A Qualitative Descriptive Study of Motivation States for Physical Activity Among Middle-Aged Adults With Type 1 Diabetes Mellitus.

Abstract

Background: Midlife adults with type 1 diabetes mellitus (T1DM) face unique physiological and psychological challenges when balancing physical activity and rest. The Wants and Aversions for Neuromuscular Tasks model accounts for competing desires and aversions for movement and rest, addressing the limitations of general physical activity frameworks. Thus, we employed a qualitative descriptive study guided by the Wants and Aversions for Neuromuscular Tasks model to explore momentary motivational states governing movement and rest among midlife adults with T1DM following an exercise-support intervention.

Methods: We conducted semistructured interviews with 23 midlife adults with T1DM (mean age 48, SD 11 y, 78% female, 91% non-Hispanic white, 35% overweight, and 26% obese). Through directed content analysis, we employed deductive Wants and Aversions for Neuromuscular Tasks framework-driven and inductive coding to map participant reflections.

Results: The overarching themes mapped across the 4 quadrants revealed complex dynamics. In quadrant 1 (dread move, crave rest), participants expressed motivational conflicts driven by fatigue, device malfunctions, and glucose excursions, often opting for light movement to restore energy. Quadrant 2 (dread move, dread rest), obligation-driven resistance transformed into pride and gratification upon completion. Quadrant 3 (crave move, crave rest), participants opted for activities like yoga or outdoor walks for active recovery. In quadrant 4 (crave move, dread rest), individuals found flow in enjoyable activities and articulated an internal drive to exercise conflicting with physical fatigue or glycemic levels necessitating rest.

Conclusions: The findings underscore the dynamic nature of desires and aversions of movement and rest among midlife adults with T1DM. These insights can inform future physical activity interventions.