Background: Diagnosis with Type 2 Diabetes is an opportunity for individuals to change their physical activity and
dietary behaviours. Diabetes treatment guidelines recommend theory-based, patient-centred care and advocate the
provision of support for patient motivation but the motivational experiences of people newly diagnosed ...
Background: Diagnosis with Type 2 Diabetes is an opportunity for individuals to change their physical activity and
dietary behaviours. Diabetes treatment guidelines recommend theory-based, patient-centred care and advocate the
provision of support for patient motivation but the motivational experiences of people newly diagnosed with
diabetes have not been well studied. Framed in self-determination theory, this study aimed to qualitatively explore
how this patient group articulate and experience different types of motivation when attempting lifestyle change.
Methods: A secondary analysis of semi-structured interview data collected with 30 (n female = 18, n male = 12)
adults who had been newly diagnosed with type two diabetes and were participants in the Early ACTID trial was
undertaken. Deductive directed content analysis was performed using NVivo V10 and researcher triangulation to
identify and describe patient experiences and narratives that reflected the motivation types outlined in selfdetermination theory and if/how these changed over time.
Results: The findings revealed the diversity in motivation quality both between and within individuals over
time and that patients with newly-diagnosed diabetes have multifaceted often competing motivations for
lifestyle behaviour change. Applying self-determination theory, we identified that many participants reported
relatively dominant controlled motivation to comply with lifestyle recommendations, avoid their non-compliance
being “found out” or supress guilt following lapses in behaviour change attempts. Such narratives were accompanied
by experiences of frustrating slow behaviour change progress. More autonomous motivation was expressed as
something often achieved over time and reflected goals to improve health, quality of life or family time.
Motivational internalisation was evident and some participants had integrated their behaviour change to a
new way of life which they found resilient to common barriers.
Conclusions: Motivation for lifestyle change following diagnosis with type two diabetes is complex and can
be relatively low in self-determination. To achieve the patient empowerment aspirations of current national
health care plans, intervention developers, and clinicians would do well to consider the quality not just quantity of their
patients’ motivation.