordan
- Edith Cowan University, Joondalup, Australia
| | | | - Mahmoud Alhussami
- The University of Jordan, Amman, Jordan
- University of Dammam, Saudi Arabia
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Pei L, Wang Y, Sun CY, Zhang Q. Individual, social and environmental predictors of regular exercise among adults with type 2 diabetes and peripheral neuropathy in China. Int J Nurs Pract 2016; 22:451-460. [DOI: 10.1111/ijn.12474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/06/2016] [Accepted: 06/21/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Li Pei
- School of Nursing; Tianjin Medical University; Tianjin China
| | - Yan Wang
- Nursing Department; The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine; Tianjin China
| | - Chunyan Y Sun
- School of Nursing; Tianjin Medical University; Tianjin China
| | - Qing Zhang
- Nursing Department, School of Nursing; Tianjin Medical University; Tianjin China
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van der Weegen S, Verwey R, Spreeuwenberg M, Tange H, van der Weijden T, de Witte L. It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial. J Med Internet Res 2015. [PMID: 26209025 PMCID: PMC4529491 DOI: 10.2196/jmir.4579] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Physical inactivity is a major public health problem. The It’s LiFe! monitoring and feedback tool embedded in the Self-Management Support Program (SSP) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care. Objective Our aim was to evaluate whether the SSP combined with the use of the monitoring and feedback tool leads to more physical activity compared to usual care and to evaluate the additional effect of using this tool on top of the SSP. Methods This was a three-armed cluster randomised controlled trial. Twenty four family practices were randomly assigned to one of three groups in which participants received the tool + SSP (group 1), the SSP (group 2), or care as usual (group 3). The primary outcome measure was minutes of physical activity per day. The secondary outcomes were general and exercise self-efficacy and quality of life. Outcomes were measured at baseline after the intervention (4-6 months), and 3 months thereafter. Results The group that received the entire intervention (tool + SSP) showed more physical activity directly after the intervention than Group 3 (mean difference 11.73, 95% CI 6.21-17.25; P<.001), and Group 2 (mean difference 7.86, 95% CI 2.18-13.54; P=.003). Three months after the intervention, this effect was still present and significant (compared to Group 3: mean difference 10.59, 95% CI 4.94-16.25; P<.001; compared to Group 2: mean difference 9.41, 95% CI 3.70-15.11; P<.001). There was no significant difference in effect between Groups 2 and 3 on both time points. There was no interaction effect for disease type. Conclusions The combination of counseling with the tool proved an effective way to stimulate physical activity. Counseling without the tool was not effective. Future research about the cost-effectiveness and application under more tailored conditions and in other target groups is recommended. Trial Registration ClinicalTrials.gov: NCT01867970, https://clinicaltrials.gov/ct2/show/NCT01867970 (archived by WebCite at http://www.webcitation.org/6a2qR5BSr).
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Affiliation(s)
- Sanne van der Weegen
- CAPHRI School for Public Health and Primary Care, Department Health Services Research, Maastricht University, Maastricht, Netherlands.
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Caro-Bautista J, Martín-Santos FJ, Villa-Estrada F, Morilla-Herrera JC, Cuevas-Fernández-Gallego M, Morales-Asencio JM. Using qualitative methods in developing an instrument to identify barriers to self-care among persons with type 2 diabetes mellitus. J Clin Nurs 2014; 24:1024-37. [DOI: 10.1111/jocn.12740] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Jorge Caro-Bautista
- UGC Limonar; IBIMA; Distrito Sanitario Málaga-Valle del Guadalhorce; Universidad de Málaga; Málaga Spain
| | | | - Francisca Villa-Estrada
- UGC Capuchinos; IBIMA; Distrito Sanitario Málaga-Valle del Guadalhorce; Universidad de Málaga; Málaga Spain
| | | | - Magdalena Cuevas-Fernández-Gallego
- UGC Colonia Santa Inés-Teatinos-Portada Alta; IBIMA; Distrito Sanitario Málaga-Valle del Guadalhorce; Universidad de Málaga; Málaga Spain
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Verwey R, van der Weegen S, Spreeuwenberg M, Tange H, van der Weijden T, de Witte L. A monitoring and feedback tool embedded in a counselling protocol to increase physical activity of patients with COPD or type 2 diabetes in primary care: study protocol of a three-arm cluster randomised controlled trial. BMC FAMILY PRACTICE 2014; 15:93. [PMID: 24885096 PMCID: PMC4030038 DOI: 10.1186/1471-2296-15-93] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/25/2014] [Indexed: 08/24/2023]
Abstract
Background Physical activity is important for a healthy lifestyle. Although physical activity can delay complications and decrease the burden of the disease, the level of activity of patients with chronic obstructive pulmonary disease (COPD) or type 2 Diabetes Mellitus (DM2) is often far from optimal. To stimulate physical activity, a monitoring and feedback tool, consisting of an accelerometer linked to a smart phone and webserver (It’s LiFe! tool), and a counselling protocol for practice nurses in primary care was developed (the Self-management Support Program). The main objective of this study is to measure the longitudinal effects of this counselling protocol and the added value of using the tool. Methods/Design This three-armed cluster randomised controlled trial with 120 participants with COPD and 120 participants with DM2 (aged 40–70), compares the counselling protocol with and without the use of the tool (group 1 and 2) with usual care (group 3). Recruitment takes place at GP practices in the southern regions of the Netherlands. Randomisation takes place at the practice level. The intended sample (three arms of 8 practices) powers the study to detect a 10-minute difference of moderate and intense physical activity per day between groups 1 and 3. Participants in the intervention groups have to visit the practice nurse 3–4 times for physical activity counselling, in a 4-6-month period. Specific activity goals tailored to the individual patient's preferences and needs will be set. In addition, participants in group 1 will be instructed to use the tool in daily life. The primary outcome, physical activity, will be measured in all groups with a physical activity monitor (PAM). Secondary outcomes are quality of life, general - and exercise - self-efficacy, and health status. Follow-up will take place after 6 and 9 months. Separately, a process evaluation will be conducted to explore reasons for trial non-participation, and the intervention’s acceptability for participating patients and nurses. Discussion Results of this study will give insight into the effects of the It’s LiFe! monitoring and feedback tool combined with care from a practice nurse for people with COPD or DM2 on physical activity. Trial registration ClinicalTrials.gov:
NCT01867970
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Affiliation(s)
- Renée Verwey
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands.
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