Predictors of maintaining motivation to exercise in women with breast cancer – preliminary results of a qualitative study
Authors:
I. Burešová 1; J. Halámková 2; I. Kiss 2; I. Hrnčiříková 2; K. Kapounková 3; A. Ziklová 1
Published in:
Klin Onkol 2024; 38(Sborník abstrakt): 112-118
Category:
Article
doi:
https://doi.org/10.48095/ccko2023S112
Overview
Background: Given the importance of physical activity (PA) for treatment success, survival and quality of life in cancer patients, this study aimed to identify predictors that influence patients’ ability to maintain PA during and after treatment and to explore factors that help overcome barriers to PA engagement.
Patient population and methods: Mixed research design combining the results of longitudinal follow-up of selected psychophysiological correlates in breast cancer patients who participated in a movement program as part of their treatment with a retrospective qualitative investigation conducted through a focus group.
Results: In the group of respondents (N = 6, median of age 50.2 years) with the longest time since the end of the PA program (24 months), effective strategies to help patients maintain participation in the PA program and exercise activity after its completion were identified, including: individually tailored exercise plan, psychosocial support from medical staff and relatives, monitoring progress and providing feedback. Group exercise, support from loved ones and medical staff played an important role in increasing motivation to maintain participation in PA. Predictors of retention in physical activity included previous exercise routine, with psychological factors (motivation, self-regulation, self-confidence and perception of own physical fitness) also playing a key role. A combination of tailoring the exercise programme to individual needs, complemented by the provision of comprehensive support, appears to be highly effective. This approach helps patients overcome barriers to their engagement in regular PA and maximize its benefits.
Conclusion: The results of this study present a specific picture of the key psychological and health benefits of physical activity in breast cancer patients enrolled in a PA program, and also present a picture of predictors of retention in this activity, which is particularly relevant in the context of developing effective intervention programs in this area. Understanding these factors can lead to the development of targeted individualized strategies suitable for integration into existing treatment and care systems for cancer patients and survivors.
Keywords:
exercise – barriers – breast neoplasm – predictors – supporting factors
Sources
- Cramer H, Lauche R, Klose P et al. Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer. Cochrane Database Syst Rev 2017; 1 (1): CD010802. doi: 10.1002/14651858.CD010802.pub2.
- Misiąg W, Piszczyk A, Szymańska-Chabowska A et al. Physical activity and cancer care: a review. Cancers (Basel) 2022; 14 (17): 4154. doi: 10.3390/cancers14174154.
- Knols R, Aaronson NK, Uebelhart D et al. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 2005; 23 (16): 3830–3842. doi: 10.1200/JCO.2005.02.148.
- Knobf MT, Musanti R, Dorward J. Exercise and quality of life outcomes in patients with cancer. Semin Oncol Nurs 2007; 23 (4): 285–296. doi: 10.1016/j.soncn.2007.08.007.
- Cuthbert CA, King-Shier KM, Ruether JD et al. The effects of exercise on physical and psychological outcomes in cancer caregivers: results from the RECHARGE randomized controlled trial. Ann Behav Med 2018; 52 (8): 645–661. doi: 10.1093/abm/kax040.
- Patsou ED, Alexias GD, Anagnostopoulos FG et al. Effects of physical activity on depressive symptoms during breast cancer survivorship: a meta-analysis of randomised control trials. ESMO Open 2017; 2 (5): e000271. doi: 10.1136/esmoopen-2017-000271.
- Juvet LK, Thune I, Elvsaas IKØ et al. The effect of exercise on fatigue and physical functioning in breast cancer patients during and after treatment and at 6 months follow-up: a meta-analysis. Breast 2017; 33: 166–177. doi: 10.1016/j.breast.2017.04.003.
- Zyzniewska-Banaszak E, Kucharska-Mazur J, Mazur A. Physiotherapy and physical activity as factors improving the psychological state of patients with cancer. Front Psychiatry 2021; 12: 772694. doi: 10.3389/fpsyt.2021.772694.
- Rodríguez-Cañamero S, Cobo-Cuenca A, Carmona-Torres J et al. Impact of physical exercise in advanced-stage cancer patients: systematic review and meta-analysis. Cancer Med 2022; 11: 3714–3727. doi: 10.1002/cam4.4746.
- Lahart I, Metsios G, Nevill A, Carmichael A. Physical activity for women with breast cancer after adjuvant therapy. Cochrane Database Syst Rev 2014; CD011292. doi: 10.1002/14651858.CD011292.pub2.
- Pinto B, Dunsiger S, Waldemore M. Physical activity and psychosocial benefits among breast cancer patients. Psychooncology 2013; 22 (10): 193–199. doi: 10.1002/pon.3272.
- Zanghì M, Petrigna L, Maugeri G et al. The practice of physical activity on psychological, mental, physical, and social wellbeing for breast-cancer survivors: an umbrella review. Int J Environ Res Public Health 2022; 19 (16): 10391. doi: 10.3390/ijerph191610391.
- Friedenreich C, Katzmarzyk P, Powell K et al. Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc 2019; 51 (6): 1252–1261. doi: 10.1249/MSS.0000000000001937.
- Brown J, Winters-Stone K, Lee A et al. Cancer, physical activity, and exercise. Compr Physiol 2012; 2 (4): 2775–2809. doi: 10.1002/cphy.c120005.
- Schmidt T, Süß P, Schulte D et al. Supportive care in oncology—from physical activity to nutrition. Nutrients 2022; 14 (6): 1149. doi: 10.3390/nu14061149.
- Garcia D, Thomson C. Physical activity and cancer survivorship. Nutr Clin Pract 2014; 29 (6): 768–779. doi: 10.1177/0884533614551969.
- Lin C. Does physical activity have value in end-of-life cancer care? Cancer Nurs 2015; 38 (4): 251–252. doi: 10.1097/NCC.0000000000000271.
- Torregrosa C, Chorin F, Beltran E et al. Physical activity as the best supportive care in cancer: the clinician’s and the researcher’s perspectives. Cancers (Basel) 2022; 14 (21): 5402. doi: 10.3390/cancers14215402.
- Protani M, Coory M, Martin J. Effect of obesity on survival of women with breast cancer: Systematic review and meta-analysis. Breast Cancer Res Treat 2010; 123 (3): 627–635. doi: 10.1007/s10549-010-0990-0.
- Chan D, Vieira A, Aune D et al. Body mass index and survival in women with breast cancer—systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 2014; 25 (10): 1901–1914. doi: 10.1093/annonc/mdu042.
- Pajares B, Pollán M, Martín M et al. Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis. Breast Cancer Res 2013; 15 (6): R105. doi: 10.1186/bcr3572.
- Jung A, Hüsing A, Behrens S et al. Postdiagnosis weight change is associated with poorer survival in breast cancer survivors: a prospective population-based patient cohort study. Int J Cancer 2021; 148 (1): 18–27. doi: 10.1002/ijc.33181.
- van Waart H, Stuiver M, van Harten W et al. Effect of low-intensity physical activity and moderate- to high-intensity physical exercise during adjuvant chemotherapy on physical fitness, fatigue, and chemotherapy completion rates: Results of the PACES randomized clinical trial. J Clin Oncol 2015; 33 (17): 1918–1927. doi: 10.1200/JCO.2014.59.1081.
- Schmitz K, Campbell A, Stuiver M et al. Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA Cancer J Clin 2019; 69 (6): 468–484. doi: 10.3322/caac.21579.
- Avancini A, Pala V, Trestini I et al. Exercise levels and preferences in cancer patients: a cross-sectional study. Int J Environ Res Public Health 2020; 17 (15): 5351. doi: 10.3390/ijerph17155351.
- Hirschey R, Bryant A, Macek C et al. Predicting physical activity among cancer survivors: meta-analytic path modeling of longitudinal studies. Health Psychol 2020; 39 (4): 269–280. doi: 10.1037/hea0000845.
- Ungar N, Wiskemann J, Sieverding M. Physical activity enjoyment and self-efficacy as predictors of cancer patients’ physical activity level. Front Psychol 2016; 7: 898. doi: 10.3389/fpsyg.2016.00898.
- Kampshoff C, van Mechelen W, Schep G et al. Participation in and adherence to physical exercise after completion of primary cancer treatment. Int J Behav Nutr Phys Act 2016; 13 (1): 100. doi: 10.1186/s12966-016-0425-3.
- Frikkel J, Götte M, Beckmann M et al. Fatigue, barriers to physical activity and predictors for motivation to exercise in advanced cancer patients. BMC Palliat Care 2020; 19 (1): 43. doi: 10.1186/s12904-020-00542-z.
- Vallance J, Plotnikoff R, Karvinen K et al. Understanding physical activity maintenance in breast cancer survivors. Am J Health Behav 2010; 34 (2): 225–236. doi: 10.5993/AJHB.34.2.10.
- Husebø A, Dyrstad S, Søreide J et al. Predicting exercise adherence in cancer patients and survivors: a systematic review and meta-analysis of motivational and behavioural factors. J Clin Nurs. 2013; 22 (1–2): 4–21. doi: 10.1111/j.1365-2702.2012.04322.x.
- Browall M, Mijwel S, Rundqvist H et al. Physical activity during and after adjuvant treatment for breast cancer: an integrative review of women’s experiences. Integr Cancer Ther 2018; 17 (1): 16–30. doi: 10.1177/1534735416683807.
- Takemura N, Ho M, Cheung D et al. Effectiveness of motivational strategies on physical activity behavior and associated outcomes in patients with cancer: a systematic review and meta-analysis. Worldviews Evid Based Nurs 2023; 21 (3): 253–262. doi: 10.1111/wvn.12691.
- Pudkasam S, Feehan J, Talevski J et al. Motivational strategies to improve adherence to physical activity in breast cancer survivors: a systematic review and meta-analysis. Maturitas 2021; 152: 32–47. doi: 10.1016/J.MATURITAS.2021.06.008.
- Hardcastle S, Maxwell-Smith C, Hince D et al. The wearable activity technology and action-planning trial in cancer survivors: physical activity maintenance post-intervention. J Sci Med Sport 2021; 24 (9): 902–907. doi: 10.1016/j.jsams.2021.04.004.
- IJsbrandy C, Ottevanger P, Diogeni M et al. Effectiveness of implementation strategies to increase physical activity uptake during and after cancer treatment: a systematic review. Crit Rev Oncol Hematol 2018; 122: 157–163. doi: 10.1016/j.critrevonc.2017.09.005.
- Berclaz G, Li S, Price K et al. Body mass index as a prognostic feature in operable breast cancer: The International Breast Cancer Study Group experience. Ann Oncol 2004; 15 (6): 875–884. doi: 10.1093/annonc/mdh222.
- But-Hadžić J, Dervisevic M, Karpljuk D et al. Six-minute walk distance in breast cancer survivors—a systematic review with meta-analysis. Int J Environ Res Public Health 2021; 18 (5): 2591. doi: 10.3390/ijerph18052591.
- Šestiminutový test chůze. [online]. Dostupné z: https: //www.tribune.cz/archiv/sestiminutovy-test-chuzi/.
- Nyrop K, Williams G, Muss H et al. Weight gain during adjuvant endocrine treatment for early-stage breast cancer: what is the evidence? Breast Cancer Res Treat 2016; 158 (2): 203–217. doi: 10.1007/s10549-016-3874-0.
- Berg M, Winkels R, Kruif J et al. Weight change during chemotherapy in breast cancer patients: a meta-analysis. BMC Cancer 2017; 17 (1): 259. doi: 10.1186/s12885-017-3242-4.
- Pedersen B, Delmar C, Bendtsen M et al. Changes in weight and body composition among women with breast cancer during and after adjuvant treatment: a prospective follow-up study. Cancer Nurs 2017; 40 (5): 369–376. doi: 10.1097/NCC.0000000000000426.
- Avancini A, Tregnago D, Rigatti L et al. Factors influencing physical activity in cancer patients during oncological treatments: a qualitative study. Integr Cancer Ther 2020; 19: 1534735420971365. doi: 10.1177/15347354209 71365.
- 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 (1): 50. doi: 10.1186/s12966-021-01116-9.
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