Becoming active post-hospitalisation discharge – an exploration of motivational profiles during exercise change in obese patients

ABSTRACT

Despite the urgent need to prevent weight regain in the long-term, it remains questionable whether inpatient multicomponent behavioural obesity treatments positively impact their patients, leaving them with favourable (i.e. autonomous) motivational profiles towards exercising. Based on Organismic Integration Theory, a sub-theory of Self-Determination Theory, this study retrospectively examined how exercise motivational profiles relate to exercise behaviour outcomes of a behavioural obesity treatment. Obese patients for whom outpatient treatment was deemed ineffective (N = 262; 34.2% female, body mass index >30 kg/m²) were administered to a 3-week inpatient obesity treatment. The study design incorporates both longitudinal and retrospective cross-sectional aspects. Patients completed questionnaires concerning exercise behaviour (pre-hospitalisation/6 months post-discharge) and behavioural regulations (6 months post-discharge). Exercise motivational profiles were generated based on the six behavioural regulations using K-means non-hierarchical cluster analysis. The self-reported dependent variable represents a change in patients’ exercise status (i.e. remaining inactive, becoming active). Chi-square tests related motivational profiles to exercise behaviour. Three profiles emerged: a moderate-controlled cluster (n = 80), a moderate-autonomous cluster (n = 78) and a high-autonomous cluster (n = 104). Of the patients who became active over time, the majority belonged to the high-autonomous cluster. No significant differences were found between patients who became active or remained inactive and whether they belonged to the moderate-controlled or moderate-autonomous cluster. Although the moderate-controlled and moderate-autonomous clusters differ greatly in their motivational quality, moderately controlled motivation does not seem detrimental regarding exercise change, as both clusters result in similar exercise behaviour outcomes.

KEYWORDS:

• Organismic integration theory
• post-discharge
• person-centred
• self-determination
• cluster analysis

Acknowledgements

The authors would like to thank Matthew J. Watson for professionally proofreading the English language of the manuscript prior to submission.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Anna Wasserkampf http://orcid.org/0000-0003-0297-1436

Additional information

Funding

This work was supported by the Gesellschaft für Rehabilitationswissenschaften Nordrhein-Westfalen e.V. (Society for Rehabilitation Research North Rhine-Westphalia e.V.) under [grant number GFR 10001 | 623-12].