Korean J Health Promot.  2021 Sep;21(3):117-128. 10.15384/kjhp.2021.21.3.117.

Exercise Experience of Elderly Medicaid Beneficiaries with Osteoarthritis Based on Self-Determination Theory

Affiliations
  • 1Department of Nursing, Yonsei University Wonju College of Medicine, Wonju, Korea

Abstract

Background
Osteoarthritis is the most common chronic disease among elders, and it crucially requires self-management. This study aimed to qualitatively examine exercise experiences of elderly Medicaid beneficiaries with osteoarthritis receiving exercise intervention based on self-determination theory (SDT).
Methods
Eight elders who received a community-based exercise intervention were interviewed three times. Using the interview transcriptions and field notes, researchers conducted an interpretative phenomenological analysis based on SDT to explore the motivational process of exercise compliance.
Results
Three meaningful profiles (non-compliant, intermitter, and compliant) were identified along with satisfaction with needs (autonomy, competence, and relatedness) that motivate exercise compliance based on SDT. Compliance of exercise is primarily initiated by external regulation and followed by the internalization process of recognizing and accepting the value of the behavior.
Conclusions
The concepts of SDT could be used to explore factors associated with motivation and gradual behavior change among elderly Medicaid beneficiaries with osteoarthritis. Autonomy, competence, relatedness, external regulation, and identified regulation control may be applied to establish a strategy that promotes behavior change by satisfying the psychological needs and internalizing the behavior of these elders.

Keyword

Elderly; Exercise; Medicaid; Osteoarthritis; Qualitative research

Reference

1. Health Insurance Review and Assessment Service, National Health Insurance Service. 2019 medical aid statistics [Internet]. Wonju: Health Insurance Review and Assessment Service, National Health Insurance Service;2019. [cited 2021 Mar 10]. Available from: http://www.hira.or.kr/bbsDummy.do;INTERSESSIONID=TnydxPgYOSguKyYju_9JsuZwqtfGwx6poii_vnHce4cG54ijuzqo!1339119577!-1620127281?pgmid=HIRAA020045010000&brdScnBltNo=4&brdBltNo=2336#none.
2. Gay C, Chabaud A, Guilley E, Coudeyre E. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Ann Phys Rehabil Med. 2016; 59(3):174–83.
Article
3. Marszalek J, Price LL, Harvey WF, Driban JB, Wang C. Outcome expectations and osteoarthritis: association of perceived benefits of exercise with self-efficacy and depression. Arthritis Care Res (Hoboken). 2017; 69(4):491–8.
Article
4. Oppong R, Jowett S, Lewis M, Clarkson K, Paskins Z, Croft P, et al. Cost-effectiveness of a model consultation to support self-management in patients with osteoarthritis. Rheumatology (Oxford). 2018; 57(6):1056–63.
Article
5. Jönsson T, Nero H, Dahlberg L. Exercise dose-response in individuals participating in a supported osteoarthritis self-management program; an observational register study. Osteoarthritis Cartilage. 2018; 26:S322–3.
Article
6. Loew L, Brosseau L, Kenny GP, Durand-Bush N, Poitras S, De Angelis G, et al. An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial. Clin Rheumatol. 2017; 36(7):1607–16.
Article
7. Rodgers WM, Hall CR, Duncan LR, Pearson E, Milne MI. Becoming a regular exerciser: examining change in behavioural regulations among exercise initiates. Psychol Sport Exerc. 2010; 11(5):378–86.
Article
8. Kinnafick FE, Thøgersen-Ntoumani C, Duda J. The effect of need supportive text messages on motivation and physical activity behaviour. J Behav Med. 2016; 39(4):574–86.
Article
9. Raposo FZ, Caldeira P, Batalau R, Araújo D, Silva MN. Self-determination theory and nonlinear pedagogy: an approach to exercise professionals’ strategies on autonomous motivation. Retos. 2020; (37):680–6.
10. Zervou F, Stavrou NAM, Koehn S, Zounhia K, Psychountaki M. Motives for exercise participation: the role of individual and psychological characteristics. Cogent Psychol. 2017; 4(1):1345141.
Article
11. Phillips AS, Guarnaccia CA. Self-determination theory and motivational interviewing interventions for type 2 diabetes prevention and treatment: a systematic review. J Health Psychol. 2020; 25(1):44–66.
Article
12. Choi JH, Park DJ, Noh GY. The effect of attributes of exercise/fitness apps on app usage: a convergence perspective based on the self-determination theory. J Digit Convergence. 2015; 13(6):327–39.
Article
13. Park AR. A structural model of health behavior compliance in patients with percutaneous coronary intervention based on self-determination theory. J East-West Nur Res. 2018; 24(2):101–9.
14. Jeong HW, So HS. Structural equation modeling of self-care behaviors in kidney transplant patients based on self-determination theory. J Korean Acad Nurs. 2018; 48(6):731–42.
Article
15. Hyun DY, Lee HR. The effect of motivation factors of the elderly’s leisure activity on leisure satisfaction: focused on the mediation of constraint factors. J Korea Policy Sci. 2017; 21(1):25–51.
16. Deci EL, Ryan RM. Cognitive evaluation theory. Boston: Springer;1985. p. 43–85.
17. Deci EL, Ryan RM. Self-determination theory: a macrotheory of human motivation, development, and health. Can Psychol. 2008; 49(3):182–5.
Article
18. Ryan RM, Deci EL. A self-determination theory approach to psychotherapy: the motivational basis for effective change. Can Psychol. 2008; 49(3):186–93.
Article
19. Smith JA, Osborn M. Interpretative phenomenological analysis. In : Smith JA, editor. Qualitative psychology: a practical guide to research methods. London: Sage Publications;2003. p. 51–80.
20. Anney VN. Ensuring the quality of the findings of qualitative research: looking at trustworthiness criteria. JETERAPS. 2014; 5(2):272–81.
21. Guba EG, Lincoln YS. Fourth generation evaluation. Thousand Oaks: SAGE Publications;1989. p. 228–51.
22. Ng B, Abbas D. Self-determination theory: attributes of healthy aging. In : Ng B, Ho G, editors. Self-determination theory: attributes of healthy aging. Singapore: Springer;2020. p. 19–30.
23. Obara-Gołębiowska M, Brycz H, Lipowska M, Lipowski M. The role of motivation to reduce obesity among elderly people: response to priming temptation in obese individuals. Int J Environ Res Public Health. 2018; 15(2):244.
Article
24. Kinnafick FE, Thøgersen-Ntoumani C, Duda JL. Physical activity adoption to adherence, lapse, and dropout: a self-determination theory perspective. Qual Health Res. 2014; 24(5):706–18.
25. Teixeira PJ, Marques MM, Silva MN, Brunet J, Duda JL, Haerens L. A classification of motivation and behavior change techniques used in self-determination theory-based interventions in health contexts: an expert consensus study. Motiv Sci. 2020; 6(4):438–55.
26. Ryan RM, Deci EL. Intrinsic and extrinsic motivations: classic definitions and new directions. Contemp Educ Psychol. 2000; 25(1):54–67.
Article
27. Hagger MS, Protogerou C. Self‐determination theory and autonomy support to change healthcare behavior. In : Hadler A, Sutton S, Osterberg L, editors. the Wiley handbook of healthcare treatment engagement: theory, research, clinical practice. Hoboken: Wiley;2020. p. 141–58.
28. Vansteenkiste M, Aelterman N, De Muynck GJ, Haerens L, Patall E, Reeve J. Fostering personal meaning and self-relevance: a self-determination theory perspective on internalization. J Exp Educ. 2018; 86(1):30–49.
Article
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