HealthResJ, health, medicine, nursing, research

COVID-19 Fear and COVID-19 Anxiety as Predictors of Exercise Benefit-Barrier Perception in Type 2 Diabetes Patients in the COVID-19 process Exercise Benefit-Barrier Perception in Type 2 Diabetes Patients

Vol. 10 No. 3 (2024)
Published: Jul 4, 2024
Anxiety Benefit Perception COVID-19 Exercise Fear type 2 diabetes
Hamdiye Arda Sürücü
Meltem sungur
Ezgi Nur Temiz

Background: Exercise is an important building block in the management of type 2 diabetes. Perceptions of benefits and barriers related to that behavior may affect individuals' tendency towards protective behaviors such as exercise.

Aim: The aim of this study was to examine the fear of COVID-19, anxiety of COVID-19 and descriptive features as predictors of exercise benefit-barrier perception in type 2 diabetes patients during the COVID-19.

Method: The research sample consisted of 161 patients with type 2 diabetes. Patient diagnosis form, Exercise Benefits-Barriers Scale, Coronavirus (COVID-19) Fear Scale (CFS) and Coronavirus Anxiety Scale (CAS) were used as data collection tools. The data was shown as percentage and mean ± standard deviation (SD), and Pearson/Spearmen correlation and linear regression analyses were used to examine the relationship between the variables.

Results: In the study, when asked what the biggest barrier to exercising as a person with diabetes was, 38.31% of the individuals with type 2 diabetes said "COVID-19 pandemic". The total exercise benefit perception of individuals with diabetes was significant (F: 17.873, p<.001). In addition, for the perception of total exercise benefit, paying attention to risky situations (Hypoglycemia or hyperglycemia preventive behaviors) before doing physical activity (β = -.384), development of diabetic foot in the last six months (β =.163), COVID-19 anxiety (β =.205) were found to be statistically significant predictors (p<.001).

Conclusion: At the end of the study, it was found that illiteracy, having a history of diabetic foot development in the last six months, being married and an increase in the level of COVID-19 anxiety increased the perception of exercise benefit in individuals with Type 2 diabetes.

Article Details
  • Section
  • Original Articles
Download data is not yet available.
Al-Daghri NM, Almiman AA, Wani K, Khattak MN, Aljohani NJ, Alfawaz H, Sabico S. COVID-19 Lockdown and Lifestyle Changes in Saudi Adults with Types 1 & 2 Diabetes. Fron-tiers in Public Health. 2022;2178.
Lim S, Bae JH, Kwon HS, Nauck MA. COVID-19 and diabe-tes mellitus: from pathophysiology to clinical management. Nature Reviews. Endocrinology.2021;17(1):11–30.
International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels, Belgium. Retrieved from (2019). Accessed July 30, 2021.
Sacre JW, Holmes‐Truscott E, Salim A, Anstey KJ, Drum-mond GR, Huxley RR, Shaw JE. Impact of the COVID‐19 pandemic and lockdown restrictions on psychosocial and behavioural outcomes among Australian adults with type 2 diabetes: findings from the PREDICT cohort study. Diabetic Medicine. 2021;e14611.
Roberts AJ, Taplin CE, Isom S, Divers J, Saydah S, Jensen ET, Pihoker C. Association between fear of hypoglycemia and physical activity in youth with type 1 diabetes: The SEARCH for diabetes in youth study. Pediatric Diabetes. 2020;21(7):1277-1284.
American Diabetes Association. Introduction: Standards of medical care in diabetes. Diabetes care, 45(Supplement-1). 2022;1-2.
Dinçer Ş, Metin G. Tip 2 Diyabet ve Egzersiz. Türkiye Klin-ikleri Spor Hekimliği-Özel Konular. 2015;1(2):31-37.
Füzéki E, Schröder J, Reer R, Groneberg DA, Banzer W. Go-ing Online?Can Online Exercise Classes during COVID-19-Related Lockdowns Replace in-Person Offers? International Journal of Environmental Research and Public Health. 2022;19(4):1942.
Ghosh A, Arora B, Gupta R, Anoop S, Misra A. Effects of nationwide lockdown during COVID-19 epidemic on life-style and other medical issues of patients with type 2 dia-betes in north India. Diabetes & Metabolic Syndrome. 2020;14(5):917–920.
Singh K, Kondal D, Mohan S, Jaganathan S, Deepa M, Ven-kateshmurthy NS, Eggleston K. Health, psychosocial, and economic impacts of the COVID-19 pandemic on people with chronic conditions in India: a mixed methods study. BMC Public Health. 2021;21(1):685.
Fisher L, Polonsky W, Asuni A, Jolly Y, Hessler D. The early impact of the COVID-19 pandemic on adults with type 1 or type 2 diabetes: A national cohort study. Journal of Diabe-tes and its Complications. 2020;34(12):107748.
García-Lara RA, Gómez-Urquiza JL, Membrive-Jiménez MJ, Velando-Soriano A, Granados-Bolivar ME, Romero-Béjar JL, Suleiman-Martos N. Anxiety, distress and stress among pa-tients with diabetes during COVID-19 pandemic: A system-atic review and meta-analysis. Journal of Personalized Medicine. 2022;12(9):1412.
Meira Jr CM, Meneguelli KS, Leopoldo MP, Florindo AA. Anxiety and leisure-domain physical activity frequency, duration, and intensity during covid-19 pandemic. Fron-tiers in Psychology. 2020;11:603770.
Creese B, Khan Z, Henley W, et al. Loneliness, physical activity, and mental health during COVID-19: A longitudi-nal analysis of depression and anxiety in adults over the age of 50 between 2015 and 2020. Int Psychogeriatr. 2021;33(5):505-514. doi:10.1017/S1041610220004135
Saraçoğlu E, Avcı İA. Diyabet Hastalarının Covid-19 Salgınıyla İlgili Endişelerinin ve Bakım İhtiyaçlarının Belir-lenmesi. Türkiye Diyabet ve Obezite Dergisi. 2021;5(2):202-209.
Erdfelder E, Faul F, Buchner A. Gpower: A general power analysis program. Behavior research methods, instruments, &computers. 1996;28(1):1-11.
Ikechukwu EC, Gloria MU, Ikenna UC, Chinonso UV, Ekezi U, Nkechi C. Physical Activity Level and Factors Affecting Ex-ercise Participation among Nigerian Adults with and With-out Diabetes. World Health. 2021;60:85.
Vanden Bosch M, Wesley E, Strouse S. Perceptions of Phys-ical Activity in Middle-aged Women with Type 2 Diabetes. Western Journal of Nursing Research. 2021;43(7):640-648.
Sechrist KR, Walker S, Pender NJ. Development and psy-chometric evaluation of the exercise benefits/barriers scale. Research in nursing & health. 1987;10(6):357-365.
Ortabag T, Ceylan S, Akyuz A, Bebis H. The validity and reliability of the exercise benefits/barriers scale for Turkish Military nursing students. South African Journal for Re-search in Sport, Physical Education and Recreation. 2010;32(2):55-70.
Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pak-pour AH. The Fear of COVID-19 Scale: Development and Initial Validation [published online ahead of print, 2020 Mar 27]. Int J Ment Health Addict. 2020:1-9. doi:10.1007/s11469-020-00270-8
Bakioğlu F, Korkmaz O, Ercan H. Fear of COVID-19 and Positivity: Mediating Role of Intolerance of Uncertainty, Depression, Anxiety, and Stress. Int J Ment Health Addict. 2021;19(6):2369-2382. doi:10.1007/s11469-020-00331-y
Lee SA, Jobe MC, Mathis AA. Mental health characteristics associated with dysfunctional coronavirus anxiety [pub-lishedonlineahead of print, 2020 Apr 16]. PsycholMed. 2020:1-2. doi:10.1017/S003329172000121X
Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Stud. 2022;46(5):1052-1058. doi:10.1080/07481187.2020.1774969
Hsu HJ, Chung DT, Lee LY, Lin IP, Chen SC. Beliefs, Benefits and Barriers Associated with Physical Activity: Impact of These Factors on Physical Activity in Patients With Type II Diabetes Mellitus. Clinical Nursing Research. 2021;30(3):302-310.
Kim TDT. The Factors Predicting Physical Activity Among Vietnamese with Type 2 Diabetes Mellitus in Hanoi, Viet Nam. วารสาร สาธารณสุข มหาวิทยาลัย บูรพา. 2017;11(2):85-95.
Prévost MS, Rabasa-Lhoret R, Talbo MK, Yardley JE, Curry EG, Brazeau AS. Gender Differences in Strategies to Prevent Physical Activity–Related Hypoglycemia in Patients With Type 1 Diabetes: A BETTER Study. Diabetes Care. 2022;45(3):e51-e53.
Al-Moteri M, Plummer V, Youssef HA, Yaseen RW, Al Malki M, Elryah AAI, Karani, AA. The Experiences of People with Diabetes during COVID-19 Pandemic Lockdown. Interna-tional Journal of Environmental Research and Public Health. 2021;19(1):340.
Paiement K, Frenette V, Wu Z, Suppere C, Messier V, Lasalle-Vaillancourt A, Rabasa-Lhoret R. Is Having Better Knowledge on Type 1 Diabetes Management Associated With Lower Reported Hypoglycemic Risk During and After Physical Activity?. Canadian Journal of Diabetes. 2021;45(7):3.
Gordon CD, Nelson GA. Physical activity correlates among persons with type 2 diabetes in Jamaica. International Journal of Diabetes in Developing Countries. 2019;39(1):108-114.
Akkoyun M, Özer Z. Hemodiyaliz Uygulanan Hastalarda Egzersiz Engellerinin Belirlenmesi/Determination of Exercise Barriers in Patients Undergoing Hemodialysis. Nefroloji Hemşireliği Dergisi. 2021;16(3):102-114.
Doğru BV, Kasar KS. Hemodiyaliz Hastalarının Fiziksel Ak-tivite Düzeyleri, Algılanan Egzersiz Yararları, Engelleri ve İlişkili Faktörler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2022;9(1):10-16.
Yan AF, Sun X, Zheng J, Mi B, Zuo H, Ruan G, Shi Z. (). Perceived risk, behavior changes and Health-related out-comes during COVID-19 pandemic: Findings among adults with and without diabetes in China. Diabetes research and clinical practice. 2020;167:108350.
Kumar A, Arora A, Sharma P, Anikhindi SA, Bansal N, Singla V, Srivastava A. Is diabetes mellitus associated with mortali-ty and severity of COVID-19? A meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):535-545.
Çalik A, Kapucu S. Developing Healthy Life Style Behaviors in Diabetic Patients: Pender’s Health Promotion Model. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2017;4(2):62-75.
Thu THD, Leelukkanaveera Y, Lawang W. The Factors Pre-dicting Physical Activity Among Vietnamese with Type 2 Diabetes Mellitus in Hanoi, Viet Namvv. The Public Health Journal of Burapha University. 2016;11(2):85-95.
López-Bueno R, Calatayud J, Ezzatvar Y, Casajús JA, Smith L, Andersen LL, López-Sánchez GF. Association between cur-rent physical activity and current perceived anxiety and mood in the initial phase of COVID-19 confinement. Fron-tiers in psychiatry. 2020;11:729.
Kadariya S, Aro AR. Barriers and facilitators to physical activity among urban residents with diabetes in Nepal. PLoS One. 2018;13(6):e0199329.
Abate HK, Ferede YM, Mekonnen CK. Adherence to physi-cal exercise recommendations among type 2 diabetes pa-tients during the COVID-19 pandemic. International Jour-nal of Africa Nursing Sciences. 2022;16:100407.
Bala R, Srivastava A, Potsangbam T, Anal L, Ningthoujam GD. Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East. Diabetes & Metabolic Syndrome: Clin-ical Research & Reviews. 2021;15(1):93-98.
Schuch FB, Bulzing RA, Meyer J, López-Sánchez GF, Grabovac I, Willeit P, Smith L. Moderate to vigorous physi-cal activity and sedentary behavior changes in self-isolating adults during the COVID-19 pandemic in Brazil: a cross-sectional survey exploring correlates. Sport sciences for health. 2022;18(1):155-163.
Most read articles by the same author(s)