Motivation for self-management among adults with type 2 diabetes

PhD thesis in Health, medicine and welfareBackground: The demands of daily diabetes self-management behaviours have been described as challenging and many individuals fail to adhere to this regimes. There is, therefore, a growing recognition of the need to focus on the motivation to maintain self-management behaviours among people with type 2 diabetes. However, although many researchers have identified motivation as critical for diabetes self-management, few studies have explicitly focused on this topic. Aims: The overall aim of this thesis is to use both qualitative and quantitative approaches to develop knowledge about factors that may be related to motivation for self-management among adults with type 2 diabetes. These factors include ability expectations, values, and social support and their relationship with diabetes self-management behaviours. Methods: In 2007, 19 adults with type 2 diabetes participated in focus group interviews about factors that may stimulate motivation for diabetes management. The analysis of the interview text was inspired by the qualitative content analysis method. In 2008, 425 adults with type 2 diabetes completed the questionnaire about diet and exercise management, ability expectations, values, and social support from healthcare practitioners, family and friends, as well as data about sociodemographic factors. Several statistical procedures were applied. Results: Six life-values were identified, several of which are related to fundamental human needs. The results indicated that life values may be critical motivational factors for engaging in a diabetes selfmanagement. The results also suggested that goals related to selfmanagement were formulated in more general than specific terms. Descriptive analysis revealed a pattern of high scores on intrinsic motivation (ability expectations and values) and a more moderate level of diet and exercise management. Moreover, relatively few participants reported that diet and exercise implied negative values for them. In the multiple regression analysis, results showed a tendency for respondents with higher exercise ability expectations to report taking more exercise; v the same tendency was found for diet management. However, indicators of intrinsic motivational factors explained more variances for exercise management than for diet management. [...