Motivation and physical activity among rheumatoid arthritis patients: a self-determination theory approach

摘要

Rheumatoid Arthritis (RA) is a chronic inflammatory disease that can negatively impact people both psychologically and physically. Health benefits of regular physical activity (PA) have been demonstrated for RA patients (Cooney et al., 2011), however people living with RA are more likely to be sedentary (Sokka et al., 2008; Yu et al., 2015). A Self-Determination Theory (SDT) based approach was adopted in this thesis. The validity and reliability of the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) was tested (Chapter 2) within RA patients via a mixed method approach. In a second study (Chapter 3), hypothesised relationships based on SDT between autonomy support from the important other (s), basic psychological needs, motivation regulations and RA patients’ subjective vitality and self-reported PA was tested via structural equation modelling. Presumed mediation effects were also examined. As an incongruence between PA measurement has been found previously (Semanik et al., 2011), the agreement with self-reported PA and sedentary time (ST) were determined (Chapter 4) on both objective and subjective PA, then related to the VO2 max test. The next investigation (Chapter 5) assessed the associations between motivation regulations, objectively measured PA/ST and a key indicator of compromised mental health (i.e., depressive symptoms). Overall findings of this thesis were discussed in Chapter 6, and future research directions, practical implication and limitations proposed.