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- Title
Reduced Exercise Self-Efficacy and Tolerance Among Disadvantaged Individuals with Diabetes.
- Authors
Homko, Carol J.; Zamora, Linda C.; Santamore, William P.; Kashem, Abul; Berger, Phillip; Mcconnell, Timothy; Bove, Alfred A.
- Abstract
Background: The adoption of healthy life-style behaviors reduces the risk for cardiovascular disease (CVD) and improves glycemic control among individuals with diabetes. The purpose of this study was to examine knowledge of CVD risk factors, risk perception and feelings of self-efficacy among patients with diabetes. Methods: The sample consisted of inner city and rural underserved patients who were enrolled in a telemedicine trial to reduce CVD risk. All subjects had a 10% or greater CVD risk on the Framingham 10 year absolute risk index. To assess knowledge of CVD risk factors a 29-item multiple-choice questionnaire was created for this study. Subjects were asked to rate their perception of risk, medication, nutrition and exercise self-efficacy and underwent a 6-minute walk test to assess exercise tolerance. Results: Baseline data were available for 465 subjects (211 with diabetes, mean A1c 7.7 ± 1.8% and 254 non-diabetics). The average age of diabetic subjects was 60.3 ± 10.0 and 60.5 ± 9.6 years (NS) in the non-diabetes group. Diabetic subjects had significantly higher BMIs versus controls (33.9 ± 7.1 and 30.1 ± 5.4 kg/m²; p < 0.001) and their Framingham risk score was also significantly increased (20.0 ± 11.3% versus 14.2 ± 7.0%; p < 0.001). Diabetic and control subjects had similar overall CVD knowledge (64 ± 15% and 63 ± 15% correct respectively; NS), exercise and nutrition test scores but diabetics scored significantly lower on the lipid questions (62 ± 28% versus 68 ± 27%; p< 0.001). Levels of medication (2.7 ± 0.4 and 2.6 ± 0.4) and nutrition self-efficacy (2.5 ± 0.8 and 2.6 ± 0.7) were similar between the two groups. Mean levels of perceived CVD risk were higher in the diabetes group as compared to controls (0.53 ± 1.3 and 0.21 ± 1.4; p < 0.03). Diabetics had significantly lower feelings of exercise self-efficacy (2.6 ± 0.8 compared to 2.8 ± 0.9; p < 0.001) and decreased exercise tolerance (1394 ± 388 versus 1586 ± 285 feet; p<0.001). Conclusions: Despite an increased perception of risk, individuals with diabetes demonstrate lower feelings of exercise self-efficacy and reduced exercise tolerance, both of which could negatively impact on diabetes self-care and cardiovascular risk profiles.
- Subjects
PEOPLE with diabetes; CARDIOVASCULAR diseases risk factors; RISK perception; SELF-efficacy; HEALTH self-care
- Publication
Diabetes, 2007, Vol 56, pA89
- ISSN
0012-1797
- Publication type
Article