The Cultural Perspectives of Physical Activity and Its Barriers in ...

Organised by:
Co-Sponsored:
Malaysian Healthy Ageing Society

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Sazlina Shariff Ghazali 1,3 , Colette Browning 2 ,
Shajahan Yasin 3
1
Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia,
Malaysia
2
Primary Care Research Unit, School of Primary Health Care, Monash University, Australia
3
Jeffrey Cheah School of Medicine and Health Sciences, Monash University Sunway Campus, Malaysia

* Regular physical activity in older persons with type 2 diabetes has
many health benefits
(Sigal et al 2007, Church et al 2005, Gregg et al 2003)
* However, participation rate remains poor
(Shazwani et al, 2010)
* Barriers to physical activity is a major contribution to nonparticipation
* Barriers: Personal, family environment, physical environment, cultural
barriers
* Motivators: health related (perceived good health, social support: family,
friends and healthcare providers)
(Kolt et al 2006, Mier et al 2007, Shazwani et al 2010, Bird et al 2009)
* Defining physical activity and its barriers has been extensively
reported, very few studies explored cultural contributions to
perceptions of physical activity
*

To explore the cultural definition of
physical activity and its barriers in
older Malays with type 2 diabetes
*

*A qualitative study was
conducted in an urban primary
care clinic in Selangor, Malaysia
*Part of a RCT to promote
physical activity in sedentary
older adults with type 2
diabetes
*Four focus groups were
conducted
*A total of 25 Malay participants
aged ≥60 years with type 2
diabetes, who were either
sedentary or did regular
exercise were purposively
recruited
*

*They were asked to explore the meaning of
physical activity and barriers to physical
activity using a guiding questions
*The focus groups’ duration ranged from 1-1.5
hours
*The were audio-taped, transcribed verbatim
and translated
*Thematic analysis was performed using QSR
NVivo 8 software
*This study was approved by the MUHREC &
Malaysian MoH Medical Research Ethics
Committee
*

*
Characteristics Men (N=18) Women (N=7)
Age range (years) 60 – 77 60 - 73
Mean age ± SD (years) 65.9 ± 4.3 65.3 ± 4.2
Marital status
Married
Widow/widower
Highest education
Primary
Secondary
Tertiary
Working status
Not working
Working
18 (100%)
0
5 (27.8%)
11 (61.1%)
2 (11.1%)
15 (83.3%)
3 (16.7%)
3 (42.9%)
4 (57.1%)
2 (28.6%)
4 (57.1%)
1 (14.3%)
6 (85.7%)
1 (14.3%)
Mean monthly income ± SD (RM) 1,750.00 ± 1,242.98 1,342.85 ± 1,688.05
Mean duration of diabetes ± SD (years) 12.2 ± 9.2 15.0 ± 12.9
Engaged in regular exercise 7 (38.9%) 2 (28.6%)

*Household related activities:
*Women: household chores
*Men: Yard-work (Berkebun)
*Leisure-time activities:
*Sports, brisk walking, jogging
*Work related activities:
*Occupation which involved bodily movement such as driving
a bus
*Spiritual related activities:
*Prayers (solat)
(Kolt et al 2006, Mier et al 2007, Bird et al 2009)
*

*Spiritual related activities:
*Prayers (solat):
“From the point of view of solat, when we ruku’ (bending forward
movement with arms squared on the knees) and sujud (knealing
down on the ground with forehead on the ground)for the few
moments it is similar to stretching exercises. Here we do it five
times a day and on top off that we exercise. So from that we
already have additional exercise.”
“Praying movements is one of the best exercise. Because when we
ruku’ or sujud we are doing stretching exercises.”
*

*Personal:
*Age, lack of energy, feeling tired, laziness, lack of awareness on
benefits of PA
*Health:
*Diabetes, diabetes related complications, OA
*Environmental:
*Poorly maintained parks
*Family obligations:
*Family affairs takes priorities
(Kolt et al 2006, Mier et al 2007, Al-Kaabi et al 2009, Bird et al2009)
*Spirituality related:
*Religious activities takes priorities
*

* Family obligations:
* Family affairs takes priorities
“We have activities like marketing, sending the grandchildren to school and
back. So the time is spent on matters related to family affairs.”
“It’s our attitude on the priorities. Our Malay culture is rooted to family ties. So
our priorities will be related to family affairs or obligations. So, exercise is a less
priorities.”
* Spirituality related:
* Religious activities takes priorities
“So the Malays as a Muslim, when we are older our mission differs. When we
were younger and working we have less time to spare for religious knowledge.
So when we retired we spent more time for religious knowledge. That is our
priority.”
“For us Muslims, we want to get closer to Allah, so we think of death. So we
prepare ourselves for death and how to reach Jannah (heaven). In Islam, the
illness we have is God given. The events that happen in our lives has been predetermined
by God. There is a blessing with every circumstances. So, exercise is
only an additional activity.”
*

*A core theme that emerged in the defining physical
activity and its barriers was spirituality
*Family obligations and spiritual activities seems to
deter some older Malays with type 2 diabetes from
performing regular exercise
*It is fundamental to emphasize in self-care
management that regular exercise not only improves
glycaemic control but allows them to continue with
their religious affiliations healthily
*

*Source of fund:
*MUSC major grant (M-GPH-MG-68)
*We thanked Ministry of Health Malaysia for their approval to
conduct this study
*

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