• Adherence;
  • China;
  • Diabetes;
  • Exercise


The purpose of this article is to explore factors influencing adherence to exercise in Chinese people with type 2 diabetes (T2D). The findings can be used to explain exercise behaviours and develop interventions to improve the level of adherence to exercise.


A qualitative approach was used in this study. Data were collected at Nantong City, China. A purposive sampling scheme was used to recruit people with T2D for in-depth semi-structured interviews. Potential patients chosen from the case records in one teaching hospital were screened by telephone for eligibility. Inclusion criteria for recruiting participants were: diagnosis with T2D for at least 6 months; a treatment plan that recommends exercises; and ≥20 years of age. Exclusion criteria included: type 1 diabetes; severe complications of T2D; and cognitive impairment. Each interview was audio-recorded. Recruitment efforts were suspended when the data reached saturation. Thematic analysis was employed to identify themes influencing factors from collected data.


Seventeen participants were recruited for interviews when data reached saturation. Six themes were identified after thematic analysis: ‘beliefs about disease’, ‘health communication’, ‘feasibility of regimen’, ‘conducting skills’, ‘environmental support’ and ‘perceived benefits’.


The influencing factors should be comprehensively considered when explaining behaviour relating to exercises or designing health-promotional and health-educational interventions to improve the level of adherence to exercise. This study suggests that health professionals need to pay attention to the patient preferences during health communication to design a feasible exercise regimen in a collaborative way. Non-adherence to exercise cannot be attributed to patients only. Patients should be supported, not blamed.


The recruitment of participants from one city might limit the generalizations of the findings to larger areas of China and other ethnic groups. Gender differences related to factors influencing exercises need further consideration.