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Arbaugh C, Kimura C, Kin C. Gastrointestinal Surgical Patient and Multidisciplinary Healthcare Provider Beliefs and Practices Around Perioperative Nutrition: A Mixed-Methods Study. J Surg Res 2024; 302:80-91. [PMID: 39094260 DOI: 10.1016/j.jss.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/07/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Nutrition is critical to gastrointestinal (GI) disease prevention and treatment, including operations, yet perioperative nutrition practices vary widely. We aimed to understand GI surgical patient and health care provider's perioperative nutrition beliefs and practices. MATERIALS AND METHODS We used a mixed-methods approach, including a patient survey (n = 19), provider survey (n = 26), and semistructured interviews with a subset of providers (n = 15). Providers included surgeons, gastroenterologists, medical oncologists, advanced practice providers, and dietitians. Provider interviews were transcribed, iteratively coded, and thematically analyzed. Quantitative and qualitative data were integrated. RESULTS 94.7% of patients and 100% of providers surveyed believe that nutrition affects outcomes. Patients seek nutrition information from diverse resources (73.7% from websites or blogs, 42.1% from documentaries, and 36.8% from books or /magazines) and people (52.6% from family members, 42.1% from a significant other, partner, or spouse, and 36.8% from a dietitian or nutritionist). Providers cited a lack of quality information, misinformation, and inconsistency among health care providers as barriers to high-quality nutrition care. Both patients and providers noted that nutritional supplements have drawbacks, with 100% of patients and 96.2% of providers expressing interest in house- made plant-based protein smoothie or soup alternatives. CONCLUSIONS This study led to the development of a multidisciplinary task force, which has collaborated on multiple interventions to improve inpatient perioperative surgical nutrition (e.g., smoothie pilot and postoperative menu revisions).
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Affiliation(s)
- Carlie Arbaugh
- Department of Surgery, Stanford University School of Medicine, Stanford, California; Stanford Prevention Research Center, Stanford, California.
| | - Cintia Kimura
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Cindy Kin
- Department of Surgery, Stanford University School of Medicine, Stanford, California
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Andersen HH, Mikkelsen MK, Obarzanek CE, Paludan C, Nielsen D. Reasons for declining participation in an exercise-based trial among older women with breast cancer receiving systemic anti-cancer treatment - a qualitative interview study. Physiother Theory Pract 2024; 40:1568-1578. [PMID: 36892484 DOI: 10.1080/09593985.2023.2187675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Breast cancer is the most frequently diagnosed cancer in the world. Exercise is widely recommended for patients with breast cancer during and after treatment. However, there is a lack of studies investigating barriers related to participation in real-world exercise-based trials for older patients with breast cancer. OBJECTIVE To explore reasons for declining participation in an exercise-based trial among older patients with breast cancer during (neo)adjuvant or palliative systemic treatment. METHODS A qualitative study using semi-structured interviews. Patients who declined participation in an exercise-based trial (N = 50) were invited to participate. Semi-structured interviews were conducted with 15 participants. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analysis. RESULTS Identified main themes: 1) Lack of energy and resources, including two subthemes: 1a) Overwhelmed both mentally and physically, and 1b) The program is too comprehensive; 2) Uncertainty about reactions to chemotherapy; 3) The hospital is not the optimal exercise setting, including two subthemes: 3a) Transportation and time consumption, and 3b) No desire to spend additional time at the hospital; and 4) Staying active in my own way, including two subthemes: 4a) Motivation to exercise, and 4b) Preferences for exercise activities. CONCLUSION Many barriers were identified, including time of recruitment, information overload, symptoms and side effects, and the hospital as the exercise setting due to practical challenges and negative feelings. Participants were motivated to exercise from knowledge about the benefits of exercising. Furthermore, they preferred activities that they were already involved in or had experience with.
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Affiliation(s)
- Høgni Hammershaimb Andersen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
| | - Marta Kramer Mikkelsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
| | | | - Camilla Paludan
- Institute for Sports and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Dorte Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark
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Watts T, Courtier N, Fry S, Gale N, Gillen E, McCutchan G, Patil M, Rees T, Roche D, Wheelwright S, Hopkinson J. Access, acceptance and adherence to cancer prehabilitation: a mixed-methods systematic review. J Cancer Surviv 2024:10.1007/s11764-024-01605-3. [PMID: 38709465 DOI: 10.1007/s11764-024-01605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/12/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE The purpose of this systematic review is to better understand access to, acceptance of and adherence to cancer prehabilitation. METHODS MEDLINE, CINAHL, PsychINFO, Embase, Physiotherapy Evidence Database, ProQuest Medical Library, Cochrane Library, Web of Science and grey literature were systematically searched for quantitative, qualitative and mixed-methods studies published in English between January 2017 and June 2023. Screening, data extraction and critical appraisal were conducted by two reviewers independently using Covidence™ systematic review software. Data were analysed and synthesised thematically to address the question 'What do we know about access, acceptance and adherence to cancer prehabilitation, particularly among socially deprived and minority ethnic groups?' The protocol is published on PROSPERO CRD42023403776 RESULTS: Searches identified 11,715 records, and 56 studies of variable methodological quality were included: 32 quantitative, 15 qualitative and nine mixed-methods. Analysis identified facilitators and barriers at individual and structural levels, and with interpersonal connections important for prehabilitation access, acceptance and adherence. No study reported analysis of facilitators and barriers to prehabilitation specific to people from ethnic minority communities. One study described health literacy as a barrier to access for people from socioeconomically deprived communities. CONCLUSIONS There is limited empirical research of barriers and facilitators to inform improvement in equity of access to cancer prehabilitation. IMPLICATIONS FOR CANCER SURVIVORS To enhance the inclusivity of cancer prehabilitation, adjustments may be needed to accommodate individual characteristics and attention given to structural factors, such as staff training. Interpersonal connections are proposed as a fundamental ingredient for successful prehabilitation.
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Appiah EO, Oti-Boadi E, Amertil NP, Afotey R, Lavoe H, Garti I, Menlah A, Sekyi EKN. Journeying together: spousal experiences with prostate cancer in Ghana. Ecancermedicalscience 2024; 18:1692. [PMID: 38774571 PMCID: PMC11108047 DOI: 10.3332/ecancer.2024.1692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Indexed: 05/24/2024] Open
Abstract
Background Prostate cancer (PCa) is a significant global health concern for men. In Sub-Saharan Africa, PCa rates witnessed a 69% increase from 1990 to 2010. Despite this, there is a dearth of literature examining the experiences of spouses of men with PCa in Africa, as the majority of studies concentrate primarily on men. Methods The study used a qualitative exploratory design, conducting in-depth face-to-face interviews with a semi-structured guide. Participants were selected through purposive sampling, with 35 recruited. Data was recorded, transcribed verbatim, and analysed using content analysis, resulting in 2 themes and 11 subthemes. Results The research revealed that spouses providing care for husbands with PCa faced notable effects on their physical and emotional well-being. Notably, they reported experiencing leg pains due to prolonged sitting by their partners, as well as disruptions in sleep and a loss of appetite triggered by the hospital smell. Conclusion Women encounter challenges in caring for their partners with PCa. Understanding these experiences will contribute to improving public support and assistance. Future studies should concentrate on developing interventions to help them cope with these challenges.
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Affiliation(s)
- Evans Osei Appiah
- Nursing Department, Purdue University, 425 South River Road, West Lafayette, IN, USA
- https://orcid.org/0000-0002-6730-4725
| | - Ezekiel Oti-Boadi
- Department of Nursing, Heritage Christian College, PO Box AN16798, Amasaman, Accra, Ghana
| | - Ninon P Amertil
- Nursing Department, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | | | | | - Isabella Garti
- University of Charles Darwin, Brinkin, Northern Territory Australia
| | - Awube Menlah
- Nursing Department, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
- https://orcid.org/0000-0002-0683-1572
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Western B, Ivarsson A, Vistad I, Demmelmaier I, Aaronson NK, Radcliffe G, van Beurden M, Bohus M, Courneya KS, Daley AJ, Galvão DA, Garrod R, Goedendorp MM, Griffith KA, van Harten WH, Hayes SC, Herrero-Roman F, Hiensch AE, Irwin ML, James E, Kenkhuis MF, Kersten MJ, Knoop H, Lucia A, May AM, McConnachie A, van Mechelen W, Mutrie N, Newton RU, Nollet F, Oldenburg HS, Plotnikoff R, Schmidt ME, Schmitz KH, Schulz KH, Short CE, Sonke GS, Steindorf K, Stuiver MM, Taaffe DR, Thorsen L, Velthuis MJ, Wenzel J, Winters-Stone KM, Wiskemann J, Berntsen S, Buffart LM. Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study. Scand J Med Sci Sports 2024; 34:e14575. [PMID: 38339809 DOI: 10.1111/sms.14575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/04/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. METHODS This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. RESULTS Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2 , performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment. CONCLUSIONS There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.
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Affiliation(s)
- Benedikte Western
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andreas Ivarsson
- Centre of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden
| | - Ingvild Vistad
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Sørlandet Hospital, Kristiansand, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Demmelmaier
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Gillian Radcliffe
- Lane Fox Respiratory Research Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Marc van Beurden
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany
- Heidelberg University, Heidelberg, Germany
- Faculty of Health, University of Antwerp, Antwerp, Belgium
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Amanda J Daley
- Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Rachel Garrod
- Department of Respiratory Medicine, King's College London, London, UK
| | - Martine M Goedendorp
- Department of Psychology, University of Groningen, Groningen, Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Wim H van Harten
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
- University of Twente, Enschede, The Netherlands
| | - Sandi C Hayes
- School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | | | - Anouk E Hiensch
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Erica James
- School of Medicine & Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Amsterdam University Medical Centers, Cancer Center Amsterdam and LYMMCARE, Amsterdam, The Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Alex McConnachie
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nanette Mutrie
- Physical Activity for Health Research Center, University of Edinburgh, Edinburgh, UK
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Frans Nollet
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Hester S Oldenburg
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ron Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, Callaghan, New South Wales, Australia
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | | | - Karl-Heinz Schulz
- Competence Center for Sports- and Exercise Medicine (Athleticum) and Institute for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
- Cancer and Exercise Recovery Research Group (CanRex), Melbourne School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Gabe S Sonke
- Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Disease (NCT), Heidelberg, Germany
| | - Martijn M Stuiver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Lene Thorsen
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Miranda J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Jennifer Wenzel
- Johns Hopkins School of Nursing, Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | | | - Joachim Wiskemann
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Clinic, Heidelberg, Germany
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Paulo CM, Ali AA, Schmeusser BN, Midenberg E, Helman TA, Diller ML, Pisters MF, Ogan K, Master VA. Barriers and facilitators to physical activity prehabilitation in patients with kidney cancer. Eur J Oncol Nurs 2023; 65:102333. [PMID: 37295278 DOI: 10.1016/j.ejon.2023.102333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Timely and effective physical activity (PA) prehabilitation is an evidence-based approach for improving a patient's health status preoperatively. Identifying barriers and facilitators to PA prehabilitation can help inform best practices for exercise prehabilitation program implementation. We explore the barriers and facilitators to PA prehabilitation in patients undergoing nephrectomy. METHODS A qualitative exploratory study was conducted by interviewing 20 patients scheduled for nephrectomy. Interviewees were selected via convenience sampling strategy. The interviews were semi-structured and discussed experienced and perceived barriers/facilitators to PA prehabilitation. Interview transcripts were imported to Nvivo 12 for coding and semantic content analysis. A codebook was independently created and collectively validated. Themes of barriers and facilitators were identified and summarized in descriptive findings based on frequency of themes. RESULTS Five relevant themes of barriers to PA prehabilitation emerged: 1) mental factors, 2) personal responsibilities, 3) physical capacity, 4) health conditions, and 5) lack of exercise facilities. Contrarily, facilitators potentially contributing to PA prehabilitation adherence in kidney cancer included 1) holistic health, 2) social and professional support, 3) acknowledgment of health benefits, 4) exercise type and guidance, and 5) Communication channels. CONCLUSION AND KEY FINDINGS Kidney cancer patient's adherence to physical activity prehabilitation is influenced by multiple biopsychosocial barriers and facilitators. Hence, adherence to physical activity prehabilitation requires timely adaptation of health beliefs and behavior embedded in the reported barriers and facilitators. For this reason, prehabilitation strategies should strive to be patient-centered and include health behavioral change theories as underlying frameworks for sustaining patient engagement and self-efficacy.
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Affiliation(s)
- Cristiany M Paulo
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Adil A Ali
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Benjamin N Schmeusser
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA; Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eric Midenberg
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA; Department of Urology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Talia A Helman
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Maggie L Diller
- Department of Surgery of Emory University, 1364 Clifton Road, Atlanta, GA, 30322, USA
| | - Martijn F Pisters
- Physical Therapy Research, Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
| | - Kenneth Ogan
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Viraj A Master
- Department of Urology, Emory University, 1364 E Clifton Rd NE, Atlanta, GA, 30322, USA; Winship Cancer Institute, Emory University, Atlanta, GA, USA.
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Desai K, Applebaum AJ, Latte-Naor S, Pendleton EM, Cheyney S, Li QS, Bao T, Chimonas S, Mao JJ. Interest in and Barriers to Practicing Yoga among Family Caregivers of People with Cancer. Int J Yoga 2023; 16:5-11. [PMID: 37583540 PMCID: PMC10424271 DOI: 10.4103/ijoy.ijoy_203_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 08/17/2023] Open
Abstract
Background Family caregivers of people with cancer report high levels of psychological distress. Yoga, with well-documented mental health benefits, could be a useful intervention to address distress in this population. However, little is known about yoga practices among cancer caregivers. The present study evaluates their interest in and barriers to yoga practice. Methods We conducted a cross-sectional survey study of family caregivers of cancer patients at five suburban satellite locations of an academic cancer center. Survey items and statistical analyses focused on yoga usage as well as interest in and barriers to yoga practice. Results Among 539 participants, most were females (64.8%), white (84.2%), and caring for a spouse or partner (54.7%). Interest in practicing yoga among study participants was 42.3%. Increased interest was independently associated with being females (odds ratio [OR] = 3.30, 95% confidence interval [CI] = 1.98-5.51, P < 0.001) and employed (part-time: OR = 2.58, 95% CI = 1.1-6.18, P = 0.03; full-time: OR = 1.77, 95% CI = 1.1-2.01, P = 0.02). Few participants (6.3%) were currently practicing yoga, although 31% had done so in the past. Sixty-one percent of those who had practiced before their loved one's diagnosis stopped practicing yoga afterward. Commonly cited barriers to yoga practice included time constraints (37.3%) and psychological obstacles (33.6%). About a quarter of those who had never practiced yoga lacked awareness of yoga's benefits (26.6%). Conclusion Despite the low use of yoga, interest in practicing was moderately high, especially among women and employed caregivers. As caregivers face numerous barriers to yoga practice, strategies are needed to overcome these barriers and help them access yoga's health benefits.
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Affiliation(s)
- Krupali Desai
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Allison J. Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Shelly Latte-Naor
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Eva M. Pendleton
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Sarah Cheyney
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Qing S. Li
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Ting Bao
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Susan Chimonas
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Jun J. Mao
- Department of Medicine, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, NY, USA
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Voorn MJJ, Schröder CD, Boogaart VEMVKD, Willems W, Bongers BC, Janssen‐Heijnen MLG. The clinical decision‐making process of healthcare professionals within a personalized home‐based rehabilitation during sequential chemoradiotherapy for stage III non‐small lung cancer: A case study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 28:e1979. [PMID: 36300694 DOI: 10.1002/pri.1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/05/2022] [Accepted: 10/09/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The purpose of this case study was to demonstrate the clinical decision-making process of healthcare professionals within a rehabilitation program during chemoradiotherapy (CHRT) for a high-risk patient diagnosed with stage III non-small cell lung cancer (NSCLC). The course of CHRT and patient's preferences, facilitators, and barriers were considered. CASE-DESCRIPTION The patient was a 69-year-old man with a history of rheumatoid arthritis diagnosed with stage III NSCLC. INTERVENTION A home-based, personalized, and partly supervised rehabilitation program during CHRT, including aerobic, resistance, and breathing exercises, as well as nutritional counseling. OUTCOMES The patient suffered from side effects of CHRT, which required adjustments in the context and intensity of the exercises. An important facilitator for the patient was encouraged by his wife in following the home-based rehabilitation program. During home visits, the patient and physiotherapists performed the exercises together to help him to overcome the burden and motivate the patient to adhere to the rehabilitation program. CONCLUSION This case study demonstrates that physical exercise training could be performed by adjusting training intensity and the way in which the physical exercise training was delivered, while the patient experienced side effects from CHRT. In addition, the involvement and support of (in)formal caregivers seems essential for adherence to rehabilitation.
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Affiliation(s)
- Melissa J. J. Voorn
- Department of Clinical Epidemiology VieCuri Medical Centre Venlo The Netherlands
- Adelante Rehabilitation Centre Venlo The Netherlands
- Department of Epidemiology GROW School for Oncology and Developmental Biology Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
| | | | | | - Wendy Willems
- Department of Dietetics VieCuri Medical Centre Venlo The Netherlands
| | - Bart C. Bongers
- Department of Nutrition and Movement Sciences Nutrition and Translational Research in Metabolism (NUTRIM) Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
- Department of Epidemiology Care and Public Health Research Institute (CAPHRI) Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
| | - Maryska L. G. Janssen‐Heijnen
- Department of Clinical Epidemiology VieCuri Medical Centre Venlo The Netherlands
- Department of Epidemiology GROW School for Oncology and Developmental Biology Faculty of Health, Medicine and Life Sciences Maastricht University Maastricht The Netherlands
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Martín-Moya R, Ruiz-Montero PJ, García ER. Personal barriers to physical practice by older adults in different socio-economic locations: a qualitative study. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dijkstra F, van der Sluis G, Jager-Wittenaar H, Hempenius L, Hobbelen JSM, Finnema E. Facilitators and barriers to enhancing physical activity in older patients during acute hospital stay: a systematic review. Int J Behav Nutr Phys Act 2022; 19:99. [PMID: 35908056 PMCID: PMC9338465 DOI: 10.1186/s12966-022-01330-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/06/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To improve older patients' physical activity (PA) behavior, it is important to identify facilitators and barriers to enhancing PA in older patients (≥ 65 years) during hospitalization from the perspectives of patients, caregivers, and healthcare professionals (HCPs). METHODS In this systematic review, a search of PubMed, CINAHL, PsycINFO, EMBASE, and Web of Science (January 2000-May 2021) was performed, and quantitative, qualitative, and mixed-methods studies were included. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Identified facilitators and barriers were categorized using the social ecological model at the intrapersonal, interpersonal, and institutional levels. RESULTS The 48 included articles identified 230 facilitators and 342 barriers. The main facilitators at the intrapersonal level included: knowledge, awareness, and attitudes; interpersonal level: social support, including encouragement and interdisciplinary collaboration; and institutional level: stimulating physical environment, patient activities and schedules, and PA protocols. The main barriers at the intrapersonal level included: physical health status, having lines or drains, patients' fear, and HCPs' safety concerns; interpersonal level: patient-HCP relation and HCPs' unclear roles; and institutional level: lack of space and resources, including time and equipment. Best evidence synthesis provided moderate level of evidence for three barriers: patients' unwillingness or refusal to move, patients having symptoms, and patients having lines or drains. No moderate level of evidence was found for facilitators. CONCLUSION The PA behavior of older adults during hospitalization is multidimensional. Our overview highlights facilitators and barriers on multilevel scale (intrapersonal, interpersonal, and institutional levels) that guides patients, caregivers, HCPs, and researchers in future clinical practice, and intervention development and implementation.
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Affiliation(s)
- F Dijkstra
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands.
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- FAITH research, Groningen/Leeuwarden, The Netherlands.
| | - G van der Sluis
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of Health Strategy and Innovation, Nij Smellinghe Hospital Drachten, Drachten, The Netherlands
| | - H Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L Hempenius
- Geriatric Center, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - J S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E Finnema
- Research Group Living, Wellbeing and Care for Older People, NHL Stenden University of Applied Sciences, Rengerslaan 8-10, P.O. Box 1080, 8900, CB, Leeuwarden, The Netherlands
- Department of Health Science, Section of Nursing Research & Education, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- FAITH research, Groningen/Leeuwarden, The Netherlands
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
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Sattar S, Haase KR, Alibhai SM, Penz K, Szafron M, Harenberg S, Amir E, Kuster S, Pitters E, Campbell D, McNeely ML. Feasibility and efficacy of a remotely delivered fall prevention exercise program for community-dwelling older adults with cancer: Protocol for the STABLE trial. J Geriatr Oncol 2022; 13:1273-1280. [DOI: 10.1016/j.jgo.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/07/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
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12
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Shehu E, Roggendorf S, Golla A, Koenig A, Stangl GI, Diestelhorst A, Medenwald D, Vordermark D, Steckelberg A, Schmidt H. Development and Evaluation of a Multimodal Supportive Intervention for Promoting Physical Function in Older Patients with Cancer. Cancers (Basel) 2022; 14:cancers14112599. [PMID: 35681580 PMCID: PMC9179325 DOI: 10.3390/cancers14112599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/12/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
Physical function (PF) in older patients with cancer may decline during and after oncologic therapy. This study aimed to develop and pilot test an individually tailored unsupervised physical activity (PA) program and dietary recommendations to promote PF in older patients with cancer. Following development and pretest, the intervention was pilot tested to explore feasibility, acceptance, adherence and potential benefit. Patients ≥60 years, with heterogeneous cancer diagnoses, starting outpatient radiotherapy were randomized in two study arms: paper-based vs. video-based instructions. Based on assessments of PF, PA, nutrition, cognition, mental health, social support, HRQOL and personal goals, participants received individual recommendations for PA and nutrition. After 12 weeks of intervention (T1), reassessments were performed. The postal 4-week follow-up questionnaire included PA, nutrition and HRQOL. Participants (n = 24, 14 female, mean age 70 ± 7 years) showed comparable characteristics in both study arms. The majority rated the program as helpful. Facilitators and barriers to PA adherence were collected. Both modes of instructions were appreciated equally. PF (EORTC QLQ-C30) declined slightly (not clinically relevant >10 pts.) at group level T0: 76 ± 16, T1: 68 ± 21, T2: 69 ± 24. The intervention was feasible, well accepted, showing potential benefit for the maintenance of PF during outpatient radiotherapy, and should be further tested in a larger sample.
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Affiliation(s)
- Eni Shehu
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (E.S.); (S.R.); (A.S.)
| | - Sigrid Roggendorf
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (E.S.); (S.R.); (A.S.)
| | - André Golla
- Institute of Rehabilitation Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany;
| | - Antonia Koenig
- Institute of Agricultural and Nutrition Science, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (A.K.); (G.I.S.)
| | - Gabriele I. Stangl
- Institute of Agricultural and Nutrition Science, Martin Luther University Halle-Wittenberg, 06120 Halle, Germany; (A.K.); (G.I.S.)
| | - Andrea Diestelhorst
- Clinic and Polyclinic of Radiotherapy, University Hospital Halle, 06120 Halle, Germany; (A.D.); (D.M.); (D.V.)
| | - Daniel Medenwald
- Clinic and Polyclinic of Radiotherapy, University Hospital Halle, 06120 Halle, Germany; (A.D.); (D.M.); (D.V.)
| | - Dirk Vordermark
- Clinic and Polyclinic of Radiotherapy, University Hospital Halle, 06120 Halle, Germany; (A.D.); (D.M.); (D.V.)
| | - Anke Steckelberg
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (E.S.); (S.R.); (A.S.)
| | - Heike Schmidt
- Institute of Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (E.S.); (S.R.); (A.S.)
- Clinic and Polyclinic of Radiotherapy, University Hospital Halle, 06120 Halle, Germany; (A.D.); (D.M.); (D.V.)
- Correspondence:
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13
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Voorn MJJ, Bongers BC, van Kampen-van den Boogaart VEM, Driessen EJM, Janssen-Heijnen MLG. Feasibility of Rehabilitation during Chemoradiotherapy among Patients with Stage III Non-Small Cell Lung Cancer: A Proof-of-Concept Study. Cancers (Basel) 2022; 14:cancers14102387. [PMID: 35625990 PMCID: PMC9139205 DOI: 10.3390/cancers14102387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Rehabilitation during chemoradiotherapy (CHRT) might (partly) prevent reduction in physical fitness and nutritional status and could improve treatment tolerance in patients with stage III non-small cell lung cancer (NSCLC). The aim of this proof-of-concept study was to investigate the feasibility of a multimodal program for rehabilitation during CHRT. A home-based multimodal rehabilitation program (partly supervised moderate-intensity physical exercise training and nutritional support) during CHRT was developed in collaboration with patients with stage III NSCLC and specialized healthcare professionals. A predetermined number of six patients with stage III NSCLC (aged > 50 years) who underwent CHRT and participated in this program were monitored in detail to assess its feasibility for further development and optimization of the program. The patient’s level of physical functioning (e.g., cardiopulmonary exercise test, six-minute walking test, handgrip strength, body mass index, fat free mass index, energy and protein intake) was evaluated in order to provide personalized advice regarding physical exercise training and nutrition. The program appeared feasible and well-tolerated. All six included patients managed to perform the assessments. Exercise session adherence was high in five patients and low in one patient. The performed exercise intensity was lower than prescribed for all patients. Patients were motivated to complete the home-based rehabilitation program during CHRT. Preliminary effects on physical and nutritional parameters revealed relatively stable values throughout CHRT, with inter-individual variation. Supervised and personalized rehabilitation in patients with stage III NSCLC undergoing CHRT seems feasible when the intensity of the physical exercise training was adjusted to the possibilities and preferences of the patients. Future research should investigate the feasibility of a supervised and personalized rehabilitation program during CHRT with a low-to-moderate exercise intensity with the aim to prevent physical decline during CHRT.
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Affiliation(s)
- Melissa J. J. Voorn
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (E.J.M.D.); (M.L.G.J.-H.)
- Adelante Rehabilitation Centre, 5912 BL Venlo, The Netherlands
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-77-320-6905
| | - Bart C. Bongers
- Department of Nutrition and Movement Sciences, (NUTRIM) School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | | | - Elisabeth J. M. Driessen
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (E.J.M.D.); (M.L.G.J.-H.)
| | - Maryska L. G. Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands; (E.J.M.D.); (M.L.G.J.-H.)
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
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Dorado Chaparro J, Fernández-Bermejo Ruiz J, Santofimia Romero MJ, del Toro García X, Cantarero Navarro R, Bolaños Peño C, Llumiguano Solano H, Villanueva Molina FJ, Gonçalves Silva A, López JC. Phyx.io: Expert-Based Decision Making for the Selection of At-Home Rehabilitation Solutions for Active and Healthy Aging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5490. [PMID: 35564884 PMCID: PMC9103419 DOI: 10.3390/ijerph19095490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 12/10/2022]
Abstract
While the importance of physical activity in older adults is beyond doubt, there are significant barriers limiting the access of older adults to physical exercise. Existing technologies to support physical activity in older adults show that, despite their positive impacts on health and well-being, there is in general a lack of engagement due to the existing reluctance to the use of technology. Usefulness and usability are two major factors for user acceptance along with others, such as cost, privacy, equipment and maintenance requirements, support, etc. Nevertheless, the extent to which each factor impacts user acceptance remains unclear. Furthermore, other stakeholders, besides the end users, should be considered in the decision-making process to develop such technologies, including caregivers, therapists and technology providers. In this paper, and in the context of physical rehabilitation and exercise at home, four different alternatives with incremental characteristics have been defined and considered: a software-based platform for physical rehabilitation and exercise (Alternative 1), the same software platform with a conventional RGB camera and no exercise supervision (Alternative 2), the same software platform with a convention RGB camera and exercise supervision (Alternative 3) and finally, the same software platform with a depth camera and exercise supervision (Alternative 4). A multiple attribute decision-making methodology, based on the ordinal priority approach (OPA) method, is then applied using a group of experts, including end users, therapists and developers to rank the best alternative. The attributes considered in this method have been usefulness, cost, ease of use, ease of technical development, ease of maintenance and privacy, concluding that Alternative 3 has been ranked as the most appropriate.
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Affiliation(s)
- Javier Dorado Chaparro
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Jesús Fernández-Bermejo Ruiz
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - María José Santofimia Romero
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Xavier del Toro García
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Rubén Cantarero Navarro
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Cristina Bolaños Peño
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Henry Llumiguano Solano
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Félix Jesús Villanueva Molina
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
| | - Anabela Gonçalves Silva
- Center for Health Technology and Services Research, Health Sciences School, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Juan Carlos López
- Computer Architecture and Networks Group, School of Computer Science, University of Castilla-La Mancha, 13071 Ciudad Real, Spain; (J.F.-B.R.); (M.J.S.R.); (X.d.T.G.); (R.C.N.); (C.B.P.); (H.L.S.); (F.J.V.M.); (J.C.L.)
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Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14082026. [PMID: 35454932 PMCID: PMC9032592 DOI: 10.3390/cancers14082026] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although cancer survivors may experience health benefits from favorable lifestyle changes, many cancer survivors do not adhere to lifestyle recommendations or make favorable lifestyle changes after cancer diagnosis. This systematic review of the literature aimed to provide an overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. It provides a structured overview of the large variety of determinants of changes in different lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) derived from the 123 included papers (71 quantitative and 52 qualitative). Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors and inform researchers and healthcare professionals about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Abstract The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.
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Gell N, Hoffman E, Patel K. Technology Support Challenges and Recommendations for Adapting an Evidence-Based Exercise Program for Remote Delivery to Older Adults: Exploratory Mixed Methods Study. JMIR Aging 2021; 4:e27645. [PMID: 34889743 PMCID: PMC8704113 DOI: 10.2196/27645] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/15/2021] [Accepted: 10/25/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Tele-exercise has emerged as a means for older adults to participate in group exercise during the COVID-19 pandemic. However, little is known about the technology support needs of older adults for accessing tele-exercise. OBJECTIVE This study aims to examine the needs of older adults for transition to tele-exercise, identify barriers to and facilitators of tele-exercise uptake and continued participation, and describe technology support challenges and successes encountered by older adults starting tele-exercise. METHODS We used an exploratory, sequential mixed methods study design. Participants were older adults with symptomatic knee osteoarthritis (N=44) who started participating in a remotely delivered program called Enhance Fitness. Before the start of the classes, a subsample of the participants (n=10) completed semistructured phone interviews about their technology support needs and the barriers to and facilitators for technology adoption. All of the participants completed the surveys including the Senior Technology Acceptance Model scale and a technology needs assessment. The study team recorded the technology challenges encountered and the attendance rates for 48 sessions delivered over 16 weeks. RESULTS Four themes emerged from the interviews: participants desire features in a tele-exercise program that foster accountability, direct access to helpful people who can troubleshoot and provide guidance with technology is important, opportunities to participate in high-value activities motivate willingness to persevere through the technology concerns, and belief in the ability to learn new things supersedes technology-related frustration. Among the participants in the tele-exercise classes (mean age 74, SD 6.3 years; 38/44, 86% female; mean 2.5, SD 0.9 chronic conditions), 71% (31/44) had a computer with a webcam, but 41% (18/44) had little or no experience with videoconferencing. The initial technology orientation sessions lasted on average 19.3 (SD 10.3) minutes, and 24% (11/44) required a follow-up assistance call. During the first 2 weeks of tele-exercise, 47% of participants (21/44) required technical assistance, which decreased to 12% (5/44) during weeks 3 to 16. The median attendance was 100% for the first 6 sessions and 93% for the subsequent 42 sessions. CONCLUSIONS With appropriate support, older adults can successfully participate in tele-exercise. Recommendations include individualized technology orientation sessions, experiential learning, and availability of standby technical assistance, particularly during the first 2 weeks of classes. Continued development of best practices in this area may allow previously hard-to-reach populations of older adults to participate in health-enhancing, evidence-based exercise programs.
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Affiliation(s)
- Nancy Gell
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, United States
| | - Elise Hoffman
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Kushang Patel
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
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Lehto RH, Wyatt G, Sender J, Miller SE. An Evaluation of Natural Environment Interventions for Informal Cancer Caregivers in the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111124. [PMID: 34769643 PMCID: PMC8583496 DOI: 10.3390/ijerph182111124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
Abstract
Home-based informal caregiving by friends and family members of patients with cancer is be-coming increasingly common globally with rates continuing to rise. Such caregiving is often emo-tionally and cognitively demanding, resulting in mental exhaustion and high perceived burden. Support for caregivers may be fostered by engagement with the natural environment. Interaction with nature is associated with mental health benefits such as stress reduction and improved well-being. The purpose of this paper was to evaluate the state of the science regarding the use of nat-ural environment interventions to support caregivers of cancer patients in the community. A comprehensive scoping review using the Arksey and O’Malley framework and the Preferred Re-porting Items for Systematic Reviews and Meta-analyses assessed natural environment therapies and mental health outcomes among cancer caregivers. Databases searched included CINAHL, PubMed, Scopus, Cochrane, and Alt HealthWatch. Findings recovered a total of five studies over a 10-year period that met criteria, demonstrating a lack of empirical evidence addressing this po-tential resource to support caregivers. Often, study appraisal was not on nature exposure, but ra-ther other aspects of the projects such as program evaluation, exercise, or complementary thera-pies. Both qualitative and quantitative designs were used but sample sizes were small. Caregivers experienced beneficial results across the various studies and future work could enhance these findings.
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Affiliation(s)
- Rebecca H. Lehto
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA; (G.W.); (J.S.)
- Correspondence:
| | - Gwen Wyatt
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA; (G.W.); (J.S.)
| | - Jessica Sender
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA; (G.W.); (J.S.)
| | - Sara E. Miller
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA 16802, USA;
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Avancini A, Tregnago D, Rigatti L, Sartori G, Yang L, Trestini I, Bonaiuto C, Milella M, Pilotto S, Lanza M. Factors Influencing Physical Activity in Cancer Patients During Oncological Treatments: A Qualitative Study. Integr Cancer Ther 2021; 19:1534735420971365. [PMID: 33349064 PMCID: PMC7758643 DOI: 10.1177/1534735420971365] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introduction: Although the literature supports the importance of physical activity in the oncological context, in Italy a large number of patients are not sufficiently active. Methods: The present study aimed to explore factors influencing an active lifestyle in cancer patients during oncological treatments. Semi-structured focus groups, including 18 patients with different cancer types, were conducted at the Oncology Unit in the University Hospital Trust of Verona (Italy). The interviews were audio-recorded, transcribed verbatim, and analyzed with content analysis. Results: According to the Health Belief Model, transcripts were categorized into the following themes: benefits, barriers, and cues to action. Patients reported a series of physical, physiological, and psychological benefits deriving from an active lifestyle. The main barriers hampering the physical activity participation were represented by treatment-related side effects, advanced disease, and some medical procedures, for example, ileostomy. Several strategies that can trigger patients to exercise were identified. Medical advice, social support from family and friends, features such as enjoyment, setting goals, and owning an animal can motivate patients to perform physical activity. At the same time, an individualized program based on patients’ characteristics, an available physical activity specialist to consult, more detailed information regarding physical activity in the oncological setting, and having accessible structures were found important facilitators to implementing active behavior. Conclusions: Overall, patients have a positive view regarding physical activity, and a variety of obstacles and cues to action were recognized. Considering this information may help to improve adherence to a physical activity program over time, consequently increasing the expected benefits.
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Affiliation(s)
| | | | | | | | - Lin Yang
- Alberta Health Services, Calgary, Canada.,University of Calgary, Calgary, Canada
| | | | | | - Michele Milella
- University of Verona, Verona, Italy.,Medical Oncology, Verona, Italy
| | - Sara Pilotto
- University of Verona, Verona, Italy.,Medical Oncology, Verona, Italy
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Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act 2021; 18:50. [PMID: 33823832 PMCID: PMC8025326 DOI: 10.1186/s12966-021-01116-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients' PA participation. METHODS A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions. RESULTS Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients' PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs. CONCLUSIONS There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
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Affiliation(s)
- Sarah Elshahat
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Charlene Treanor
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
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20
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Roche M, Ravot C, Malapert A, Paget-Bailly S, Garandeau C, Pitiot V, Tomatis M, Riche B, Galamand B, Granger M, Barbavara C, Bourgeois C, Genest E, Stefani L, Haïne M, Castel-Kremer E, Morel-Soldner I, Collange V, Le Saux O, Dayde D, Falandry C. Feasibility of a prehabilitation programme dedicated to older patients with cancer before complex medical-surgical procedures: the PROADAPT pilot study protocol. BMJ Open 2021; 11:e042960. [PMID: 33811052 PMCID: PMC8023742 DOI: 10.1136/bmjopen-2020-042960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ageing is associated with an increased prevalence of comorbidities and sarcopenia as well as a decline of functional reserve of multiple organ systems, which may lead, in the context of the disease-related and/or treatment-related stress, to functional deconditioning. The multicomponent 'Prehabilitation & Rehabilitation in Oncogeriatrics: Adaptation to Deconditioning risk and Accompaniment of Patients' Trajectories (PROADAPT)' intervention was developed multiprofessionally to implement prehabilitation in older patients with cancer. METHODS The PROADAPT pilot study is an interventional, non-comparative, prospective, multicentre study. It will include 122 patients oriented to complex medical-surgical curative procedures (major surgery or radiation therapy with or without chemotherapy). After informed consent, patients will undergo a comprehensive geriatric assessment and will be offered a prehabilitation kit that includes an advice booklet with personalised objectives and respiratory rehabilitation devices. Patients will then be called weekly and monitored for physical and respiratory rehabilitation, preoperative renutrition, motivational counselling and iatrogenic prevention. Six outpatient visits will be planned: at inclusion, a few days before the procedure and at 1, 3, 6 and 12 months after the end of the procedure. The main outcome of the study is the feasibility of the intervention, defined as the ability to perform at least one of the components of the programme. Clinical data collected will include patient-specific and cancer-specific characteristics. ETHICS AND DISSEMINATION The study protocol was approved by the Ile de France 8 ethics committee on 5 June 2018. The results of the primary and secondary objectives will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03659123. Pre-results of the trial.
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Affiliation(s)
- Mélanie Roche
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Christine Ravot
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Amélie Malapert
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Sophie Paget-Bailly
- Methodology and Quality of Life Unit in Oncology, University Hospital Centre Besancon, Besancon, France
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire Et Génique, Université Bourgogne Franche-Comté, Besancon, France
| | - Charlène Garandeau
- Direction à la Recherche Clinique et à l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Virginie Pitiot
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Mélanie Tomatis
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Riche
- Service de Biostatistique - Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire de Biométrie et Biologie Évolutive CNRS UMR 5558, Équipe Biostatistiques Santé, Université de Lyon, Lyon, France
| | - Béatrice Galamand
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Marion Granger
- Geriatrics Unit, Hospices Civils de Lyon, Lyon, France
- Centre Hospitalier de Chambery, Chambery, France
| | | | - Chrystelle Bourgeois
- Department of Medical Oncology, Centre Hospitalier Annecy Genevois, Pringy, France
| | | | - Laetitia Stefani
- Department of Medical Oncology, Centre Hospitalier Annecy Genevois, Pringy, France
| | - Max Haïne
- Pôle de gérontologie et Médecine de Réadaptation, Hôpital Nord-Ouest, Villefranche-sur-Saone, France
| | | | - Isabelle Morel-Soldner
- Geriatrics Unit, Centre Hospitalier de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Vincent Collange
- Département anesthésie réanimation, Medipole Lyon-Villeurbanne, Villeurbanne, France
| | - Olivia Le Saux
- Therapeutic targeting of the tumor cell and its immune microenvironment, Centre de Recherche en Cancerologie de Lyon, Lyon, France
| | - David Dayde
- Plateforme Transversale de Recherche de l'IC-HCL, Hospices Civils de Lyon, Lyon, France
| | - Claire Falandry
- Geriatrics Unit, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, INSA Lyon, Charles Mérieux Medical School, Oullins, France
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21
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Abstract
Curative-intent surgery is the treatment of choice for thoracic malignancies, including lung cancer. There is significant complexity and uncertainty associated with the diagnosis, prognosis, and surgical treatment decision-making in thoracic surgery. From a patient point of view, this complexity and uncertainty can be overwhelming. Therefore, for high-quality cancer care, an emphasis on patient-centered care-including the improvement in quality of life (QOL) through symptom and functional monitoring-is essential. Using the current literature and our previous research, the purpose of this paper is to: (I) review the current evidence on symptom and functional monitoring in surgery; (II) describe strategies to monitor symptoms and functional recovery in surgery; and (III) describe a model of patient-centered care in thoracic surgery.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Jae Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
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