Influencing factors of exercise behavior in patients with type 2 diabetes:a systematic review of qualitative studies
Open accessAbstract
Background: Exercise is an critical component of diabetes health management. Long-term regular exercise can improve blood glucose levels and prevent or control diabetes-related complications. When facing exercise decision-making, patients are often full of confusion and hesitation, and may refuse to participate, thus affecting the effect of blood glucose control. Purpose: The objective of this review was to systematically evaluate and integrate qualitative research on factors influencing exercise behaviour and exercise experience in diabetes patients to provide references for formulating management strategies to improve patients' exercise compliance. Patients and Methods: PubMed, Web of Science, Embase, PsycINFO, CINAHL, Scopus, CNKI, VIP, Wanfang and SinoMed were searched for qualitative studies or mixed methods studies concerning qualitative research on exercise influencing factors or experience in diabetes patients from the establishment of the database to March 2025. The quality evaluation of the included studies was critically conducted using an established tool after study selection.And then extract and analyse the data, using a systematic review and thematic synthesis approach to analyse the data. Results: A total of 32 studies were included, using thematic analysis, 11 interrelated themes were identified. Among them, exercise stimulates positive emotions and makes exercise a habit; perceiving the benefits of exercise; external support system; correct understanding of exercise; suitable exercise mode serves as promoting factors, obstacle factors including limitations due to personal conditions or concerns about adverse events caused by exercise; lack of knowledge related to exercises or misconceptions about it; being restricted by external conditions; incomplete support system; personal emotions and psychosocial factors; cultural restrictions and other reasons. Conclusion: The influencing factors of exercise behavior are complex and have a profound impact on patients' exercise compliance. Medical staff should clarify the four core dimensions that affect patients' exercise behavior, enhance patients' exercise-related knowledge through health education and other methods, encourage patients to choose exercise methods that are suitable for themselves, and encourage family members or peers to participate with patients, and promote patients' active participation in exercise by exerting their autonomy, thereby achieving more ideal health outcomes.
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Exercise self-management is often one of the most difficult self-care behaviors for patients with T2DM to initiate and maintain over time, compared with dietary adherence, medication taking, and blood glucose monitoring.
“However, compared with dietary adherence, medication taking, and blood glucose monitoring, exercise self-management is often one of the most difficult self-care behaviors for patients with T2DM to initiate and maintain over time (4).”
From Behavior change pathways by which digital wearable devices support exercise self-management in type 2 diabetes: a scoping review with machine learning–assisted text mining (2026) · cites this paper as [4]
The Introduction (page not available) says patients with T2DM show poor willingness to begin exercise and difficulty adhering to it over time. The paper does not establish that exercise is more difficult to initiate or maintain than dietary adherence, medication taking, or blood glucose monitoring. (LLM, conf=0.88)
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References 42 · Cited by 2
Research works printed but not linked: 9
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- Authors
- Han, Z., & Wang, L.
- Affiliations
- Liaoning University of Traditional Chinese Medicine (CN)
- Corresponding author
- Han, Zhu
- Venue
- Patient Preference and Adherence
- Publisher
- Informa UK Limited
- Published
- 2025-11
- Volume
- Volume 19
- Pages
- 3435-3451
- ISSN
- 1177-889X (ISSN-L)
- PMC
- PMC12596837
- OpenAlex
- W4415850767
- Cited by
- 2
- References
- 42
- Citations by year
- 2026: 2
- FWCI
- 0.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Patient Preference and Adherence (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (acceptedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- type 2 diabetes, exercise behavior, exercise adherence, barriers to exercise, facilitators of exercise, exercise experience, psychosocial factors, family and peer support, health education, glycemic control
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