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Golsteijn RHJ, Bolman C, Volders E, Peels DA, de Vries H, Lechner L. Development of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: OncoActive. BMC Cancer 2017. [PMID: 28651586 PMCID: PMC5485671 DOI: 10.1186/s12885-017-3397-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Cancer and cancer treatment coincide with substantial negative physical, psychological and psychosocial problems. Physical activity (PA) can positively affect the negative effects of cancer and cancer treatment and thereby increase quality of life in CPS. Nevertheless, only a minority of CPS meet PA guidelines. We developed the OncoActive (OncoActief in Dutch) intervention: a computer-tailored PA program to stimulate PA in prostate and colorectal CPS, because to our knowledge there are only a few PA interventions for these specific cancer types in the Netherlands Methods The OncoActive intervention was developed through systematic adaptation of a proven effective, evidence-based, computer-tailored PA intervention for adults over fifty, called Active Plus. The Intervention Mapping (IM) protocol was used to guide the systematic adaptation. A literature study and interviews with prostate and colorectal CPS and health care professionals revealed that both general and cancer-specific PA determinants are important and should be addressed. Change objectives, theoretical methods and applications and the actual program content were adapted to address the specific needs, beliefs and cancer-related issues of prostate and colorectal CPS. Intervention participants received tailored PA advice three times, on internet and with printed materials, and a pedometer to set goals to improve PA. Pre- and pilot tests showed that the intervention was highly appreciated (target group) and regarded safe and feasible (healthcare professionals). The effectiveness of the intervention is being evaluated in a randomized controlled trial (RCT) (n = 428), consisting of an intervention group and a usual care waiting-list control group, with follow-up measurements at three, six and twelve months. Participants are recruited from seventeen hospitals and with posters, flyers and calls in several media. Discussion Using the Intervention Mapping protocol resulted in a systematically adapted, theory and evidence-based intervention providing tailored PA advice to prostate and colorectal CPS. If the intervention turns out to be effective in increasing PA, as evaluated in a RCT, possibilities for nationwide implementation and extension to other cancer types will be explored. Trial registration The study is registered in the Dutch Trial Register (NTR4296) on November 23rd 2013 and can be accessed at http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4296.
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Affiliation(s)
- R H J Golsteijn
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands.
| | - C Bolman
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
| | - E Volders
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
| | - D A Peels
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
| | - H de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - L Lechner
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
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Morielli AR, Boulé NG, Usmani N, Joseph K, Tankel K, Severin D, Courneya KS. Predictors of adherence to aerobic exercise in rectal cancer patients during and after neoadjuvant chemoradiotherapy. PSYCHOL HEALTH MED 2017. [PMID: 28635312 DOI: 10.1080/13548506.2017.1344356] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This pilot study explored predictors of adherence to exercise during and after neoadjuvant chemoradiotherapy (NACRT) in rectal cancer patients. Eighteen rectal cancer patients were prescribed three supervised aerobic exercise sessions/week during NACRT followed by ≥150 min/week of unsupervised aerobic exercise after NACRT. Although not statistically significant, adherence to supervised exercise during NACRT was meaningfully better for patients who were women (d = .82; P = .12), younger (d = -.62; P = .30), married (d = .62; P = .42), with better mental health (r = .32; P = .21), fewer diarrhea symptoms (r = .48; P = .052), and higher anticipated enjoyment (r = .31; P = .23), support (r = .32; P = .22), and motivation (r = .31; P = .23). After NACRT, adherence was significantly better for patients who reported worse mental health (r = -.56; P = .046) and meaningfully better for patients who were women (d = .54; P = .38), better educated (d = .77; P = .22), had no comorbidities (d = -.63; P = .17), and exercised at baseline (d = 1.05; P = .12). Demographics, tumor side effects, and motivational variables may predict adherence to exercise during and after NACRT.
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Affiliation(s)
- Andria R Morielli
- a Faculty of Physical Education and Recreation , University of Alberta , Edmonton , Canada
| | - Normand G Boulé
- a Faculty of Physical Education and Recreation , University of Alberta , Edmonton , Canada
| | - Nawaid Usmani
- b Department of Oncology , University of Alberta, Cross Cancer Institute , Edmonton , Canada
| | - Kurian Joseph
- b Department of Oncology , University of Alberta, Cross Cancer Institute , Edmonton , Canada
| | - Keith Tankel
- b Department of Oncology , University of Alberta, Cross Cancer Institute , Edmonton , Canada
| | - Diane Severin
- b Department of Oncology , University of Alberta, Cross Cancer Institute , Edmonton , Canada
| | - Kerry S Courneya
- a Faculty of Physical Education and Recreation , University of Alberta , Edmonton , Canada
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Smith L, Croker H, Fisher A, Williams K, Wardle J, Beeken RJ. Cancer survivors’ attitudes towards and knowledge of physical activity, sources of information, and barriers and facilitators of engagement: A qualitative study. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12641] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 12/23/2022]
Affiliation(s)
- L. Smith
- Department of Life Sciences; The Cambridge Centre for Sport and Exercise Science; Anglia Ruskin University; Cambridge UK
| | - H. Croker
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - A. Fisher
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - K. Williams
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - J. Wardle
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - R. J. Beeken
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
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Cummins C, Kayes NM, Reeve J, Smith G, MacLeod R, McPherson KM. Navigating physical activity engagement following a diagnosis of cancer: A qualitative exploration. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27925326 DOI: 10.1111/ecc.12608] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2016] [Indexed: 11/28/2022]
Abstract
This qualitative descriptive study explored cancer survivors' experiences of barriers and facilitators to undertaking physical activity to inform how services and professionals might offer better support. Purposive and theoretical sampling was used to recruit 25 people who were up to 5 years post-cancer diagnosis. Participants took part in face to face, semi-structured interviews, and transcripts were analysed using thematic analysis. The analysis identified five interrelated themes which represented cancer survivors' views: 1) You're on your own-a sense of abandonment post-treatment, and lack of sufficient and tailored information; 2) Dis-ease-disruption to self and identity, and a heightened awareness of physical self and fragility; 3) Becoming acclimatised-physical activity in the face of treatment-related side effects and residual impairment; 4) Importance of others-encouragement and support from health professionals, family and friends, and cancer-specific exercise groups; 5) Meanings people ascribed to physical activity-these were central and could help or hinder engagement. Our findings suggest being able to live well and re-engage in meaningful activities following a diagnosis of cancer is both complex and challenging. There appear to be gaps in current service provision in supporting the broader health and well-being of cancer survivors.
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Affiliation(s)
- C Cummins
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - N M Kayes
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - J Reeve
- Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - G Smith
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - R MacLeod
- Palliative and Supportive Care, HammondCare, Greenwich, NSW, Australia.,Northern Clinical School, University of Sydney, Sydney, NSW, Australia
| | - K M McPherson
- Centre for Person Centred Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.,Health Research Council of New Zealand, Auckland, New Zealand
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Rabin C. Barriers to Increasing Physical Activity Among Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2016; 6:372-376. [PMID: 27893307 DOI: 10.1089/jayao.2016.0056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Increasing physical activity may reduce some of the physical and mental health risks faced by young adult cancer survivors. Unfortunately, most young survivors are sedentary. The aim of this study was to identify barriers experienced by young survivors attempting to increase their physical activity; a better understanding of these barriers may yield more efficacious interventions for this population. Data on physical activity barriers were collected during an intervention for 18-to-39-year-old survivors. Findings indicated that participants faced a variety of barriers, including limited time and health-related issues. An exploratory analysis suggested that health-related barriers may impact postintervention levels of physical activity.
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Affiliation(s)
- Carolyn Rabin
- Clinical Psychology Department, William James College , Newton, Massachusetts
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Toohey K, Pumpa KL, Arnolda L, Cooke J, Yip D, Craft PS, Semple S. A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors. PeerJ 2016; 4:e2613. [PMID: 27781180 PMCID: PMC5075690 DOI: 10.7717/peerj.2613] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 09/27/2016] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8) or the continuous low to moderate intensity training group (n = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Results Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01) with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.
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Affiliation(s)
- Kellie Toohey
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Kate L Pumpa
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Leonard Arnolda
- ANU Medical School, Australian National University , Canberra , ACT , Australia
| | - Julie Cooke
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Desmond Yip
- ANU Medical School, Australian National University , Canberra , ACT , Australia
| | - Paul S Craft
- ANU Medical School, Australian National University , Canberra , ACT , Australia
| | - Stuart Semple
- Discipline of Sport and Exercise Science/Faculty of Health, University of Canberra, Canberra, ACT, Australia; Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
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Maxwell-Smith C, Zeps N, Hagger MS, Platell C, Hardcastle SJ. Barriers to physical activity participation in colorectal cancer survivors at high risk of cardiovascular disease. Psychooncology 2016; 26:808-814. [PMID: 27478009 DOI: 10.1002/pon.4234] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Lifestyle factors including inadequate physical activity may contribute to increased risk of developing cardiovascular disease in colorectal cancer survivors. Identification of the barriers to physical activity is important for forming an evidence base of factors to target in future physical activity programs aimed at improving cardiovascular health in this population. METHODS Colorectal cancer survivors (N = 24) from St. John of God Subiaco Hospital participated in semi-structured interviews about their current physical activity behaviors and perceived barriers to physical activity. RESULTS Inductive thematic analysis of interviews revealed 5 overarching themes relating to barriers to physical activity: psychological barriers, environmental barriers, knowledge of guidelines, lack of practitioner support, and energy/age barriers. CONCLUSIONS Novel findings revealed participants' dependence on practitioner support, including a reliance on practitioners to recommend lifestyle change. Survivors also revealed that regular checkups to monitor cardiovascular risk replaced the need for healthy lifestyle changes. IMPLICATIONS With survivors holding the advice of clinicians in high regard, an opportunity exists for clinicians to facilitate lifestyle change. Health care professionals such as nurses can implement motivational strategies and provide additional health information during follow-up visits, to ensure long-term adherence. Individuals who reported psychological, motivational, and environmental barriers may benefit from interventions to improve self-regulation, planning, and problem-solving skills.
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Affiliation(s)
- Chloe Maxwell-Smith
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Nik Zeps
- Department of Oncology, St. John of God Hospital, Perth, Western Australia, Australia
| | - Martin S Hagger
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Cameron Platell
- Department of Oncology, St. John of God Hospital, Perth, Western Australia, Australia
| | - Sarah J Hardcastle
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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Abstract
BACKGROUND Performing regular exercise of at least 150 minutes weekly has benefits for colorectal cancer survivors. However, barriers inhibit these survivors from performing regular exercise. OBJECTIVES The aim of this study was to explore exercise behaviors and significant factors influencing weekly exercise time of more than 150 minutes in colorectal cancer survivors. METHODS A cross-sectional study design was used to recruit participants in Taiwan. Guided by the ecological model of health behavior, exercise barriers were assessed including intrapersonal, interpersonal, and environment-related barriers. A multiple logistic regression was used to explore the factors associated with the amount of weekly exercise. RESULTS Among 321 survivors, 57.0% of them had weekly exercise times of more than 150 minutes. The results identified multiple levels of significant factors related to weekly exercise times including intrapersonal factors (occupational status, functional status, pain, interest in exercise, and beliefs about the importance of exercise) and exercise barriers related to environmental factors (lack of time and bad weather). No interpersonal factors were found to be significant. CONCLUSIONS Colorectal cancer survivors experienced low levels of physical and psychological distress. Multiple levels of significant factors related to exercise time including intrapersonal factors as well as exercise barriers related to environmental factors should be considered. IMPLICATIONS FOR PRACTICE Healthcare providers should discuss with their patients how to perform exercise programs; the discussion should address multiple levels of the ecological model such as any pain problems, functional status, employment status, and time limitations, as well as community environment.
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Falzon C, Chalabaev A, Schuft L, Brizzi C, Ganga M, d'Arripe-Longueville F. Beliefs about physical activity in sedentary cancer patients: an in-depth interview study in France. Asian Pac J Cancer Prev 2016; 13:6033-8. [PMID: 23464399 DOI: 10.7314/apjcp.2012.13.12.6033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
This study was designed to identify beliefs about physical activity in cancer patients. Semi- structured interviews were conducted with 20 patients under treatment, who were invited to identify perceived barriers for not adopting a physically active lifestyle and to express their beliefs about physical activity. Content analyses revealed five main categories of beliefs including four types of barriers: (a) barriers related to the side effects of treatment; (b) barriers related to a lack of perceived physical abilities; (c) barriers related to a lack of interest for physical activity; (d) beliefs about the negative effects of physical activity, and (e) beliefs about the positive effects of physical activity. These findings extend the existing literature by indicating how stereotypes may play a role in explaining sedentary lifestyles in cancer patients.
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Affiliation(s)
- Charlene Falzon
- LAMHESS EA6309 Universities of Nice Sophia-Antipolis and Toulon-Var, France.
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Stoutenberg M, Sogor A, Arheart K, Cutrono SE, Kornfeld J. A Wellness Program for Cancer Survivors and Caregivers: Developing an Integrative Pilot Program with Exercise, Nutrition, and Complementary Medicine. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:47-54. [PMID: 25663357 DOI: 10.1007/s13187-014-0785-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Integrative Wellness Program (IWP) at the University of Miami Sylvester Comprehensive Cancer Center (SCCC) sought to provide integrative wellness education to cancer patients, survivors, and caregivers by offering instruction in exercise, nutrition, and complementary and alternative medicine. The objective of this study was to assess the impact of the IWP on the overall wellness of the individuals participating in the program. Three different 10-week versions of the IWP were conducted over a 1-year period. Each session focused on a different wellness topic presented through interactive lectures and applied activities. A series of self-report questionnaires were administered at baseline and again at the completion of the program to assess improvements in physical activity levels, dietary habits, sleep hygiene, and quality of life. Participants were generally older, Caucasian, female, had higher levels of education, and still currently receiving treatment. Significant changes were observed in two measures: Starting the Conversation (-2.0 ± 2.40, p = .037) and the Sticking To It subscale of the Self-Efficacy and Eating Habits Survey (1.7 ± 1.22, p = .0013). A trend for improvement in the Reducing Fat subscale of the Self-Efficacy Eating Habits (0.44 ± 0.60, p = .056) was also observed. Participant satisfaction surveys indicated high levels of satisfaction and applicability of the material presented. The significant improvements detected related to dietary habits, combined with the responses from the participant satisfaction surveys, suggest that the IWP was well received and can positively impact the overall wellness of cancer patients, survivors, and their caregivers.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA.
| | - Alyssa Sogor
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Kris Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
| | - Stacy E Cutrono
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julie Kornfeld
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1008, Miami, FL, 33136, USA
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Craike M, Gaskin CJ, Courneya KS, Fraser SF, Salmon J, Owen PJ, Broadbent S, Livingston PM. Predictors of adherence to a 12-week exercise program among men treated for prostate cancer: ENGAGE study. Cancer Med 2016; 5:787-94. [PMID: 26872005 PMCID: PMC4864808 DOI: 10.1002/cam4.639] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 11/19/2015] [Accepted: 12/17/2015] [Indexed: 01/21/2023] Open
Abstract
Understanding the factors that influence adherence to exercise programs is necessary to develop effective interventions for people with cancer. We examined the predictors of adherence to a supervised exercise program for participants in the ENGAGE study – a cluster randomized controlled trial that assessed the efficacy of a clinician‐referred 12‐week exercise program among men treated for prostate cancer. Demographic, clinical, behavioral, and psychosocial data from 52 participants in the intervention group were collected at baseline through self‐report and medical records. Adherence to the supervised exercise program was assessed through objective attendance records. Adherence to the supervised exercise program was 80.3%. In the univariate analyses, cancer‐specific quality of life subscales (role functioning r = 0.37, P = 0.01; sexual activity r = 0.26, P = 0.06; fatigue r = −0.26, P = 0.06, and hormonal symptoms r = −0.31, P = 0.03) and education (d = −0.60, P = 0.011) were associated with adherence. In the subsequent multivariate analysis, role functioning (B = 0.309, P = 0.019) and hormonal symptoms (B = −0.483, P = 0.054) independently predicted adherence. Men who experienced more severe hormonal symptoms had lower levels of adherence to the exercise program. Those who experienced more positive perceptions of their ability to perform daily tasks and leisure activities had higher levels of adherence to the exercise program. Hormonal symptoms and role functioning need to be considered when conducting exercise programs for men who have been treated for prostate cancer.
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Affiliation(s)
- Melinda Craike
- Deakin University Geelong, School of Psychology, Centre for Social and Early Emotional Development Faculty of Health, Geelong, Australia
| | - Cadeyrn J Gaskin
- Deakin University Geelong, School of Psychology, Centre for Social and Early Emotional Development Faculty of Health, Geelong, Australia
| | - Kerry S Courneya
- Behavioral Medicine Laboratory, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
| | - Steve F Fraser
- Deakin University Geelong, School of Exercise and Nutrition Sciences, Centre for Physical Activity and Nutrition Research (C-PAN), Faculty of Health, Geelong, Australia
| | - Jo Salmon
- Deakin University Geelong, School of Exercise and Nutrition Sciences, Centre for Physical Activity and Nutrition Research (C-PAN), Faculty of Health, Geelong, Australia
| | - Patrick J Owen
- Deakin University Geelong, School of Exercise and Nutrition Sciences, Centre for Physical Activity and Nutrition Research (C-PAN), Faculty of Health, Geelong, Australia
| | - Suzanne Broadbent
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
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Morielli AR, Usmani N, Boulé NG, Severin D, Tankel K, Nijjar T, Joseph K, Courneya KS. Exercise motivation in rectal cancer patients during and after neoadjuvant chemoradiotherapy. Support Care Cancer 2016; 24:2919-26. [PMID: 26847350 DOI: 10.1007/s00520-016-3110-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 01/26/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Aerobic exercise is safe and feasible for rectal cancer patients during and after neoadjuvant chemoradiotherapy (NACRT), but their motivation to perform such exercise is unknown. Here, we explore the motivational outcomes, perceived benefits and harms, and perceived barriers to exercise during and after NACRT. METHODS Rectal cancer patients (n = 18) participated in supervised aerobic exercise during NACRT followed by unsupervised exercise after NACRT. Using the theory of planned behavior, we assessed perceived benefits, harms, enjoyment, support, difficulty, and barriers for exercise both during and after NACRT. RESULTS Patients reported that exercise during NACRT was more enjoyable (p = 0.003) and less difficult (p = 0.037) than initially anticipated. The most common perceived benefits of exercise during NACRT were cardiovascular endurance (75 %), quality of life (75 %), and self-esteem (65 %). After NACRT, the most common perceived benefits were physical functioning (93 %), cardiovascular endurance (86 %), and quality of life (79 %). The most common perceived harms of exercise during NACRT were fatigue (31 %), diarrhea (31 %), and skin irritation (24 %). After NACRT, the most common perceived harms were fatigue (21 %) and hand-foot-syndrome (15 %). Side effects from NACRT were the most common exercise barrier during NACRT (88 %) whereas lack of motivation was the most common barrier after NACRT (79 %). CONCLUSIONS Rectal cancer patients reported aerobic exercise during NACRT to be more enjoyable and less difficult than anticipated despite significant barriers. This positive motivational response may facilitate recruitment and adherence in future interventions. Moreover, rectal cancer patients identified potential benefits and harms that should be closely monitored in future interventions.
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Affiliation(s)
- Andria R Morielli
- Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada
| | - Nawaid Usmani
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Normand G Boulé
- Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada
| | - Diane Severin
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Keith Tankel
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Tirath Nijjar
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Kurian Joseph
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB, T6G 2H9, Canada.
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Quantifying physical activity and the associated barriers for women with ovarian cancer. Int J Gynecol Cancer 2016; 25:577-83. [PMID: 25628105 DOI: 10.1097/igc.0000000000000349] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE The purpose of this study was to quantify physical activity levels and determine the barriers to physical activity for women with ovarian cancer. MATERIALS AND METHODS Women with ovarian cancer from 3 oncology clinics enrolled in the cross-sectional study. Physical activity and barriers to physical activity were measured using the International Physical Activity Questionnaire and Perceived Physical Activity Barriers scale, respectively. Demographic, medical, and anthropometric data were obtained from medical records. RESULTS Ninety-five women (response rate, 41%), with a mean (SD) age of 61 (10.6) years, a body mass index of 26.5 (6.8) kg/m², and 36.6 (28.2) months since diagnosis, participated in the study. The majority of the participants had stage III (32%) or IV (32%) ovarian cancer, were undergoing chemotherapy (41%), and had a history of chemotherapy (93%). The majority of the participants reduced their physical activity after diagnosis, with 19% meeting recommended physical activity guidelines. The participants undergoing treatment reported lower moderate-vigorous physical activity compared with those not undergoing active treatment (mean [SD], 42 [57] vs 104 [119] min/wk; P < 0.001) and less total physical activity barriers (mean [SD], 49 vs 47; P > 0.4). The greatest barriers to physical activity included fatigue (37.8%), exercise not in routine (34.7%), lack of self-discipline (32.6%), and procrastination (27.4%). CONCLUSIONS Women with ovarian cancer have low levels of physical activity. There are disease-specific general barriers to physical activity participation. The majority of the participants reduced their physical activity after diagnosis, with these patients reporting a higher number of total barriers. Behavioral strategies are required to increase physical activity adherence in this population to ensure that recommended guidelines are met to achieve the emerging known benefits of exercise oncology.
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Bourke L, Smith D, Steed L, Hooper R, Catto J, Albertsen PC, Tombal B, Payne HA, Rosario DJ. Exercise interventions for men with prostate cancer. Cochrane Database Syst Rev 2015. [DOI: 10.1002/14651858.cd011251.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Liam Bourke
- Sheffield Hallam University; Health and Wellbeing Research Institute; Sheffield UK S10 2BP
| | - Dianna Smith
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Centre for Primary Care and Public Health; 58 Turner Street London UK E1 2AB
| | - Liz Steed
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Centre for Primary Care and Public Health; 58 Turner Street London UK E1 2AB
| | - Richard Hooper
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London; Centre for Primary Care and Public Health; 58 Turner Street London UK E1 2AB
| | - James Catto
- University of Sheffield; Academic Urology Unit and Institute for Cancer Studies, The Medical School; Beech Hill Road Sheffield UK S10 2JF
| | - Peter C Albertsen
- University of Connecticut Health Center; Department of Surgery, Division of Urology; Farmington Connecticut USA
| | - Bertrand Tombal
- University Clinics Saint Luc/Catholic University of Louvain; Brussels Belgium
| | - Heather A Payne
- University College London Hospitals; Department of Oncology; 235 Euston Road London UK NW1 2BU
| | - Derek J Rosario
- University of Sheffield; Department of Oncology; Beech Hill Road Royal Hallamshire Hospital Sheffield UK S010 2RX
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Patterns and correlates of accelerometer-assessed physical activity and sedentary time among colon cancer survivors. Cancer Causes Control 2015; 27:59-68. [DOI: 10.1007/s10552-015-0683-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/13/2015] [Indexed: 12/28/2022]
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Mas S, Quantin X, Ninot G. Barriers to, and Facilitators of Physical Activity in Patients Receiving Chemotherapy for Lung Cancer: An exploratory study. J Palliat Care 2015. [PMID: 26201210 DOI: 10.1177/082585971503100204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM Physical activity (PA) has a positive effect on the cardiorespiratory fitness, lung cancer symptoms, and quality of life of lung cancer patients. The aim of our study was to identify barriers to, and facilitators of PA in lung cancer patients. METHODS We collected data from five patients diagnosed with primary, advanced non-small-cell lung cancer (NSCLC) who were receiving chemotherapy. Choosing a qualitative approach, we conducted an exploratory analysis using the thematic analysis technique to process the data. RESULTS Seven barriers to, and facilitators of PA were identified and grouped into four categories. We found that psychological and social factors affect patients' willingness and ability to engage in PA, while physiological and environmental factors have an impact on the duration, intensity, and regularity of their PA. CONCLUSION Our study highlighted some of the effects that the barriers to PA have on the practice of it in our patient group. Our findings may be used by professionals to design adapted PA programs.
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Perceived barriers and benefits to physical activity in colorectal cancer patients. Support Care Cancer 2015; 24:903-910. [PMID: 26268781 PMCID: PMC4689774 DOI: 10.1007/s00520-015-2860-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/17/2015] [Indexed: 12/26/2022]
Abstract
Purpose There is emerging evidence for the benefits of physical activity (PA) post-diagnosis for colorectal cancer (CRC) survivors. However, population studies suggest activity levels in these patients are very low. Understanding perceived barriers and benefits to activity is a crucial step in designing effective interventions. Methods Patients who were between 6 months and 5 years post-diagnosis with non-metastasised disease were identified from five London (UK) hospitals. Four hundred and ninety five completed a lifestyle survey that included open-ended questions on their perceived barriers (what things would stop you from doing more physical activity?) and benefits (what do you think you would gain from doing more physical activity?). Patients also recorded their activity levels using the Godin Leisure Time Exercise Questionnaire, along with sociodemographic and treatment variables. Results The most commonly reported barriers related to cancer and its treatments (e.g. fatigue). Age and mobility-related comorbidities (e.g. impaired mobility) were also frequently cited. Those who reported age and mobility as barriers, or reported any barrier, were significantly less active even after adjustment for multiple confounders. The most frequently reported benefits were physiological (e.g. improving health and fitness). Cancer-related benefits (such as prevention of recurrence) were rarely reported. Those perceiving physiological benefits or perceiving any benefits were more active in unadjusted models, but associations were not significant in adjusted models. Conclusions We have identified important barriers and facilitators in CRC survivors that will aid in the design of theory-based PA interventions.
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van Putten M, Husson O, Mols F, Luyer MDP, van de Poll-Franse LV, Ezendam NPM. Correlates of physical activity among colorectal cancer survivors: results from the longitudinal population-based profiles registry. Support Care Cancer 2015; 24:573-583. [PMID: 26173977 PMCID: PMC4689770 DOI: 10.1007/s00520-015-2816-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 05/25/2015] [Indexed: 02/01/2023]
Abstract
Purpose Physical activity can improve health of cancer survivors. To increase physical activity levels among colorectal cancer (CRC) survivors, we need to understand which factors affect physical activity. Therefore, this study examined the longitudinal relationship between symptom-related, functioning-related, and psychological barriers and socio-demographic and clinical factors with physical activity among CRC survivors. Methods CRC survivors identified from the population-based Eindhoven Cancer Registry (ECR) diagnosed between 2000 and 2009 were included. Survivors completed validated questionnaires measuring moderate-to-vigorous physical activity (MVPA) and barriers in 2010(T1), 2011(T2), and 2012(T3). Linear-mixed models and linear regression techniques were used. Results Response rates were 74 % (N = 2451, T1); 47 % (N = 1547, T2); and 41 % (N = 1375, T3). Several factors were negatively associated with MVPA: symptom-related barriers (e.g., fatigue, dyspnea, chemotherapy side effects, pain, appetite loss, and weight loss); psychological barriers (i.e., depressive symptoms and anxiety); functioning-related barriers (e.g., low physical or role functioning, unfavorable future perspective); socio-demographic (i.e., older age, female, no partner); and clinical factors (i.e., obesity). However, no within-subject effects were significantly associated with MVPA. Groups of functioning-related barriers, socio-demographic factors, symptom-related barriers, psychological barriers, and clinical factors explained 11, 3.9, 3.8, 2.4, and 2.2 % of the variance in MVPA at T1, respectively. Conclusions Several functioning-related and symptom-related barriers and few socio-demographic factors were associated with physical activity among CRC survivors. Future interventions to promote physical activity among CRC survivors could benefit by taking into account functioning aspects and symptoms of cancer and its treatment, and assess the causal direction of these associations.
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Affiliation(s)
- Margreet van Putten
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands
| | - Olga Husson
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Floortje Mols
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands.,CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Misha D P Luyer
- Department of Gastrointestinal and Oncological Surgeon, Catharina Hospital, Eindhoven, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands.,CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Nicole P M Ezendam
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands. .,CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
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Kang DW, Chung JY, Lee MK, Lee J, Park JH, Kim DI, Jones LW, Ahn JB, Kim NK, Jeon JY. Exercise barriers in Korean colorectal cancer patients. Asian Pac J Cancer Prev 2015; 15:7539-45. [PMID: 25292025 DOI: 10.7314/apjcp.2014.15.18.7539] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To identify barriers to exercise in Korean colorectal cancer patients and survivors, and to analyze differences in exercise barriers by age, gender, treatment status, and physical activity level. MATERIALS AND METHODS A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. RESULTS The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. CONCLUSIONS Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.
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Affiliation(s)
- Dong-Woo Kang
- Department of Sport and Leisure Studies, Yonsei University, Seoul, Korea E-mail : ,
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Vasudevan V, Rimmer JH, Kviz F. Development of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments. Disabil Health J 2015; 8:547-56. [PMID: 26087721 DOI: 10.1016/j.dhjo.2015.04.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Despite the widely known benefits of physical activity, people with disabilities are more likely to be inactive when compared to people without disabilities. Previous questionnaires that measure barriers physical activity for people with disabilities do not measure barriers from an ecological perspective. OBJECTIVE The purpose of this study was to develop the Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) that measures barriers using an ecological framework. METHODS This study consisted of two phases. In Phase one, developed the content validity by (a) developing an item bank, (b) identifying missing items and combining items using a Delphi panel, and (c) refine item wording via cognitive interviews. In Phase two, people with mobility impairments took part in in-person interviews to establish test-retest reliability, internal consistency, and construct validity of the BPAQ-MI. RESULTS Exploratory factor analysis revealed the BPAQ-MI was comprised of eight subscales or factors: health; beliefs and attitudes; family; friends; fitness center built environment; staff and policy; community built environment; and safety. The BPAQ-MI demonstrated very good test-retest reliability. Cronbach's alpha ranged from 0.792 to 0.935. The BPAQ-MI showed significant negative correlations with exercise (minutes/week) and significant positive correlations between BPAQ-MI subscales and inactivity (hours/day). CONCLUSIONS The BPAQ-MI is the first questionnaire that places greater equity at measuring barriers to physical activity across the intrapersonal, interpersonal, organizational, and community domains. The BPAQ-MI has the potential to assist researchers in understanding the complex relationship between barriers and ultimately develop physical activity interventions that address these barriers.
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Affiliation(s)
- Vijay Vasudevan
- Institute on Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd., M/C 626, Chicago, IL 60608, USA.
| | - James H Rimmer
- Lakeshore Foundation Endowed Chair in Health Promotion and Rehabilitation Sciences, 1705 University Blvd., School of Health Professions Building, University of Alabama at Birmingham, Birmingham, AL 35294-1212, USA
| | - Frederick Kviz
- School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St. M/C 923, Chicago, IL 60612, USA
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Husson O, Oerlemans S, Mols F, Schep G, Van De Poll-Franse LV. High levels of physical activity are associated with lower levels of fatigue among lymphoma patients: Results from the longitudinal PROFILES registry. Acta Oncol 2015; 54:678-84. [PMID: 25752967 DOI: 10.3109/0284186x.2014.996664] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies show a cross-sectional association between physical activity (PA) and fatigue among lymphoma cancer patients. However, few longitudinal studies have examined whether PA has a sustained effect on fatigue over time. PURPOSE To examine the longitudinal relationship between PA and fatigue. METHODS All living individuals diagnosed with lymphoma between 1999 and 2010 as registered by the Dutch population-based Eindhoven Cancer Registry received a questionnaire on three time points. Generalized linear mixed models were used to estimate the independent effects of PA on fatigue. RESULTS PA and fatigue levels did not differ between patients short-term (< 1 year) and long-term after diagnosis (1-5 years or > 5 years). PA behavior was relatively constant over time with 84% of the patients meeting the Dutch PA guidelines at all assessment periods. Fatigue scores also remained fairly stable over time with 46% of the patients never being fatigued and 29% always being fatigued. Multivariate analyses showed that patients who met the PA guidelines scored 6.2 (95% CI 3.1-9.2) points lower on total fatigue over time (between subject effect; p < 0.01), compared to patients not meeting PA guidelines. CONCLUSION During a period of two years, PA and fatigue levels were rather stable within lymphoma patients. Patients who met the PA guidelines reported lower levels of fatigue compared to those not meeting the guidelines, which appeared to be a constant association over time. The observed association between PA and fatigue underlines the importance to focus upon physical training in the care of cancer patients.
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Affiliation(s)
- Olga Husson
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University , Tilburg , The Netherlands
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72
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Identification and evaluation of the salient physical activity beliefs of colorectal cancer survivors. Cancer Nurs 2015; 37:14-22. [PMID: 23448955 DOI: 10.1097/ncc.0b013e3182813972] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. OBJECTIVE The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. INTERVENTION/METHODS Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. RESULTS Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. CONCLUSIONS Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. IMPLICATIONS FOR PRACTICE Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.
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Exercise barriers self-efficacy: development and validation of a subcale for individuals with cancer-related lymphedema. Health Qual Life Outcomes 2015; 13:37. [PMID: 25889016 PMCID: PMC4369084 DOI: 10.1186/s12955-015-0223-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/16/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers. METHODS A lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale. RESULTS The final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (>0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach's alpha = 0.93) and test-retest reliability (ICC = 0.67, p < 0.01). CONCLUSIONS A valid and reliable lymphedema-specific subscale has been developed to assess exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.
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Cheifetz O, Dorsay JP, MacDermid JC. Exercise facilitators and barriers following participation in a community-based exercise and education program for cancer survivors. J Exerc Rehabil 2015; 11:20-9. [PMID: 25830140 PMCID: PMC4378345 DOI: 10.12965/jer.150183] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 02/22/2015] [Indexed: 11/22/2022] Open
Abstract
Cancer survivors participating in supervised exercise programs learn to exercise safely with oversight from care providers who monitor and facilitate their progress. This study investigated the long-term exercise participation levels and identified exercise barriers for graduates from a specialized cancer exercise and education program. Subjects were graduates from a 12-week supervised exercise program (www.canwellprogram.ca) who participated in a, prospective, long-term evaluation. Measures included: six-minute walk test (6-MWT), STEEP treadmill test, Functional Assessment Cancer Therapy-General (FACT-G), Edmonton Symptom Assessment System (ESAS), Godin Leisure-Time Exercise Questionnaire, and exercise barriers survey. Analysis was performed using the paired t -test. Fifty-seven (55% of eligible cohort) CanWell participants (mean age= 60; 74% females) were included in this study. Post program changes included statistically significant reductions in total min on the treadmill and a trend towards improvements in 6-MWT distance. No significant changes were recorded in total FACT-G or ESAS score, however functional well-being approached statistical significant improvements. The most commonly reported exercise barriers included fatigue, cost, and return to work. While most participants (86%) believed they were able to exercise, only 63% reported being able to progress their exercise. These finding demonstrated that although CanWell graduates have substantial support from exercise specialists and most have early success with exercise, environment-related factors diminish long-term independent adherence to exercise. Providing cancer survivors with the skills needed to monitor and progress their exercise routines, or access to “tune-ups” may increase exercise adherence and maximize benefits.
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Affiliation(s)
- Oren Cheifetz
- Hematology/Oncology Program, Hamilton Health Sciences, Hamilton, Ontario, Canada ; School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jan Park Dorsay
- Oncology Rehabilitation Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Joy C MacDermid
- School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
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Missel M, Pedersen JH, Hendriksen C, Tewes M, Adamsen L. Exercise intervention for patients diagnosed with operable non-small cell lung cancer: a qualitative longitudinal feasibility study. Support Care Cancer 2015; 23:2311-8. [PMID: 25577502 DOI: 10.1007/s00520-014-2579-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 12/18/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose was to explore operable lung cancer patient experiences with an exercise intervention from a longitudinal perspective according to patient motivation and patient perceived benefits and barriers of exercise. METHODS Nineteen patients enrolled in an exercise intervention 2 weeks post-surgery participated in qualitative interviews at three time points. A criteria sampling strategy was applied. Ricoeur's phenomenological hermeneutical philosophy inspired the analysis. RESULTS Patients initiated exercising median 15 days postoperative. Eight patients included in the interview study dropped out of the intervention due to side effects of chemotherapy (n = 3) and external circumstances (n = 5). The mean attendance rate for the eleven participants who completed the intervention was 82 %. No patients experienced severe adverse events. Motivation for participation included patients' expectations of physical benefits and the security of having professionals present. Patients experienced physical and emotional benefits and affirmed their social identity. Barriers were primarily related to side effects of chemotherapy. CONCLUSION The exercise intervention was undertaken safely by operable lung cancer patients initiated 2 weeks after surgery. The intervention put the patients on track to a healthier lifestyle regarding physical activity and smoking. The study indicates that exercise initiated early in the treatment trajectory is beneficial for operable lung cancer patients and especially for those who were physically active and motivated pre-illness and who did not experience side effect of treatment.
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Affiliation(s)
- Malene Missel
- Department of Thoracic Surgery, the Heart Centre, University Hospital of Copenhagen Rigshospitalet, Denmark, Blegdamsvej 9, 2100, Copenhagen, Denmark,
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Falzon C, Sabiston C, Bergamaschi A, Corrion K, Chalabaev A, D'Arripe-Longueville F. Development and validation of the Cancer Exercise Stereotypes Scale. J Psychosoc Oncol 2015; 32:708-26. [PMID: 25174265 DOI: 10.1080/07347332.2014.955237] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The objective of this study was to develop and validate a French-language questionnaire measuring stereotypes related to exercise in cancer patients: The Cancer Exercise Stereotypes Scale (CESS). Four successive steps were carried out with 806 participants. First, a preliminary version was developed on the basis of the relevant literature and qualitative interviews. A test of clarity then led to the reformulation of six of the 30 items. Second, based on the modification indices of the first confirmatory factorial analysis, 11 of the 30 initial items were deleted. A new factorial structure analysis showed a good fit and validated a 19-item instrument with five subscales. Third, the stability of the instrument was tested over time. Last, tests of construct validity were conducted to examine convergent validity and discriminant validity. The French-language CESS appears to have good psychometric qualities and can be used to test theoretical tenets and inform intervention strategies on ways to foster exercise in cancer patients.
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Affiliation(s)
- Charlène Falzon
- a Laboratory of Human Motricity, Education Sport and Health - EA 6309 , University of Nice Sophia-Antipolis , Nice , France
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Packel LB, Prehn AW, Anderson CL, Fisher PL. Factors influencing physical activity behaviors in colorectal cancer survivors. Am J Health Promot 2014; 30:85-92. [PMID: 25372238 DOI: 10.4278/ajhp.140103-quan-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To elucidate factors that impact intention (INT) to be active as well as actual physical activity (PA) behavior in colorectal cancer survivors (CRC-S) using the theory of planned behavior (TpB). Planning for PA was explored as a mediator of the INT-behavior relationship. Chemotherapy-induced neuropathy and fatigue were also explored. DESIGN A cross-sectional quantitative mailed survey was used. SETTING The study was conducted among community-dwelling adults living in Pennsylvania when diagnosed with colorectal cancer (CRC). SUBJECTS Subjects comprised 843 CRC-S diagnosed with CRC in Pennsylvania in 2009. MEASURES The survey included questions about planning for PA, TpB constructs, medical and social variables, and PA as measured by a modified Godin Leisure Time Questionnaire. ANALYSIS Descriptive statistics were used to characterize the sample. A mediation analysis was used to determine if planning mediated the relationship between INT and actual PA behavior. A stepwise regression was used to determine predictors of INT and PA. RESULTS Ninety-six CRC-S responded, with 25% meeting PA recommendations for health promotion, suggesting that CRC-S are insufficiently active. Perceived behavioral control (PBC) and social norm (SN) accounted for 43% of the variance in INT, whereas 30% of the variance in PA was explained by PBC and age. Neuropathy negatively impacted PA behavior (p = .008). Both action and coping planning partially mediated the INT-behavior relationship (β = 20.08, p = .007; β = 22.85, p = .001, respectively). CONCLUSION Survivors at risk for inactivity are those with low PBC, low SN, and neuropathy, and those who are older.
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Brunet J, Amireault S, Chaiton M, Sabiston CM. Identification and prediction of physical activity trajectories in women treated for breast cancer. Ann Epidemiol 2014; 24:837-42. [DOI: 10.1016/j.annepidem.2014.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 07/14/2014] [Accepted: 07/22/2014] [Indexed: 11/28/2022]
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Loh SY, Lee SY, Quek KF, Murray L. Barriers to participation in a randomized controlled trial of Qigong exercises amongst cancer survivors: lessons learnt. Asian Pac J Cancer Prev 2014; 13:6337-42. [PMID: 23464455 DOI: 10.7314/apjcp.2012.13.12.6337] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical trials on cancer subjects have one of the highest dropout rates. Barriers to recruitment range from patient-related, through institutional-related to staff-related factors. This paper highlights the low response rate and the recruitment barriers faced in our Qigong exercises trial. MATERIALS AND METHOD The Qigong trial is a three-arm trial with a priori power size of 114 patients for 80% power. The University Malaya Medical Centre database showed a total of 1,933 patients from 2006-2010 and 751 patients met our inclusion criteria. These patients were approached via telephone interview. 131 out of 197 patients attended the trial and the final response rate was 48% (n=95/197). RESULTS Multiple barriers were identified, and were regrouped as patient- related, clinician-related and/or institutional related. A major consistent barrier was logistic difficulty related to transportation and car parking at the Medical Centre. conclusions: All clinical trials must pay considerable attention to the recruitment process and it should even be piloted to identify potential barriers and facilitators to reduce attrition rate in trials.
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Affiliation(s)
- Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Courneya KS, Segal RJ, Gelmon K, Mackey JR, Friedenreich CM, Yasui Y, Reid RD, Proulx C, Trinh L, Dolan LB, Wooding E, Vallerand JR, McKenzie DC. Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy. Int J Behav Nutr Phys Act 2014; 11:85. [PMID: 24997476 PMCID: PMC4110703 DOI: 10.1186/s12966-014-0085-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 06/27/2014] [Indexed: 02/01/2023] Open
Abstract
Background Exercise is beneficial for breast cancer patients during chemotherapy but adherence to different types and doses of exercise is a challenge. The purpose of this study was to examine predictors of adherence to different types and doses of exercise during breast cancer chemotherapy in a multicenter randomized controlled trial. Methods Breast cancer patients in Edmonton, Vancouver, and Ottawa, Canada receiving chemotherapy (N = 301) were randomized to a standard dose of 25–30 minutes of aerobic exercise (STAN), a higher dose of 50–60 minutes of aerobic exercise (HIGH), or a higher dose of 50–60 minutes of combined aerobic and resistance exercise (COMB). Predictors included demographic, medical, fitness, and quality of life variables. Exercise adherence was measured as the percentage of supervised exercise sessions completed. Results Overall adherence to the supervised exercise sessions was 73% (SD = 24%). In a multivariate regression model, six independent predictors explained 26.4% (p < 0.001) of the variance in exercise adherence. Higher exercise adherence was achieved by breast cancer patients in Vancouver (p < 0.001), with fewer endocrine symptoms (p = 0.009), randomized to STAN (p = 0.009), with fewer exercise limitations (p = 0.009), receiving shorter chemotherapy protocols (p = 0.015), and with higher VO2peak (p = 0.017). Disease stage (p for interaction = 0.015) and body mass index (p for interaction = 0.030) interacted with group assignment to predict adherence. For disease stage, patients with stage I/IIa disease adhered equally well to all three exercise interventions whereas patients with stage IIb/III disease adhered better to the STAN intervention than the two higher dose exercise interventions. For body mass index, healthy weight patients adhered equally well to all three exercise interventions whereas overweight patients adhered best to STAN and worst to COMB; and obese patients adhered best to STAN and worst to HIGH. Conclusions Determinants of exercise adherence in breast cancer patients receiving chemotherapy are multidisciplinary and may vary by the exercise prescription.
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81
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Lynch BM, Courneya KS, Sethi P, Patrao TA, Hawkes AL. A randomized controlled trial of a multiple health behavior change intervention delivered to colorectal cancer survivors: Effects on sedentary behavior. Cancer 2014; 120:2665-72. [DOI: 10.1002/cncr.28773] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/24/2014] [Accepted: 04/07/2014] [Indexed: 11/08/2022]
Affiliation(s)
- Brigid M. Lynch
- Physical Activity Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Victoria Australia
- Melbourne School of Population and Global Health; The University of Melbourne; Melbourne Victoria Australia
| | - Kerry S. Courneya
- Department of Physical Education and Recreation; University of Alberta; Edmonton Alberta Canada
| | - Parneet Sethi
- Physical Activity Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Victoria Australia
| | - Tania A. Patrao
- Menzies School of Health Research; Brisbane Queensland Australia
| | - Anna L. Hawkes
- School of Public Health and Social Work, Queensland University of Technology; Brisbane Queensland Australia
- School of Public Health, Tropical Medicine and Rehabilitation Sciences; James Cook University; Townsville Queensland Australia
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Hacker ED, Mjukian M. Review of attrition and adherence in exercise studies following hematopoietic stem cell transplantation. Eur J Oncol Nurs 2013; 18:175-82. [PMID: 24275209 DOI: 10.1016/j.ejon.2013.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 10/18/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Implementing exercise programs in people receiving high-dose chemotherapy followed by bone marrow (BMT) or hematopoietic stem cell transplantation (SCT) presents unique challenges. This review examines subject attrition rates and reasons for attrition as well as adherence to exercise interventions following BMT/SCT. METHODS Studies published between January 1985 and December 2012 that prospectively tested an exercise intervention following BMT or SCT were included in the review. Evaluation criteria included: (1) exercise modality; (2) the amount of supervision required to implement the intervention; (3) timing of the intervention; (4) subject attrition rates and reasons for attrition; and (5) exercise adherence rates. RESULTS Of the 20 studies reviewed, most tested an aerobic exercise intervention or a combination of aerobic and strength training. Supervised exercise sessions were more commonly used than unsupervised sessions. The overall attrition rate was 18% for the 998 subjects enrolled in the studies. Major reasons for attrition included death, change in health status, protocol issues, personal issues with subjects, and lost to follow-up/no reason provided. Authors of supervised exercise programs rarely published exercise adherence information. Unsupervised exercise programs relied mainly on self-report to document adherence. CONCLUSION Exercise research following BMT/SCT is becoming more sophisticated as researchers build upon the expanding literature base. Questions regarding subject attrition and adherence to exercise interventions must be addressed to identify interventions that are likely to be successful when translated into clinical practice. Subject attrition from exercise studies following BMT/SCT is relatively low. Adherence information for exercise interventions needs to be regularly addressed.
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Affiliation(s)
- Eileen Danaher Hacker
- University of Illinois at Chicago, College of Nursing (M/C 802), Department of Biobehavioral Health Science, 845 S. Damen Avenue, Chicago, IL 60612, USA.
| | - Maral Mjukian
- University of Illinois at Chicago, College of Nursing (M/C 802), Department of Biobehavioral Health Science, 845 S. Damen Avenue, Chicago, IL 60612, USA
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83
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Sellar CM, Bell GJ, Haennel RG, Au HJ, Chua N, Courneya KS. Feasibility and efficacy of a 12-week supervised exercise intervention for colorectal cancer survivors. Appl Physiol Nutr Metab 2013; 39:715-23. [PMID: 24869975 DOI: 10.1139/apnm-2013-0367] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Exercise training improves health-related physical fitness and patient-reported outcomes in cancer survivors, but few interventions have targeted colorectal cancer (CRC) survivors. This investigation aimed to determine the feasibility and efficacy of a 12-week supervised exercise training program for CRC survivors. Feasibility was assessed by tracking participant recruitment, loss to follow-up, assessment completion rates, participant evaluation, and adherence to the intervention. Efficacy was determined by changes in health-related physical fitness. Over a 1-year period, 72 of 351 (21%) CRC survivors screened were eligible for the study and 29 of the 72 (40%) were enrolled. Two participants were lost to follow-up (7%) and the completion rate for all study assessments was ≥93%. Mean adherence to the exercise intervention was 91% (standard deviation = ±18%), with a median of 98%. Participants rated the intervention positively (all items ≥ 6.6/7) and burden of testing low (all tests ≤ 2.4/7). Compared with baseline, CRC survivors showed improvements in peak oxygen uptake (mean change (MC) = +0.24 L·min(-1), p < 0.001), upper (MC = +7.0 kg, p < 0.001) and lower (MC = +26.5 kg, p < 0.001) body strength, waist circumference (MC = -2.1 cm, p = 0.005), sum of skinfolds (MC = -7.9 mm, p = 0.006), and trunk forward flexion (MC = +2.5 cm, p = 0.019). Exercise training was found to be feasible and improved many aspects of health-related physical fitness in CRC survivors that may be associated with improved quality of life and survival in these individuals.
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Affiliation(s)
- Christopher M Sellar
- a Faculty of Physical Education and Recreation, E459 Van Vliet Center, University of Alberta, Edmonton, AB T6G 2H9, Canada
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84
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Gho SA, Munro BJ, Jones SC, Steele JR. Exercise bra discomfort is associated with insufficient exercise levels among Australian women treated for breast cancer. Support Care Cancer 2013; 22:721-9. [DOI: 10.1007/s00520-013-2027-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 10/18/2013] [Indexed: 10/26/2022]
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85
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Ventura EE, Ganz PA, Bower JE, Abascal L, Petersen L, Stanton AL, Crespi CM. Barriers to physical activity and healthy eating in young breast cancer survivors: modifiable risk factors and associations with body mass index. Breast Cancer Res Treat 2013; 142:423-33. [PMID: 24177756 DOI: 10.1007/s10549-013-2749-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 10/21/2013] [Indexed: 11/29/2022]
Abstract
Physical activity (PA) and healthy eating (HE) are important behaviors to encourage in breast cancer survivors (BCS). We examined associations between various factors and barriers to PA (BPA) and barriers to HE (BHE), as well as relationships between barriers and body mass index (BMI) in younger BCS. Self-reported data from 162 BCS (mean age 48 years) were used. BPA were assessed with a 21-item scale and BHE with a 19-item scale. Participants were classified as high or low on each scale. Sociodemographic, medical, and psychosocial characteristics were compared by high/low barriers. Correlates of continuous BPA and BHE were assessed as were associations among BHE, BPA, and BMI. 61 % of participants were characterized as having low BHE and low BPA; 12 % were high for both. High BHE/high BPA participants had the least favorable scores for depression, perceived stress, social support, fatigue, bladder control, and weight problems. Factors associated with BHE were lower education, higher perceived stress, and more severe weight problems. Factors associated with BPA were more severe bladder control problems and lower physical well-being. Higher BHE and BPA were significantly and uniquely associated with higher BMI, controlling for covariates. Several biopsychosocial factors (e.g., depression, stress, and fatigue) characterize young BCS who experience barriers to both HE and PA. The correlates of BHE and BPA are distinct. Both BHE and BPA are associated with BMI. These results should be considered in designing interventions for younger women with breast cancer.
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Affiliation(s)
- Emily E Ventura
- Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA, 90095-6900, USA
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86
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Self-reported aging-related fatigue: a concept description and its relevance to physical therapist practice. Phys Ther 2013; 93:1403-13. [PMID: 23704037 DOI: 10.2522/ptj.20130011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Fatigue is one of the most common symptoms experienced by older people, both with and without chronic disease. It is unpleasant and distressing and can affect functioning and quality of life. Fatigue also may inhibit an older person from participating optimally in a physical therapy program aimed at rehabilitation or the promotion of better health. However, confusion surrounds the concept of self-reported aging-related fatigue, not only because of the complexity of the problem itself but also because of lack of clarity of definition and the use of the term "fatigue" to describe a range of different concepts. This article aims to provide clarification of the concept in the context of physical therapist clinical practice. The intention is to increase awareness of the issue among physical therapists, promoting their assessment and consideration of the problem when planning health interventions involving functioning, physical activity, and exercise for older people.
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87
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Spector D, Battaglini C, Groff D. Perceived exercise barriers and facilitators among ethnically diverse breast cancer survivors. Oncol Nurs Forum 2013; 40:472-80. [PMID: 23989021 PMCID: PMC10589869 DOI: 10.1188/13.onf.472-480] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To determine whether women with breast cancer were meeting current physical activity recommendations and to describe perceptions of exercise self-efficacy, exercise benefits and barriers, and perceptions of environmental supports for physical activity by race or ethnicity. DESIGN Cross-sectional survey. SETTING Community wellness workshops held in various locations in central and eastern North Carolina. SAMPLE 65 breast cancer survivors in treatment or post-treatment. Caucasian women comprised 46% of the sample followed by African Americans (34%) and Hispanics/Latinas (16%). METHODS Descriptive statistics were used to determine the percentage of women meeting physical activity guidelines and for comparing exercise-related perceptions. Spearman's rho correlation coefficient tests were conducted to identify associations between physical activity and exercise-related perceptions. MAIN RESEARCH VARIABLES Physical activity, perceived exercise self-efficacy, exercise barriers, and benefits. FINDINGS Hispanic/Latina women were least likely to meet physical activity recommendations. Hispanic/Latina women were more likely than Caucasian and African American women to report lack of enjoyment from exercise, lack of knowledge on how to exercise, feeling self-conscious because of looks, and discouragement as exercise barriers. CONCLUSIONS In a sociocultural context, exercise beliefs need to be considered in the development of culturally responsive exercise interventions that may enhance the health of breast cancer survivors. IMPLICATIONS FOR NURSING Considering the increasing number of breast cancer survivors from diverse racial or ethnic backgrounds, a need exists for culturally competent nursing interventions aimed at increasing exercise. When educating breast cancer survivors, nurses should address sociocultural factors that may hinder or facilitate engagement in exercise. KNOWLEDGE TRANSLATION Most women were not meeting physical activity recommendations, particularly Hispanic/Latina women. Perceptions of exercise-related beliefs differed, although not significantly, across racial and ethnic groups. More perceived exercise barriers existed for Hispanic/Latina women compared to Caucasian and African American women, which may indicate sociocultural differences.
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88
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Courneya KS, Forbes CC, Trinh L, Sellar CM, Friedenreich CM, Reiman T. Patient satisfaction with participation in a randomized exercise trial: effects of randomization and a usual care posttrial exercise program. Clin Trials 2013; 10:959-66. [PMID: 23918843 DOI: 10.1177/1740774513495985] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Participation in an exercise trial is a major commitment for cancer survivors, but few exercise trials have evaluated patient satisfaction with trial participation. PURPOSE To examine patient satisfaction with participation in the Healthy Exercise for Lymphoma Patients (HELP) Trial and to explore possible determinants. METHODS The HELP Trial randomized 122 lymphoma patients to 12 weeks of supervised aerobic exercise training (AET; n = 60) or to usual care (UC; n = 62), with the option of participating in a 4-week posttrial exercise program. At the 6-month follow-up assessment, participants evaluated their overall trial satisfaction. RESULTS Personal satisfaction with trial participation was strongly influenced by group assignment with participants randomized to AET reporting participation to be more rewarding (p < 0.001) and personally useful (p < 0.001) than participants randomized to UC. UC participants who completed the optional 4-week posttrial exercise program reported participation to be more rewarding (p = 0.008) and personally useful (p < 0.001) than UC participants who declined the program. LIMITATIONS The study is limited by the lack of a validated measure of participant satisfaction, and the fact that the offer of participation in the posttrial exercise program to the UC group was not randomized. CONCLUSIONS Lymphoma patients randomized to UC viewed it as less rewarding and personally useful despite being offered a 4-week posttrial exercise program. UC participants who completed the 4-week program reported personal satisfaction levels similar to the AET group; however, the causal direction of this association is unknown. Researchers should continue to evaluate participant satisfaction in exercise trials.
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Affiliation(s)
- Kerry S Courneya
- aFaculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
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89
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Buffart LM, Galvão DA, Brug J, Chinapaw MJM, Newton RU. Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 2013; 40:327-40. [PMID: 23871124 DOI: 10.1016/j.ctrv.2013.06.007] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/20/2013] [Accepted: 06/25/2013] [Indexed: 01/22/2023]
Abstract
Physical activity during and after cancer treatment has beneficial effects on a number of physical and psychosocial outcomes. This paper aims to discuss the existing physical activity guidelines for cancer survivors and to describe future research directions to optimize prescriptions. Studies on physical activity during and after cancer treatment were searched in PubMed, Clinicaltrials.gov, Australian New Zealand Clinical Trials Registry, and Dutch Trial registry. Physical activity guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for all cancer survivors. However, the development of these guidelines has been limited by the research conducted. To be able to develop more specific guidelines, future studies should focus on identifying clinical, personal, physical, psychosocial, and intervention moderators explaining 'for whom' or 'under what circumstances' interventions work. Further, more insight into the working mechanisms of exercise interventions on health outcomes in cancer survivors is needed to improve the efficacy and efficiency of interventions. Finally, existing programs should embrace interests and preferences of patients to facilitate optimal uptake of interventions. In conclusion, current physical activity guidelines for cancer survivors are generic, and research is needed to develop more personalized physical activity guidelines.
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Affiliation(s)
- L M Buffart
- EMGO Institute for Health and Care Research and the VU University Medical Center, Department of Epidemiology and Biostatistics, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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90
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Craike MJ, Hose K, Courneya KS, Harrison SJ, Livingston PM. Perceived benefits and barriers to exercise for recently treated patients with multiple myeloma: a qualitative study. BMC Cancer 2013; 13:319. [PMID: 23815855 PMCID: PMC3702408 DOI: 10.1186/1471-2407-13-319] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 06/24/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Understanding the physical activity experiences of patients with multiple myeloma (MM) is essential to inform the development of evidence-based interventions and to quantify the benefits of physical activity. The aim of this study was to gain an in-depth understanding of the physical activity experiences and perceived benefits and barriers to physical activity for patients with MM. METHODS This was a qualitative study that used a grounded theory approach. Semi-structured interviews were conducted in Victoria, Australia by telephone from December 2011-February 2012 with patients who had been treated for MM within the preceding 2-12 months. Interviews were transcribed and analysed using the constant comparison coding method to reduce the data to themes. Gender differences and differences between treatment groups were explored. RESULTS Twenty-four interviews were completed. The sample comprised 13 females (54%), with a mean age of 62 years (SD = 8.8). Sixteen (67%) participants had received an autologous stem cell transplant (ASCT). All participants currently engaged in a range of light to moderate intensity physical activity; walking and gardening were the most common activities. Recovery from the symptoms of MM and side effects of therapy, psychological benefits, social factors and enjoyment were important benefits of physical activity. Barriers to physical activity predominately related to the symptoms of MM and side effects of therapy, including pain, fatigue, and fear of infection. Low self- motivation was also a barrier. Women participated in a more diverse range of physical activities than men and there were gender differences in preferred type of physical activity. Women were more likely to report psychological and social benefits; whereas men reported physical activity as a way to keep busy and self-motivation was a barrier. Patients treated with an ASCT more often reported affective benefits of participation in physical activity and fatigue as a barrier. Patients treated with other therapies (e.g., chemotherapy, radiotherapy) were more likely to report pain as a barrier. CONCLUSIONS Patients with MM experience debilitating effects of their condition and therapy, which influences their level and intensity of physical activity participation. Physical activity programs should be individualised; take into consideration gender differences and the impact of different types of therapy on physical activity; and focus on meeting the psychological, coping and recovery needs of patients.
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91
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Brunet J, Taran S, Burke S, Sabiston CM. A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer. Disabil Rehabil 2013; 35:2038-45. [DOI: 10.3109/09638288.2013.802378] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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92
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Kraushaar LE, Krämer A. Web-Enabled Feedback Control Over Energy Balance Promotes an Increase in Physical Activity and a Reduction of Body Weight and Disease Risk in Overweight Sedentary Adults. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2013; 15:579-87. [DOI: 10.1007/s11121-013-0398-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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93
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Lynch BM, Dunstan DW, Vallance JK, Owen N. Don't take cancer sitting down. Cancer 2013; 119:1928-35. [DOI: 10.1002/cncr.28028] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 01/30/2013] [Accepted: 01/31/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Brigid M. Lynch
- Physical Activity Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Victoria Australia
- Melbourne School of Population Health; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
| | - David W. Dunstan
- Physical Activity Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Victoria Australia
- School of Population Health; The University of Queensland; Brisbane Queensland Australia
- School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- School of Exercise and Nutrition Sciences; Deakin University; Melbourne Victoria Australia
| | - Jeff K. Vallance
- Faculty of Health Disciplines; Athabasca University; Athabasca Alberta Canada
| | - Neville Owen
- Melbourne School of Population Health; Faculty of Medicine; Dentistry and Health Sciences; The University of Melbourne; Melbourne Victoria Australia
- School of Population Health; The University of Queensland; Brisbane Queensland Australia
- School of Public Health and Preventive Medicine; Monash University; Melbourne Victoria Australia
- Behavioral Epidemiology Laboratory; Baker IDI Heart and Diabetes Institute; Melbourne Victoria Australia
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Jung ME, Brawley LR. Concurrent self-regulatory efficacy as a mediator of the goal: Exercise behaviour relationship. J Health Psychol 2013; 18:601-11. [DOI: 10.1177/1359105313479238] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Examining exercise as a single goal-directed behaviour, without acknowledging the influence of other concurrent goals, may oversimplify the self-regulation needed in daily life. Concurrent self-regulatory efficacy, confidence in one’s ability to self-regulate the management of multiple goals, was explored as a potential mediator in the relationship between value of an exercise goal and future exercise behaviour. Undergraduate students were observed during a 4-week examination period where they faced greater than usual challenges to exercising regularly. Consistent with self-efficacy theory, concurrent self-regulatory efficacy was a significant partial mediator of the value of an exercise goal–exercise behaviour relationship.
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95
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Cancer patients’ experiences with and perceived outcomes of yoga: results from focus groups. Support Care Cancer 2013; 21:1861-70. [DOI: 10.1007/s00520-013-1728-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 01/28/2013] [Indexed: 10/27/2022]
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Rimmer JH, Hsieh K, Graham BC, Gerber BS, Gray-Stanley JA. Barrier removal in increasing physical activity levels in obese African American women with disabilities. J Womens Health (Larchmt) 2013; 19:1869-76. [PMID: 20815739 DOI: 10.1089/jwh.2010.1941] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This pilot study examined the effectiveness of a telephone-based intervention to increase physical activity in obese African American women with mobility disabilities by targeting the removal of barriers to participation. METHODS Severely obese (mean body mass index [BMI] = 49.1 kg.m²) African American women (n = 33) with mobility disabilities completed a 6-month telephone-based physical activity coaching intervention. RESULTS The major environmental/facility barriers at preintervention were cost of the program (66.7%), lack of transportation (48.5%), not aware of fitness center in the area (45.5%), and lack of accessible facilities (45.5%). The major personal barriers were pain (63.6%), don't know how to exercise (45.5%), health concerns (39.4%), don't know where to exercise (39.4%), and lack of energy (36.4%). Despite only two personal barriers being significantly lower at posttest (don't know where to exercise and don't know how to exercise) (p < 0.01), total exercise time increased from < 6 minutes/day to 27 minutes/day at posttest (p < 0.001), and total physical activity time (structured exercise, leisure, indoor and outdoor household activity) increased from 26 minutes/day to 89 minutes/day at posttest (p < 0.001). CONCLUSIONS Interventions aimed at increasing physical activity participation among obese African American women with mobility disabilities should start with increasing their awareness/knowledge on where and how to exercise. Other reported barriers (e.g., cost, transportation, finding an accessible facility, health concerns, pain) may not be as critical to alter/remove as identifying where participants can exercise (i.e., home, outdoors, gym) and providing them with a variety of routines that can be performed safely in their desired setting.
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Affiliation(s)
- James H Rimmer
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, Illinois 60608-6904, USA.
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97
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Buffart LM, van Uffelen JGZ, Riphagen II, Brug J, van Mechelen W, Brown WJ, Chinapaw MJM. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer 2012. [PMID: 23181734 PMCID: PMC3571972 DOI: 10.1186/1471-2407-12-559] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background This study aimed to systematically review the evidence from randomized controlled trials (RCTs) and to conduct a meta-analysis of the effects of yoga on physical and psychosocial outcomes in cancer patients and survivors. Methods A systematic literature search in ten databases was conducted in November 2011. Studies were included if they had an RCT design, focused on cancer patients or survivors, included physical postures in the yoga program, compared yoga with a non-exercise or waitlist control group, and evaluated physical and/or psychosocial outcomes. Two researchers independently rated the quality of the included RCTs, and high quality was defined as >50% of the total possible score. Effect sizes (Cohen’s d) were calculated for outcomes studied in more than three studies among patients with breast cancer using means and standard deviations of post-test scores of the intervention and control groups. Results Sixteen publications of 13 RCTs met the inclusion criteria, of which one included patients with lymphomas and the others focused on patients with breast cancer. The median quality score was 67% (range: 22–89%). The included studies evaluated 23 physical and 20 psychosocial outcomes. Of the outcomes studied in more than three studies among patients with breast cancer, we found large reductions in distress, anxiety, and depression (d = −0.69 to −0.75), moderate reductions in fatigue (d = −0.51), moderate increases in general quality of life, emotional function and social function (d = 0.33 to 0.49), and a small increase in functional well-being (d = 0.31). Effects on physical function and sleep were small and not significant. Conclusion Yoga appeared to be a feasible intervention and beneficial effects on several physical and psychosocial symptoms were reported. In patients with breast cancer, effect size on functional well-being was small, and they were moderate to large for psychosocial outcomes.
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Affiliation(s)
- Laurien M Buffart
- EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands.
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Diet adherence dynamics and physiological responses to a tomato product whole-food intervention in African-American men. Br J Nutr 2012. [PMID: 23200261 DOI: 10.1017/s0007114512004436] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Tomatoes may have beneficial effects on prostate health. Efficacy trials would require long-term adherence to high levels of tomato product (TP) consumption. Therefore, factors that affect adherence in men most at risk and whether increased consumption of TP negatively affects diet and health are important concerns. Cancer-free African–American (AA) men (n 36) with mean serum prostate-specific antigen of 7.4 SD 5.6) ng/ml were randomised to consume one serving of TP/d or a control diet for 3 months. Mean intervention group lycopene intake rose to 464%, with negligible control group increase. Plasma lycopene levels rose by 53 and 40% in the intervention group in months 1 and 3, respectively (P < 0.0001), with no control group change. The intervention group’s barriers to adherence score was inversely associated with both dietary (r -0.49, P = 0.02) and plasma lycopene concentration (r -0.37, P = 0.02). Their TP disadvantage score negatively correlated with the 3-month plasma lycopene concentrations (r -0.37, P = 0.008) and their weekly incentives and impediments were remarkably stable, ‘concern for prostate health’ being the most consistent over time. ‘Liking tomatoes’ and ‘study participation’ decreased in citation frequency at weeks 6 and 9, respectively. No major shifts occurred in dietary cholesterol or saturated fat, with no adverse effects on gastrointestinal complaints, serum total cholesterol, body weight or blood pressure. Lower socio-economic status AA men at higher prostate cancer risk can successfully achieve a whole food intervention goal with a corresponding rise in plasma lycopene concentrations, with no adverse effects on self-selected diet quality or health parameters.
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Transitioning from active treatment: colorectal cancer survivors' health promotion goals. Palliat Support Care 2012; 11:101-9. [PMID: 23089464 DOI: 10.1017/s1478951512000788] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The purpose of this study is to describe the post-treatment goals of colorectal cancer (CRC) survivors. We sought to determine whether goals were a salient concept during the period immediately following treatment, and whether a goal-setting intervention might be feasible and acceptable to these patients. METHOD Semi-structured qualitative interviews were administered to a convenience sample of 41 CRC patients who were 0-24 months post-treatment. Topics discussed included expectations and goals for future health, cancer prevention awareness, health-promoting behavior-change goals, and post-treatment cancer issues. Content analysis was used to explore emergent themes. RESULTS Overall, participants' health-related goals were: being healthy, getting back to normal, and not having a cancer recurrence. Most of the CRC survivors reported being proactive with their health by maintaining healthy behaviors or making healthy behavior changes, or had goals to change their behavior. All respondents had plans to maintain follow-up care and regular screening appointments. Some patients were managing treatment side effects or non-cancer issues that limited their functional abilities. Many respondents were satisfied with the care they received, and felt it was now their responsibility to do their part in taking care of themselves. SIGNIFICANCE OF RESULTS CRC survivors talk about goals, and many of them are either making or have an interest in making health behavior changes. Self-management support could be an appropriate strategy to assist patients with achieving their health goals post-treatment. Patients may need help addressing lingering treatment side effects or non-cancer issues. Healthcare providers should consider assessing patients' goals to help patients resolve post-treatment issues and promote healthy behaviors.
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Physical activity participation and barriers for people with multiple myeloma. Support Care Cancer 2012; 21:927-34. [PMID: 23052913 DOI: 10.1007/s00520-012-1607-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE This study aims to examine, for people treated for multiple myeloma, (1) differences between prediagnosis and postdiagnosis levels of physical activity, (2) perceived barriers and likelihood of attending a physical activity program, and (3) factors that influence whether or not respondents are meeting physical activity guidelines. METHODS This was a quantitative cross-sectional study; data were gathered from a larger Australian population-wide survey. Respondents completed the survey in hard copy, online, or over the telephone. Demographic and clinical variables included age, gender, locality, time since diagnosis, and marital status. The Godin Leisure-Time Questionnaire measured physical activity; barriers and likelihood of participating in a physical activity program were assessed using a five-point Likert scale. Data were analyzed using descriptive, bivariate, and multivariate analyses. RESULTS Of the 229 respondents, 53.1 % were male, 42 % aged 60-69 years, and 75.7 % were married or in a de facto relationship. Participation in physical activity declined significantly from prediagnosis levels. Fatigue, injuries, and pain were the strongest perceived barriers to participation; 41 % reported they were likely to attend an exercise program if offered. Respondents who were sufficiently active before diagnosis were 4.79 times more likely to be sufficiently active posttreatment. CONCLUSIONS People with multiple myeloma reported very low levels of physical activity across all levels of intensity; however, they were interested in attending a physical activity program. To increase physical activity among people with multiple myeloma, interventions should target perceived barriers with a particular focus on those who were not physically active prior to diagnosis.
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