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Herrero-Zapirain I, Álvarez-Pardo S, Castañeda-Babarro A, Moreno-Villanueva A, Mielgo-Ayuso JF. The Effect of Dragon Boating on the Quality of Life for Breast Cancer Survivors: A Systematic Review. Healthcare (Basel) 2024; 12:1290. [PMID: 38998825 PMCID: PMC11241423 DOI: 10.3390/healthcare12131290] [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: 05/20/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
Physical activity improves breast cancer-related symptoms in women and decreases cancer-related mortality. The main objective of this systematic review is to synthesize and analyze the evidence of the effect of dragon boating on the quality of life of female breast cancer survivors. A systematic review based on the PRISMA method was conducted using four databases (Web of Science, Scopus, Cochrane and Pubmed). The search phrase used was "Breast Cancer" AND "Dragon Boat" AND "Quality of Life". The search was conducted in June 2024. The PEDro method was used to ensure the quality of the publications. A total of 77 articles published until 2024 were selected, of which 10 met the inclusion criteria of assessing the application of dragon boating and that used a validated instrument to assess quality of life. There is no homogeneity in terms of the instrument used to measure QOL. The SF-36 was the most commonly used, followed by the FACT-B and the EORTC QLQ-C30. Five out of ten articles compared the improvement in quality of life between dragon boating and other physical activities, while 6 out of 10 analyzed the pre-post effect of dragon boat use. Dragon boating is a physical activity alternative that improves the quality of life of breast cancer survivors and reduces the symptomatology caused by the disease and its treatments. As dragon boat programs are applied over a longer period of time, the improvements in quality of life are greater. When compared with other types of physical activity, dragon boating does not show significant differences that position it as a better option for this population.
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Affiliation(s)
- Igor Herrero-Zapirain
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain; (I.H.-Z.); (J.F.M.-A.)
| | | | - Arkaitz Castañeda-Babarro
- Health, Physical Activity and Sports Science Laboratory, Department of Physical Activity and Sports, Faculty of Psychology and Education, University of Deusto, 48007 Bilbao, Spain;
| | | | - Juan Francisco Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain; (I.H.-Z.); (J.F.M.-A.)
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Fioretti C, Coppola S, Boscaino S, Celia G, Vastola R, Cozzolino M. The effectiveness of Dragon Boat racing on body image and traumatic symptoms of breast cancer patients. Health Psychol Res 2024; 12:120055. [PMID: 38915786 PMCID: PMC11196124 DOI: 10.52965/001c.120055] [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: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 06/26/2024] Open
Abstract
Objective The present study investigated the effectiveness of a Dragon Boat training program in women with breast cancer body image and traumatic distress processing. Methods 29 breast cancer patients (M(SD) age= 51 (7.41)) voluntarily participated in a physical activity program. Seventeen (Intervention Group) enrolled in a Dragon Boat racing program, while 12 (the Control Group) individually performed alternative physical activities. Before and after the intervention, patients completed the Body Image Scale (BIS) and the Impact of Event Scale - Revised (IES-R). Results The Intervention Group reported a decrease in Body Image negative perception (Pillai's trace = .352, F(1,27) = 14.111, p = .001; partial η2 = .951) and in traumatic symptoms (Pillai's trace = .283, F(1,27) = 10.682, p = .003; partial η2 = .883). Conclusions Authors discuss the role of Dragon Boat racing in improving positive body image after the experience of breast cancer.
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Affiliation(s)
- Chiara Fioretti
- Human, Philosophical and Educational Sciences University of Salerno
| | - Silvia Coppola
- Human, Philosophical and Educational Sciences University of Salerno
| | | | - Giovanna Celia
- Seraphicum Institute, Rome, Italy 3School of Specialization in Strategic-Integrated Psychotherapy
| | | | - Mauro Cozzolino
- Human, Philosophical and Educational Sciences University of Salerno
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3
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Carretti G, Dabraio A, Manetti M, Marini M. Biofeedback-Based Proprioceptive Training to Improve Functional Prerequisites of Dragon Boating in Breast Cancer Survivors. Eur J Investig Health Psychol Educ 2024; 14:1351-1368. [PMID: 38785587 PMCID: PMC11120340 DOI: 10.3390/ejihpe14050089] [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: 03/28/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Breast cancer (BC)-related sequelae drastically impact the psychophysical functioning and quality of life of affected women. Adapted physical activity (APA) has proved to effectively counteract these impairments in a non-medicalized framework. In particular, dragon boats are able to promote body functionality, social interaction, and quality of life in BC survivors, but the literature on specific motor gestures is scarce and practice is still based more on a re-educative perspective than a performative one. In this context, the present longitudinal study investigated the benefits of an adapted biofeedback-based sensorimotor training intervention on upper body functionality in a team of dragon ladies. The 8-week intervention was conceived as integrated dry workout sessions led by an APA kinesiologist and applied a novel sensorized proprioceptive device, such as a Libra board. Post-protocol evaluation revealed a significant improvement in bilateral upper limb mobility, core endurance, and trunk stability along with a distress decrease and quality of life enhancement through validated assessment tools. Our findings suggest that integrating biofeedback-based workout sessions can effectively promote upper body functionality in BC survivors practicing dragon boating. Furthermore, our innovative approach could help spread methodological hints able to boost exercise adherence in this target population, thus counteracting cancer recurrence while promoting overall well-being.
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Affiliation(s)
| | | | | | - Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (A.D.); (M.M.)
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4
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Murnaghan S, Scruton S, Urquhart R. Psychosocial interventions that target adult cancer survivors' reintegration into daily life after active cancer treatment: a scoping review. JBI Evid Synth 2024; 22:607-656. [PMID: 38015073 PMCID: PMC10986786 DOI: 10.11124/jbies-23-00044] [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] [Indexed: 11/29/2023]
Abstract
OBJECTIVE This review explored psychosocial interventions targeting adult cancer survivors' reintegration following active cancer treatment. This included the types of interventions tested and the tools used to measure reintegration. INTRODUCTION Cancer survivors face lingering health issues following the completion of cancer treatment. Many cancer survivors still experience unmet psychosocial care needs despite receiving follow-up care. Further, many survivorship interventions do not specifically address outcomes important to survivors. A number of primary studies have identified reintegration as an outcome important to cancer survivors. Reintegration is a concept that focuses on returning to normal activities, routines, and social roles after cancer treatment; however, it is emerging and abstract. INCLUSION CRITERIA Studies involving adult cancer survivors (18 years or older at diagnosis) of any cancer type or stage were included in this review. Studies with psychosocial interventions targeted at reintegrating the person into daily life after cancer treatment were included. Interventions addressing clinical depression or anxiety, and interventions treating solely physical needs that were largely medically focused were excluded. METHODS A literature search was conducted in MEDLINE (Ovid), CINAHL (EBSCOhost), and Embase. Gray literature was searched using ProQuest Dissertations and Theses (ProQuest). Reference lists of included studies were searched. Studies were screened at the title/abstract and full-text levels, and 2 independent reviewers extracted data. Manuscripts in languages other than English were excluded due to feasibility (eg, cost, time of translations). Findings were summarized narratively and reported in tabular and diagrammatic format. RESULTS The 3-step search strategy yielded 5617 citations. After duplicates were removed, the remaining 4378 citations were screened at the title and abstract level, then the remaining 306 citations were evaluated at the full-text level by 2 independent reviewers. Forty studies were included that evaluated psychosocial interventions among adult cancer survivors trying to reintegrate after active cancer treatment (qualitative n=23, mixed methods n=8, quantitative n=8, systematic review n=1). Included articles spanned 10 different countries/regions. Over half of all included articles (n=25) focused primarily on breast cancer survivors. Many studies (n=17) were conducted in primary care or community-based settings. The most common types of interventions were peer-support groups (n=14), follow-up education and support (n=14), exercise programs (n=6), and multidisciplinary/multicomponent programs (n=6). While the majority of included studies characterized the outcome qualitatively, 9 quantitative tools were also employed. CONCLUSIONS This review identified 6 types of interventions to reintegrate survivors back into their daily lives following cancer treatment. An important thread across intervention types was a focus on personalization in the form of problem/goal identification. Given the number of qualitative studies, future research could include a qualitative systematic review and meta-aggregation. Quantitative tools may not be as effective for evaluating reintegration. More primary studies, including mixed methods studies, utilizing consistent measurement tools are required. Furthermore, this work provides a basis for future research to continue examining the complexity of implementing such interventions to successfully achieve reintegration. To do so, primary studies evaluating interventions from an implementation science and complex systems perspective would be useful. REVIEW REGISTRATION Open Science Framework https://osf.io/r6bmx.
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Affiliation(s)
- Sarah Murnaghan
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sarah Scruton
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Department of Surgery, Nova Scotia Health, Halifax, NS, Canada
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Plage S. Deploying Normality: Cancer Survivor Identity and Authenticity in Ritual-like Practice. Med Anthropol 2021; 40:473-489. [DOI: 10.1080/01459740.2021.1909582] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Stefanie Plage
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Australia
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Tailored Sailing Experience to Reduce Psychological Distress and Improve the Quality of Life of Breast Cancer Survivors: A Survey-Based Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124406. [PMID: 32575442 PMCID: PMC7345345 DOI: 10.3390/ijerph17124406] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 01/03/2023]
Abstract
Background: Growing evidence indicates that physical/sporting activities may improve the health outcomes and quality of life (QoL) of breast cancer (BC) survivors. Since recent reports have suggested that sailing can improve the psychophysical well-being and QoL of people with disabilities, this pilot study evaluated the effectiveness of a tailored sailing experience on the QoL and psychological distress (PD) of BC survivors. Methods: A group of 19 breast cancer survivors, who were attending the Cancer Rehabilitation Center in Florence, were invited to participate in a sailing school and completed a survey based on a structured online questionnaire assessing QoL and PD both on departure (baseline) and one week after returning (follow-up). The survey comprised a first part (i.e., sociodemographic characteristics and the practice of physical/sporting activities at baseline; sailing experience satisfaction at follow-up) and a second part (i.e., Short Form-12 (SF-12), State/Trait-Anxiety Inventory form Y (STAI-Y), distress thermometer questionnaires). A paired Student's t-test was used to compare the baseline versus follow-up QoL and PD scores. Results: A statistically significant improvement in SF-12 mental component scores and a reduction in both STAI-Y state/trait components and distress thermometer scores were found after the sailing experience. Conclusions: We conclude that sailing practice could be a feasible intervention to increase the psychophysical well-being of BC survivors.
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Britton E, Kindermann G, Domegan C, Carlin C. Blue care: a systematic review of blue space interventions for health and wellbeing. Health Promot Int 2020; 35:50-69. [PMID: 30561661 PMCID: PMC7245048 DOI: 10.1093/heapro/day103] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
There is increasing interest in the potential use of outdoor water environments, or blue space, in the promotion of human health and wellbeing. However, therapeutic nature-based practices are currently outpacing policy and the evidence base for health or wellbeing benefits of therapeutic interventions within blue space has not been systematically assessed. This systematic review aims to address the gap in understanding the impacts of blue space within existing interventions for targeted individuals. A systematic review was carried out, searching Google Scholar, SCOPUS, PubMed, etc. through to August 2017. Only blue space interventions were included that were specifically designed and structured with a therapeutic purpose for individuals with a defined need and did not include nature-based promotion projects or casual recreation in the outdoors. Thirty-three studies met the inclusion criteria and were assessed. Overall, the studies suggest that blue care can have direct benefit for health, especially mental health and psycho-social wellbeing. The majority of papers found a positive or weak association between blue care and health and wellbeing indicators. There was also some evidence for greater social connectedness during and after interventions, but results were inconsistent and mixed across studies with very few findings for physical health. This is the first systematic review of the literature on blue care. In summary, it has been shown that mental health, especially psycho-social wellbeing, can be improved with investment in blue spaces. Key areas for future research include improving understanding of the mechanisms through which blue care can improve public health promotion.
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Affiliation(s)
- Easkey Britton
- Whitaker Institute, National University of Ireland – Galway, Galway, Ireland
| | - Gesche Kindermann
- Whitaker Institute, National University of Ireland – Galway, Galway, Ireland
- Applied Ecology Unit, Centre for Environmental Science, National University of Ireland – Galway, Galway, Ireland
| | - Christine Domegan
- Whitaker Institute, National University of Ireland – Galway, Galway, Ireland
- J.E. Cairnes School of Business & Economics, National University of Ireland – Galway, Galway, Ireland
| | - Caitriona Carlin
- Whitaker Institute, National University of Ireland – Galway, Galway, Ireland
- Applied Ecology Unit, Centre for Environmental Science, National University of Ireland – Galway, Galway, Ireland
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Coping Strategies Used by Breast, Prostate, and Colorectal Cancer Survivors: A Literature Review. Cancer Nurs 2019; 41:E23-E39. [PMID: 28723724 DOI: 10.1097/ncc.0000000000000528] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individual coping strategies are a fundamental element underpinning psychosocial distress. OBJECTIVE The aim of this study was to describe coping strategies and their measurement used by survivors of breast, prostate, and/or colorectal cancer after treatment. METHODS A search of electronic databases (PubMed, CINAHL, and PsycINFO) was conducted from January 1980 to March 2015. Data were extracted using standardized forms and included studies that explored the coping mechanisms of survivorship of breast, prostate, or colorectal cancer. RESULTS Two thousand one hundred forty-seven studies were retrieved for potential inclusion; 19 publications met the inclusion criteria and were included in the review. CONCLUSIONS Breast, prostate, and colorectal cancer survivors seem to use different coping strategies that varied throughout the survivorship trajectory. Breast cancer survivors highlighted the importance of accepting their diagnosis and engaging in physical activities that provided social and emotional support. Personality seemed to have a significant effect on coping for prostate cancer survivors. Colorectal cancer survivors emphasized the importance of seeking information to master self-management and return to social activities. IMPLICATIONS FOR PRACTICE Understanding coping strategies, during the survivorship trajectories, is essential to planning contemporary care after cancer treatment. Nurses and other healthcare professionals may use this knowledge to improve quality of life and decrease distress after diagnosis.
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Saad AM, Gad MM, Al-Husseini MJ, AlKhayat MA, Rachid A, Alfaar AS, Hamoda HM. Suicidal death within a year of a cancer diagnosis: A population-based study. Cancer 2019; 125:972-979. [PMID: 30613943 DOI: 10.1002/cncr.31876] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/09/2018] [Accepted: 10/19/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND The suicide risk after a new cancer diagnosis remains a controversial issue. This study examines the suicide risk within the year after a cancer diagnosis. This is the largest study to assess recent trends in suicide risk after a cancer diagnosis. METHODS Data were obtained from the Surveillance, Epidemiology, and End Results Program. All patients diagnosed with cancer between 2000 and 2014 were selected. The event was defined as death due to suicide within the first year after a cancer diagnosis, and patients who experienced the event after their diagnosis were observed. The observed/expected (O/E) ratio was assessed as well as the excess risk per 10,000 person-years to determine the suicide risk change after the diagnosis in comparison with the general population. RESULTS A total of 4,671,989 patients with cancer were included; 1585 committed suicide within 1 year of their diagnosis. The risk of suicide increased significantly with an O/E ratio of 2.52 and with an excess risk of 2.51 per 10,000 person-years. When the risk of suicide was studied according to the cancer site, the highest increases in the O/E ratio came after diagnoses of pancreatic cancer (8.01) and lung cancer (6.05). The risk of suicide also increased significantly after a diagnosis of colorectal cancer with an O/E ratio of 2.08. However, the risk of suicidal death did not increase significantly after breast and prostate cancer diagnoses. CONCLUSIONS The risk of suicide increases significantly in the first year after a diagnosis of cancer in comparison with the general population, and this increase varies with the type and prognosis of cancer. Close observation and referral to mental health services, when indicated, are important for mitigating such risk.
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Affiliation(s)
- Anas M Saad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | | | - Ahmad Rachid
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmad Samir Alfaar
- Ophthalmology Department, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hesham M Hamoda
- Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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Legg M, Hyde MK, Occhipinti S, Youl PH, Dunn J, Chambers SK. A prospective and population-based inquiry on the use and acceptability of peer support for women newly diagnosed with breast cancer. Support Care Cancer 2018; 27:677-685. [PMID: 30056530 DOI: 10.1007/s00520-018-4358-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 07/17/2018] [Indexed: 11/30/2022]
Abstract
The degree to which peer support is used and accepted as a supportive care approach by women with breast cancer is unclear. We examine peer support use across three major modalities (i.e. support groups, online platforms, one-on-one) and identify enablers and barriers to peer support using the beliefs framework of the theory of planned behaviour. A population-based sample of women newly diagnosed with breast cancer (n = 3105) who were on average 54.08 weeks since diagnosis completed mailed surveys at baseline measuring beliefs about peer support and intention. Peer support use was measured via telephone interview at baseline and prospectively at 12-month follow-up (n = 2780). In all, 37% of women had used at least one peer support service since diagnosis (support group = 20%, online = 18%, one-on-one = 10%). A path analysis examined what beliefs enabled or acted as barriers to peer support use at follow-up adjusting for past behaviour (i.e. baseline use), sociodemographic characteristics, and treatment. In order of relative strength, enablers included beliefs that peer support is an outlet for honest expression of feelings (β = .35), a source of empathy (β = .30), approved by doctors (β = .07), and approved by family/partner (β = .04). Barriers were beliefs that it encourages dwelling about breast cancer (β = - .06) and involves exposure to negative stories about this disease (β = - .04). Strategies which communicate the potential emotional support benefits of a shared illness experience and social approval by others, particularly the medical profession, may help to promote acceptance of peer support and encourage service uptake in breast cancer.
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Affiliation(s)
- Melissa Legg
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia. .,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.
| | - Melissa K Hyde
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
| | - Stefano Occhipinti
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia
| | - Philippa H Youl
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,University of the Sunshine Coast, Sippy Downs, Australia
| | - Jeff Dunn
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia.,School of Social Science, University of Queensland, Brisbane, Australia
| | - Suzanne K Chambers
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4222, Australia.,Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Springfield, Australia.,Prostate Cancer Foundation of Australia, Sydney, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, Australia
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11
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McDonough MH, Patterson MC, Weisenbach BB, Ullrich-French S, Sabiston CM. The difference is more than floating: factors affecting breast cancer survivors' decisions to join and maintain participation in dragon boat teams and support groups. Disabil Rehabil 2018. [PMID: 29521150 DOI: 10.1080/09638288.2018.1449259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: Peer support can be helpful in rehabilitation from breast cancer, but participation in peer support groups is low. Groups that provide support opportunities in physical activity contexts are an attractive alternative for some survivors. This study examined survivors' reasons for joining and maintaining participation on a dragon boat team, along with perceptions of barriers and attractions to traditional peer support groups. Materials and methods: Seventeen breast cancer survivors were interviewed on five occasions over their first two seasons of a newly formed dragon boating team to explore their perceptions of peer support groups and dragon boating. Data were inductively analyzed using thematic analysis. Results: Categories surrounding physical, psychological, social and community features were identified with several themes emerging within each. Advantages of dragon boating included opportunities to get a combination of physical, psychosocial and community benefits; health improvement and behavior change; and obtaining social support without the focus being on cancer. Peer support groups were identified as having advantages for forming relationships and avoiding barriers associated with physical activity. Conclusions: While neither type of program meets all needs, practical considerations are identified for incorporating advantages of both programs to improve participation. Implications for rehabilitation Further understanding of perceptions, and attractions and challenges to taking part in group programs will inform development of accessible programs that target multiple rehabilitation needs. Physical activity can provide a positive, alternative focus that takes the emphasis off of cancer, which is more accessible to some survivors. Physical activity also provides opportunities to build relationships around a common, positive goal, which can be a foundation for providing support for coping with cancer.
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Affiliation(s)
| | | | - Beth B Weisenbach
- b Department of Health & Kinesiology , Purdue University , West Lafayette , IN , USA
| | - Sarah Ullrich-French
- c Department of Educational Leadership, Sport Studies, and Educational/Counseling Psychology , Washington State University , Pullman , WA , USA
| | - Catherine M Sabiston
- d Faculty of Kinesiology & Physical Education , University of Toronto , Toronto , Canada
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Burke S, Wurz A, Bradshaw A, Saunders S, West MA, Brunet J. Physical Activity and Quality of Life in Cancer Survivors: A Meta-Synthesis of Qualitative Research. Cancers (Basel) 2017; 9:cancers9050053. [PMID: 28531109 PMCID: PMC5447963 DOI: 10.3390/cancers9050053] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/06/2017] [Accepted: 05/16/2017] [Indexed: 12/23/2022] Open
Abstract
Qualitative research on the impact of physical activity on quality of life (QoL) in adults diagnosed with cancer is accumulating. However, the field of physical activity and cancer survivorship lack a synthesis of this research to reliably understand the implications for future research and practice. The aim of this meta-synthesis was to identify, appraise, and synthesize qualitative research on cancer survivors’ perspectives of the impact of physical activity on their QoL. Seven electronic databases were searched for original studies published in English, and reference lists of relevant studies were hand-searched to identify additional studies. Forty studies met eligibility criteria and were included in this meta-synthesis. Study characteristics and major findings were extracted, and findings were summarized, compared, and synthesized. Themes identified in this review revealed that physical activity positively impacted four dimensions of cancer survivors’ QoL: physical (e.g., managing the physical consequences of cancer and its treatment), psychological (e.g., evoking positive self-perceptions), social (e.g., feeling understood by others), and spiritual (e.g., redefining life purpose). This meta-synthesis corroborates conclusions from reviews of quantitative research and illustrates that physical activity can be used to improve QoL in adult cancer survivors, regardless of diagnosis (i.e., stage, cancer type) and treatment status. It also provides detailed insight into specific aspects within each dimension of QoL impacted by physical activity from cancer survivors’ perspectives, which is important for understanding the meaning and utility of physical activity for them. However, more research is needed to further develop the qualitative evidence base in order to better understand how physical activity impacts on QoL experiences in men, young adults, and adults diagnosed with less common types of cancer at different points along cancer trajectory (i.e., diagnosis, treatment, post-treatment, palliation).
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Affiliation(s)
- Shaunna Burke
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS29JT, UK.
| | - Amanda Wurz
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa ON K1N6N5, Canada.
| | - Andrew Bradshaw
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS29JT, UK.
| | - Stephanie Saunders
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa ON K1N6N5, Canada.
| | - Malcolm A West
- Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK.
- Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, Southampton SO16 6YD, UK.
- Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
- Academic Unit of Cancer Sciences, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Jennifer Brunet
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa ON K1N6N5, Canada.
- Institut du Savoir de l'Hôpital Montfort (IRHM), Hôpital Montfort, Ottawa ON K1K 0T2, Canada.
- Cancer Therapeutic Program, Ottawa Hospital Research Institute (OHRI), Ottawa ON K1H 8L6, Canada.
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13
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Triathlon training for women breast cancer survivors: feasibility and initial efficacy. Support Care Cancer 2016; 25:1465-1473. [DOI: 10.1007/s00520-016-3531-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
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14
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Shipp S, McKinstry C, Pearson E. The impact of colorectal cancer on leisure participation: A narrative study. Br J Occup Ther 2015. [DOI: 10.1177/0308022614562794] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction The prevalence of cancer is increasing and, with enhanced early detection and treatment, survival rates have also improved. During cancer treatment and survivorship, occupational participation is significantly impacted, with leisure affected. This field has attracted limited research interest however, particularly involving men with colorectal cancer. Symptoms including cancer-related fatigue and pain may reduce ability to engage in usual leisure occupations. Method A qualitative narrative study was conducted to enhance understanding of leisure participation during and following cancer treatment. In-depth interviews were undertaken with four men with colorectal cancer attending for review at a specialist cancer centre. Audio-recorded interview data were transcribed verbatim and thematically analysed. Results All men interviewed reported significant disruption to their usual leisure occupations. Participants described participating in passive leisure occupations during treatment over more active or community-based occupations due to challenges such as having a colostomy bag and fatigue. The men described generally returning to their chosen leisure occupations and the significance this held for their wellbeing. Conclusion Given the impact of colorectal cancer on participation in leisure occupations for men, occupational therapists can assist these men to either resume previous leisure occupations or commence alternative leisure occupations to improve their quality of life.
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Affiliation(s)
- Sarah Shipp
- Occupational Therapist, Western Health, Department of Occupational Therapy, Footscray Hospital, Australia
| | - Carol McKinstry
- Senior Lecturer, La Trobe University, La Trobe Rural Health School, Bendigo, Australia
| | - Elizabeth Pearson
- PhD Candidate, La Trobe University, La Trobe Rural Health School, Bendigo, Australia
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15
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Midtgaard J, Hammer NM, Andersen C, Larsen A, Bruun DM, Jarden M. Cancer survivors' experience of exercise-based cancer rehabilitation - a meta-synthesis of qualitative research. Acta Oncol 2015; 54:609-17. [PMID: 25751760 DOI: 10.3109/0284186x.2014.995777] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Evidence for the safety and benefits of exercise training as a therapeutic and rehabilitative intervention for cancer survivors is accumulating. However, whereas the evidence for the efficacy of exercise training has been established in several meta-analyses, synthesis of qualitative research is lacking. In order to extend healthcare professionals' understanding of the meaningfulness of exercise in cancer survivorship care, this paper aims to identify, appraise and synthesize qualitative studies on cancer survivors' experience of participation in exercise-based rehabilitation. MATERIAL AND METHODS Five electronic databases (PubMed, PsychINFO, EMBASE, Cinahl and Scopus) were searched systematically for articles published up to May 2014 using keywords and MeSH terms. To be included, studies had to contain primary data pertaining to patient experiences from participation in supervised, structured moderate to vigorous-intensity exercise. RESULTS In total 2447 abstracts were screened and 37 papers were read in full. Of these, 19 studies (n = 390) were selected for inclusion and critically appraised. Synthesis of data extracted from eight studies including in total 174 patients (77% women, age 28-76 years) exclusively reporting experiences of participation in structured, supervised exercise training resulted in nine themes condensed into three categories: 1) emergence of continuity; 2) preservation of health; and 3) reclaiming the body reflecting the benefits of exercise-based rehabilitation according to cancer survivors. Accordingly, the potential of rebuilding structure in everyday life, creating a normal context and enabling the individual to re-establish confidentiality and trust in their own body and physical potential constitute substantial qualities fundamental to the understanding of the meaningfulness of exercise-based rehabilitation from the perspective of patients. CONCLUSIONS In addition to the accumulating evidence for the efficacy of exercise training in cancer rehabilitation, it is incumbent upon clinicians and policy-makers to acknowledge and promote the meaningfulness of exercise for the individual, and to use this knowledge to provide new solutions to current problems related to recruitment of underserved populations, long-term adherence and implementation.
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Affiliation(s)
- Julie Midtgaard
- Copenhagen University Hospital Rigshospitalet, The University Hospitals' Centre for Health Research (UCSF) , Copenhagen Ø , Denmark
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16
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Gibson AF, Lee C, Crabb S. ‘If you grow them, know them’: Discursive constructions of the pink ribbon culture of breast cancer in the Australian context. FEMINISM & PSYCHOLOGY 2014. [DOI: 10.1177/0959353514548100] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ‘pink ribbon culture’ dominates understandings of breast cancer in Western societies. We describe this as an ‘illness culture’, consisting of neoliberal discourses and practices, which construct the breast cancer experience. We take a feminist post-structuralist approach to review current breast cancer lay materials available to women in Australia, to examine how breast cancer is discursively constructed within this context. Further, we consider how women with breast cancer are positioned and what the implications are for women’s lives. We discuss neoliberal discourses of ‘individual responsibility and empowerment’ and ‘optimism’, and the central practices that focus on individual health behaviours and survivorship. This illness culture has productive and restrictive effects for women’s subjectivity. Whilst women are positioned as ‘empowered’ regarding their health, this comes at the price of self-regulation and responsibility. Support and information additionally reposition women in feminine, heteronormative ways, whilst excluding women who do not fit narrow cultural stereotypes.
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Affiliation(s)
| | - Christina Lee
- School of Psychology, University of Queensland, Australia
| | - Shona Crabb
- Discipline of Public Health, University of Adelaide, Australia
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17
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Ray H, Jakubec SL. Nature-based experiences and health of cancer survivors. Complement Ther Clin Pract 2014; 20:188-92. [PMID: 25160991 DOI: 10.1016/j.ctcp.2014.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 06/12/2014] [Accepted: 07/09/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Although exposure to, and interaction with, natural environments are recognized as health-promoting, little is understood about the use of nature contact in treatment and rehabilitation for cancer survivors. METHODS This narrative review summarizes the literature exploring the influence of nature-based experiences on survivor health. Key databases included CINAHL, EMBASE, Medline, Web of Science, PubMed, PsycArticles, ProQuest, and Cancerlit databases. RESULTS Sixteen articles met inclusion criteria and were reviewed. Four major categories emerged: 1) Dragon boat racing may enhance breast cancer survivor quality of life, 2) Natural environment may counteract attentional fatigue in newly diagnosed breast cancer survivors, 3) Adventure programs provide a positive experience for children and adolescent survivors, fostering a sense of belonging and self-esteem, and 4) Therapeutic landscapes may decrease state-anxiety, improving survivor health. CONCLUSIONS This review contributes to a better understanding of the therapeutic effects of nature-based experiences on cancer survivor health, providing a point of entry for future study.
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Affiliation(s)
- Heather Ray
- Dept. of Physical Education and Recreation Studies, Faculty of Health & Community Studies, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada.
| | - Sonya L Jakubec
- School of Nursing & Midwifery, Faculty of Health & Community Studies, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, AB, T3E 6K6, Canada.
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18
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Ray HA, Verhoef MJ. Dragon boat racing and health-related quality of life of breast cancer survivors: a mixed methods evaluation. Altern Ther Health Med 2013; 13:205. [PMID: 23915045 PMCID: PMC3750614 DOI: 10.1186/1472-6882-13-205] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 07/31/2013] [Indexed: 12/24/2022]
Abstract
Background Breast cancer survivors who participate in physical activity (PA) are reported to experience improved health-related quality of life (HRQOL). However, the quantitative research exploring the relationship between the team-based activity of dragon boat racing and the HRQOL of breast cancer survivors is limited. Given the rising number of breast cancer survivors, and their growing attraction to dragon boating, further exploration of the influence of this activity on HRQOL is warranted. Methods This study is designed to: 1) quantitatively assess whether and how breast cancer survivors’ participation in a season of dragon boat racing is related to HRQOL and 2) qualitatively explore the survivors’ lived experience of dragon boating and how and why this experience is perceived to influence HRQOL. A mixed methods sequential explanatory design was used with the purpose of complementing quantitative findings with qualitative data. Quantitative data measuring HRQOL were collected at baseline and post-season (N = 100); semi-structured qualitative interviews were used to elicit a personal account of the dragon boat experience (N = 15). Results Statistically significant improvements were shown for HRQOL, physical, functional, emotional and spiritual well-being, breast cancer-specific concerns and cancer-related fatigue. A trend towards significance was shown for social/family well-being. Qualitative data elaborated on the quantitative findings, greatly enhancing the understanding of how and why dragon boat racing influences HRQOL. Conclusions The use of a mixed methods design effectively captured the complex yet positive influence of dragon boating on survivor HRQOL. These findings contribute to a growing body of literature supporting the value of dragon boat racing as a viable PA intervention for enhancing survivor HRQOL.
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19
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Van Puymbroeck M, Burk BN, Shinew KJ, Cronan Kuhlenschmidt M, Schmid AA. Perceived health benefits from yoga among breast cancer survivors. Am J Health Promot 2013; 27:308-15. [PMID: 23402226 DOI: 10.4278/ajhp.110316-qual-119] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to describe the health benefits reported by breast cancer survivors following an 8-week yoga intervention. DESIGN This phenomenological study employed three focus groups with six breast cancer survivors each (n = 18) following the yoga intervention. SETTING The focus groups and yoga classes were conducted in a large hospital in a midsized town in the Midwest. SUBJECTS Eighteen female breast cancer survivors who were at least 9 months posttreatment participated in the focus groups following the 8-week yoga intervention. INTERVENTION An 8-week yoga intervention designed specifically for this population was led by a yoga therapist. MEASURES A semistructured interview guide was utilized to guide each focus group. ANALYSIS Interpretative phenomenological analysis methods were employed to explore breast cancer survivors' experiences after participating in an 8-week yoga intervention. RESULTS The findings revealed that the women in the study found health promoting benefits in the areas of physical health and healing, mental health and healing, and social health and healing. CONCLUSIONS Yoga may be an important tool in the healing process for breast cancer survivors.
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Affiliation(s)
- Marieke Van Puymbroeck
- School of Public Health-Bloomington, Indiana University, 1025 E. 7th Street, Bloomington, IN 47405, USA.
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20
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"We're All in the Same Boat": A Review of the Benefits of Dragon Boat Racing for Women Living with Breast Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:167651. [PMID: 22811743 PMCID: PMC3395246 DOI: 10.1155/2012/167651] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 05/05/2012] [Accepted: 05/06/2012] [Indexed: 11/23/2022]
Abstract
This narrative review summarizes findings from quantitative and qualitative research literature that has been published over the past 15 years since an initial, community-based pilot study first challenged the long-held medical belief that vigorous, upper-body exercise would lead to lymphedema in women who were at risk due to treatments for breast cancer. Dragon boat racing originated in China more than 2000 years ago and has become a popular recreational and competitive support around the world. From the advent of the world's first breast cancer survivor dragon boat team, Abreast in a Boat launched in Vancouver, British Columbia, in 1996, there are now more than 140 breast cancer survivor dragon boat teams paddling and competing in 12 different countries. The wealth of quantitative and qualitative research that has ensued since that pilot study further supports the initial hypothesis that resistance exercise, for example, dragon boat paddling, is not only safe for women recovering from conventional breast cancer therapies but also shows that dragon boating has been embraced as a complementary exercise therapy by the cancer survivors participating in this magical sport.
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21
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Binkley JM, Harris SR, Levangie PK, Pearl M, Guglielmino J, Kraus V, Rowden D. Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer. Cancer 2012; 118:2207-16. [PMID: 22488695 DOI: 10.1002/cncr.27469] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Women's experience of breast cancer is complex, affecting all aspects of life during and after treatment. Patients' perspectives about common impairments and functional limitations secondary to breast cancer treatment, including upper extremity motion restriction, lymphedema, fatigue, weight gain, pain, and chemotherapy-induced peripheral neuropathy, are addressed. Women often report being uninformed regarding these side effects and surprised that they do not always disappear after treatment, but remain part of their lives. Breast cancer patients express strong, unmet needs for education, information, and intervention for these side effects. Evidence suggests that rehabilitation and exercise are effective in preventing and managing many physical side effects of breast cancer treatment. Nevertheless, few women are referred to rehabilitation during or after treatment, and fewer receive baseline assessments of impairment and function to facilitate early detection of impairment and functional limitations. The prospective surveillance model of rehabilitation will serve the needs of women with breast cancer by providing education and information about treatment side effects, reducing the incidence and burden of side effects through early identification and treatment, and enhancing access to timely rehabilitation. Integration of exercise as a component of the model benefits patients at every phase of survivorship, by addressing individual concerns about exercise during and after treatment and highlighting the important contribution of exercise to overall health and survival. The prospective surveillance model of rehabilitation can meet the evident and often expressed needs of survivors for information, guidance, and intervention--thus addressing, and potentially improving, overall quality of life for individuals diagnosed with and treated for breast cancer.
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Affiliation(s)
- Jill M Binkley
- TurningPoint Women's Healthcare, Alpharetta, Georgia 30022, USA.
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22
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Healey-Ogden MJ, Austin WJ. Uncovering the lived experience of well-being. QUALITATIVE HEALTH RESEARCH 2011; 21:85-96. [PMID: 20682969 DOI: 10.1177/1049732310379113] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The words well-being, health, and wellness are commonly used in an interchangeable manner by health care professionals and the lay public. We undertook a hermeneutic phenomenological study of well-being and discovered a soulful strength and a rhythmic flow to this lived experience. There is a letting go that is experienced as a tension and rhythmic interchange, as in breathing. Harmony and balance lie at its foundation. Well-being requires a personal drive to exist. It is not experienced through purposeful means; rather, it is experienced in a self-forgetful way, in the free space where life unfolds and where people come to see their worlds in different ways. The results of this research suggest the experience of well-being holds a significant place within nursing practice for clients and for nurses.
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23
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Brunet J, McDonough MH, Hadd V, Crocker PRE, Sabiston CM. The Posttraumatic Growth Inventory: an examination of the factor structure and invariance among breast cancer survivors. Psychooncology 2010; 19:830-8. [PMID: 19862767 DOI: 10.1002/pon.1640] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The present study tested the proposed five-factor structure and invariance of the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) in a sample of physically active breast cancer survivors. METHODS A sample of breast cancer survivors (N=470, Mage=57.3, SD=7.8 years) completed the PTGI and a demographic questionnaire. The factor structure, factorial invariance, and latent mean invariance were tested using maximum likelihood structural equation modeling. RESULTS Preliminary analyses showed acceptable reliability for the PTGI subscales (alpha<0.83). Confirmatory factor analysis (CFA) supported the five related factors corresponding to: relating to others, new possibilities, personal strength, spiritual change, and appreciation of life (chi(2) (179)=822.53, CFI=0.97, NNFI=0.96, SRMR=0.05, RMSEA=0.09). Multigroup CFA supported the invariance of the PTGI across age groups, treatment type, time since diagnosis, and time since last treatment. CONCLUSIONS These findings provide support for (1) the multidimensional nature and factorial validity of the PTGI, and (2) the use of the PTGI in future research examining posttraumatic growth within samples of physically active breast cancer survivors.
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Affiliation(s)
- Jennifer Brunet
- McGill University, Kinesiology and Physical Education, Montreal, Quebec, Canada
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24
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Repass M, Matusitz J. Problematic integration theory: implications of supportive communication for breast cancer patients. Health Care Women Int 2010; 31:402-20. [PMID: 20390662 DOI: 10.1080/07399330903359326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In this analysis, the authors apply Problematic Integration (PI) Theory to the way breast cancer patients engage in and receive support. The theory focuses on the relationship between expectations and desires, and enlightens cognitive and communicative responses to situations that involve tensions between their perceived likelihoods of occurrence and their perceived values. The relationship between PI Theory and its significance in treating and providing support for patients suffering from terminal illnesses is one of great interest to health care providers and those charged with creating supportive messages and support groups for those patients.
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Affiliation(s)
- Michael Repass
- Nicholson School of Communication, University of Central Florida, Orlando, Florida, USA
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25
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Hadd V, Sabiston CM, McDonough MH, Crocker PR. Sources of Stress for Breast Cancer Survivors Involved in Dragon Boating: Examining Associations with Treatment Characteristics and Self-Esteem. J Womens Health (Larchmt) 2010; 19:1345-53. [DOI: 10.1089/jwh.2009.1440] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Valerie Hadd
- University of British Columbia, Vancouver, British Columbia, Canada
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26
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Burke SM, Sabiston CM. The meaning of the mountain: exploring breast cancer survivors' lived experiences of subjective well‐being during a climb on Mt. Kilimanjaro. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/19398440903510137] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Whitehead S, Lavelle K. Older breast cancer survivors' views and preferences for physical activity. QUALITATIVE HEALTH RESEARCH 2009; 19:894-906. [PMID: 19448032 DOI: 10.1177/1049732309337523] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Evidence suggests that physical activity improves quality of life and physical functioning among breast cancer patients and survivors. However, previous studies have tended to focus on younger patients, despite higher incidence and lower survival among older breast cancer survivors. In this study we explored physical activity preferences of older breast cancer survivors to inform the development of future targeted interventions. Twenty-nine female breast cancer survivors (1 to 5 years postdiagnosis) aged 59 to 86 (mean 66.54, SD 6.50) took part in either a semistructured interview or a focus group exploring physical activity patterns, motivators, facilitators, barriers, and preferences. The main factors influencing physical activity were body image, weight issues, vitality, mood, and the desire to carry on as normal. Preference was expressed for activities that were gentle, tailored to age and cancer-related abilities, holistic, involving other older breast cancer survivors, and with an instructor who was knowledgeable about both breast cancer and aging.
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Affiliation(s)
- Sarah Whitehead
- University of Manchester School of Nursing, Midwiferry and Social Work, Manchester, United Kingdom
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28
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Sabiston CM, McDonough MH, Sedgwick WA, Crocker PRE. Muscle gains and emotional strains: conflicting experiences of change among overweight women participating in an exercise intervention program. QUALITATIVE HEALTH RESEARCH 2009; 19:466-480. [PMID: 19299753 DOI: 10.1177/1049732309332782] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In this study we explored the experiences of women who were classified as overweight while they participated in a physical activity intervention. In line with interpretative phenomenological analysis, eight women were interviewed prior to and following a 12-week dragon boat physical activity intervention. Data were transcribed verbatim and subjected to individual-level content analysis to explore change that informed group-level idiographic analysis. From the idiographic analysis three distinct profiles were created: (a) women who consistently struggled with negative self-perceptions; (b) women who consistently experienced positive self-perceptions; and (c) women who began with negative self-perceptions and developed more positive self-images. These profiles appeared to be associated with age, since the youngest women placed significant emphasis on the body and physical appearance, whereas the oldest participants reported the most significant shift from importance of body to a greater emphasis on health and well-being. The findings, which are reported in the context of self-determination theory, suggest that women in each of these profiles had unique physical and social self-perceptions and distinct social interactions within the dragon boat intervention.
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Affiliation(s)
- Catherine M Sabiston
- Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
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29
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Wassersug RJ, Oliffe JL. The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management. J Sex Med 2008; 6:989-1000. [PMID: 19175864 DOI: 10.1111/j.1743-6109.2008.01053.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Gynecomastia (breast development in males) is a side effect of androgen deprivation therapy (ADT) for prostate cancer (PCa). Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing. Shame from gynecomastia can lead patients to stop otherwise beneficial exercise. AIMS Our first aim is to explore the social context for gynecomastia and how it is interpreted by men with the condition, as well as by others, both male and female. Subsequently, we use our understanding of why gynecomastia is psychologically distressing to propose psychosocial interventions that could help men accept this side effect of ADT. METHODS We draw on academic literature, media accounts, and web-based testimonials from men with gynecomastia, to understand how gynecomastia is perceived by both patients and the medical community. We examine these resources in light of gynecomastia's impact on sex roles, sexuality, and gender identity issues. MAIN OUTCOME MEASURES By exploring what breasts in a male mean to the individual, we produce an understanding of the social context for distress from gynecomastia. From this understanding, we derive hypotheses about who might be most distressed from gynecomastia and strategies for alleviating this distress. RESULTS The shame and stigma of gynecomastia is linked to the objectification of women. We suggest that men fear that their breasts will marginalize and subordinate them within gender hierarchies. There is little evidence that breasts on a male erotically attract either men or women. Novel options for living with gynecomastia are contrasted with medicalized strategies including mastectomy. CONCLUSION Assessment instruments need to be developed to identify patients most likely to experience distress from gynecomastia and seek out medical interventions. Surgical, radiological, or pharmacological interventions may not be universally necessary if greater acceptance of gynecomastia is made available through psychosocial support programs. For example, PCa patients may learn to accept gynecomastia through reconceptualizing their breasts as autoerotic. Support programs modeled on those of the breast cancer community, including Encore and dragon boat racing, may also help to build communities to serve patients with gynecomastia while defending individuals against shame, isolation, and loss of self-esteem.
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Affiliation(s)
| | - John L Oliffe
- University of British Columbia-School of Nursing, Vancouver, Canada
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