MAI HUONG-Proposal 27.1.2014 -Done - New1

8/13/2019 MAI HUONG-Proposal 27.1.2014 -Done - New1

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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


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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)


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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 thenumber 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)


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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


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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


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Therefore, from above literature reviews and necessarydemands 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


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RESEARCHOBJECTIVES

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


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RESEARCHHYPOTHESIS

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


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HEALTHPROMOTIONMODEL

Perceived

barriers to

action

Perceived

self-efficacy

Interpersonal

influences

Personal

factors

Health

promotionbehavior


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CONCEPTUALFRAMEWORK

Knowledge ofphysical activity

Perceived barriers

Perceived self-

efficacy

Social support

Physical activity


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OPERATIONALDEFINITIONS

Physical activity

Knowledge of physical activity

Perceived barriers

Perceived selfefficacy Social support


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Physical activityrefers 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)


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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 physicalactivity for type 2 diabetes patients questionnaire, it will

be developed by the researcher.


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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)


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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 supportrefers 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)


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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


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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


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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.


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STUDYSETTING

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 withtype 2 diabetes per day

7 AM to 11:30 AM

Thai

Nguyen


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1

54

2 3

6


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RESEARCHINSTRUMENTS

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)


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THEGLOBALPHYSICALACTIVITY

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


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THEKNOWLEDGEOFPHYSICALACTIVITY

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


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THEEXERCISEBARRIERSSCALE(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


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THEEXERCISESELF- EFFICACYSCALE

(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 unitsfrom 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 SOCIA SUPPORT FOR EXERCISE SURVEY


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THESOCIALSUPPORTFOREXERCISESURVEY

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 familyas 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


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TRANSLATIONOFINSTRUMENTSYU, LEE,ANDWOO(2004)

Viet Namversion

Original

Englishversion

English back

translatedversion

Compare

Bilingualtranslator 1

Bilingual

Translator 3

Bilingual

translator 2


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VALIDITYANDRELIABILITYOFTHEINSTRUMENTS

INTHISSTUDY

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)


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THEKNOWLEDGEOFPHYSICALACTIVITY

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


Reliability: will be send to 30 case for tested reliability byKuderRichardson Formula, with standard KR20 .7

(Kuder & Richardson, 1937)


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THEEXERCISEBARRIERSSCALE(EBS)

THE

EXERCISE

SELF

- EFFICACY

SCALE

(ESES)THESOCIALSUPPORTFOREXERCISESURVEY

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



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DATACOLLECTIONPROCEDURES

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


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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


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Sampling technique

Registration

number of each

patient

00120??

a slip of

paper/patient

00120??

00120??


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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


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DATAANALYSIS

Descriptive statistics and multiple regression analysis will

be used to analyze the data with the alpha level for

significance was set at .05


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THANKS FOR YOUR ATTENTION

Peach blossom

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MAI HUONG-Proposal 27.1.2014 -Done - New1