FACTORS PREDICTING PHYSICAL ACTIVITY

AMONG PERSONS WITH TYPE 2 DIABETES

IN THAI NGUYEN HOSPITAL, VIET NAM

Examination committee

1. Major advisor: Assist. Prof. Dr. Pawana Keeratiyutawong

2. Co-Advisor: Assist. Prof. Dr. Niphawan Samartkit 3. External Examiner: Assist. Prof. Dr. Apa Puckpinyo Presented by Nguyen Thi Mai Huong Student in Master of Nursing Science

INTRODUCTION
Background and significant Diabetes is a risk factor for significant morbidity and mortality worldwide The number of diabetes patients will be increased globally (Shaw, Sicree, & Zimmet, 2010) The cause of increasing morbidity and mortality of diabetes is

lack of blood glucose control

(Laakso, 2001; Wang et al., 2013)

Previous studies Dunning (2009) designated physical activity which was a key role in the management of type 2 diabetes

(Colberg et al., 2010; Colberg & Swain, 2000)

Physical activity can reduce insulin resistance, increases the

number of receptors, sensitivity of cells to insulin

concentration in tissue, control blood glucose levels and can prevent complications among persons with type 2 diabetes

(American Diabetes Association, 2004)

In Viet Nam, diabetes experts recommend the physical activity in type 2 diabetes is an important technique for the blood

glucose control
However, the studies about physical activity among type 2 diabetes in Viet Nam still limited In fact, at Thai Nguyen, the study regarding physical activity among persons with type 2 diabetes had few studies done

Mostly, persons with type 2 diabetes did not perform physical

activity - Did not have the knowledge and skill in physical activity - Have a lot of affect factors which are an obstruction to regular of physical activity

- Lack of self confidence in execute physical activity

- Lack of the attention, encourage of family, peers or health care providers, so they feel boring, alone, and do not want to perform physical activity

Therefore, from above literature reviews and necessary demands at Thai Nguyen, this study will be conducted in order to better understand the knowledge of physical activity, perceived barriers, perceived self - efficacy,

social support, and physical activity among persons with

type 2 diabetes in Thai Nguyen Hospital, Viet Nam

RESEARCH OBJECTIVES
1. To describe knowledge of physical activity, perceived barriers, perceived self - efficacy, social support and physical activity among persons with type 2 diabetes in Thai Nguyen Hospital, Viet Nam

2. To explore whether knowledge of physical activity, perceived barriers, perceived self - efficacy, and social support can predict physical activity among persons with type 2 diabetes in Thai Nguyen Hospital, Viet Nam

RESEARCH HYPOTHESIS
Knowledge of physical activity, perceived barriers, perceived

self - efficacy, and social support can predict physical

activity among persons with type 2 diabetes in Thai Nguyen Hospital, Viet Nam

HEALTH PROMOTION MODEL

Perceived barriers to action

Perceived self-efficacy

Health promotion behavior Personal factors Interpersonal influences

CONCEPTUAL FRAMEWORK
Knowledge of physical activity

Perceived barriers

Physical activity
Perceived selfefficacy

Social support

OPERATIONAL DEFINITIONS
Physical activity Knowledge of physical activity Perceived barriers Perceived self efficacy Social support

Physical activity refers to any body movement produced by skeletal muscles that result in expenditure of energy and its active regular daily with moderate intensity activity at least 30 minutes/1 time/1 day, or vigor intensity activity at least 20 minutes/1 time/1 day. Physical activity measure by the Global physical activity questionnaire, developed by experts in World Health

Organization (2002)

Knowledge of physical activity refers to information and

skill of physical activity in type 2 diabetes patients, such as the benefit of regular physical activity, intensity of physical activity, appropriate time, avoid dangerous from physical activity. It measure by the knowledge of physical

activity for type 2 diabetes patients questionnaire, it will

be developed by the researcher.

Perceived barriers refer to perceptions about obstacles to regular physical activity, such as take too much time, a

little place or too far, lack of encouraged by other people,

and hard feelings. It measure by the exercise barriers scale, developed by Pender (1995)

Perceived self - efficacy refers to perceptions of the

confidence in the judgment execute regular physical activity. It measure by the self-efficacy scale, developed by

Bandura (1997)
Social support refers to as perceptions of receiving instrumental and/or emotional encouragement from family, and friends for physical activity. It measure by the social support for exercise survey questionnaire, developed by Sallis et al (1987)

LITERATURE REVIEW
1. Overview of type 2 diabetes 2. Concepts and measurement of physical activity 3. The Health Promotion Theory 4. The factors related to physical activity in persons with type 2 diabetes

METHODOLOGY
Research design The descriptive predicting design Population Is outpatients at the Diabetes Clinic in Thai Nguyen National General Hospital, Viet Nam who was diagnosed with type 2 diabetes

Sample size The sample size of this study is calculated based on the formula of Tabachnick & Fidell, (1989)

N 50 + 8*M
Minimum required sample size for this study will be 82

Inclusion criteria: 1. Diagnosed at least 6 months

2. Age between 20 to 65 years old

3. Able to communicate, read and write the Viet Nam language 4. Willing to participate in the study 5. Do not have amputation, serious illness such as myocardial infarction, heart failure, renal failure, arthritis, osteoarthritis, paresis, and fracture leg, etc.

STUDY SETTING
Thai Nguyen

Thai Nguyen National General Hospital, Viet Nam 23 wards and 800 beds Outpatient Diabetes Clinic Monday, Wednesday, and Friday per week About 30 to 40 persons with type 2 diabetes per day 7 AM to 11:30 AM

RESEARCH INSTRUMENTS
1. Demographic data

2. The Global Physical Activity Questionnaire (GPAQ)

3. The Knowledge of Physical Activity Questionnaire (KPAQ) 4. The Exercise Barriers Scale (EBS) 5. The Exercise Self - Efficacy Scale (ESES) 6. The Social Support for Exercise Survey Questionnaire (SSESQ)

THE GLOBAL PHYSICAL ACTIVITY QUESTIONNAIRE (GPAQ)

Asked about the time spent in physical activity by each patient

per week
16 items and is divided into four parts Physical activity was evaluated after calculating the minutes or hours' total spent in physical activity combine of item 3, 6, 12, 15 in a week

The higher minutes or hours, means the higher performing

physical activity
The test-retest reliability in three months was .53 to .83, reliability in 10 days was

.83 to .96

THE KNOWLEDGE OF PHYSICAL ACTIVITY QUESTIONNAIRE (KPAQ)

Asked perception of patients about knowledge information

which related to physical activity

4 parts which have 16 items The answers are True, False, or Dont know responses The answer is 0 point if not correct or do not know, 1 point if correct

The higher scores indicates a higher level about knowledge

of physical activity

THE EXERCISE BARRIERS SCALE (EBS)

Asked agree level of patients about the reasons which limit their intention to execute physical activity

14 items, each item has a four point scale ranging from 1 =

Strongly disagree, 2 = Disagree, 3 = Agree, 4 = Strongly Agree The higher score indicates greater the perceived barriers to obtain Physical activity
Validity: had been tested Construct validity
Reliability: tested Internal consistency reliability. Cronbach' alpha = .87, test-retest reliability was .77

THE EXERCISE SELF - EFFICACY SCALE (ESES)

Asked perception of patients about the degree of confidence to perform physical activity 18 items, each item has a 100 point scale ranging in 10 units

from 0 to 100.
The higher score indicates higher the perceived self efficacy to obtain Physical activity
Validity: had been tested content validity, criterion validity, construct validity. Reliability: tested internal consistency Cronbach alpha = .95

THE SOCIAL SUPPORT FOR EXERCISE SURVEY QUESTIONNAIRE (SSESQ)

Asked perception of patients about the support of family and friends to material/spiritual support related to regular

physical activity
10 items, each item has five point scale in ranging from 1 = None, 2 = Rarely, 3 = A few times, 4 = Often, to 5 = Very often The higher score indicates higher the social support of family

as well as friends to obtain Physical activity

Validity: had been tested criterion and construct validity. Reliability : had been test - retest scores ranged from r = .55 to .86. Cronbach's

alpha ranged from .61 to .91

TRANSLATION OF INSTRUMENTS
YU, LEE, AND WOO (2004)
Bilingual translator 1 Bilingual translator 2 English back translated version

Original English version

Viet Nam version Bilingual Translator 3

Compare

VALIDITY AND RELIABILITY OF THE INSTRUMENTS

IN THIS STUDY

The Global Physical Activity questionnaire (GPAQ)

Reliability: will be send to 20 case for tested Test-retest reliability coefficient. The correlation coefficient index of this instrument should be .7 (Burns & Grove, 2005)

THE KNOWLEDGE OF PHYSICAL ACTIVITY QUESTIONNAIRE (KPAQ)

Validity: will be send to three experts for tested Content validity
index (CVI). Item-level content validity index score will be at least 1 (Burns & Grove, 2005) Reliability: will be send to 30 case for tested reliability by

KuderRichardson Formula, with standard KR20 .7

(Kuder & Richardson, 1937)

THE EXERCISE BARRIERS SCALE (EBS) THE EXERCISE SELF - EFFICACY SCALE (ESES) THE SOCIAL SUPPORT FOR EXERCISE SURVEY QUESTIONNAIRE (SSESQ)
Reliability: will be send to 30 case for tested Internal consistency reliability. The Cronbach's alpha coefficient of this instrument should be .8 (Burns & Grove, 2005)

DATA COLLECTION PROCEDURES

1. Submit research proposals for ethical approval to

Institutional Review Board of Nursing faculty, Burapha

University Thai Nguyen National General Hospital, Viet Nam to ask permission for data collection 2. After getting approval from Director of Thai Nguyen Hospital. Come and introduce herself, inform about purpose, method

and data collection process to the Director of Thai Nguyen

Hospital, and the Head Nurses of the Outpatient Diabetes Clinic

3. Come to Outpatient Diabetes Clinic on Monday, Wednesday, and Friday before 7 AM to recruit the subjects following the inclusion criteria

4. Then, use the simple random technique to choose

participants

Registration number of each patient

00120??

a slip of paper/patient

Sampling technique
00120??

00120??

5. Meet the participants who are selected, ask for the permission and give consent forms for signature verification

6. After receives participant's permission, invite participants to

an airy room, then distribute the self - report questionnaires 7. Will collect the answers, immediately be checked for completeness and accuracy. Say thanks to the participants

DATA ANALYSIS
Descriptive statistics and multiple regression analysis will
be used to analyze the data with the alpha level for significance was set at .05

THANKS FOR YOUR ATTENTION

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