Influencing Factors of Exercise Behavior in Patients with Type 2 diabetes:A Systematic Review of Qualitative Studies

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.

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.

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.

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.

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.