Perceived barriers to and facilitators of being physically active during adjuvant cancer treatment

Henriksson, Anna; Arving, Cecilia; Johansson, Birgitta; Igelström, Helena; Nordin, Karin

doi:10.1016/j.pec.2016.01.019

Cited by 61 publications

(68 citation statements)

References 26 publications

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“…[21][22][23][24][25][26][27] The aim of this study was to explore physically inactive breast and colon cancer patients' prediagnosis exercise history, attitudes to and experiences in initiating physical activity while undergoing adjuvant chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Rethinking exercise identity: a qualitative study of physically inactive cancer patients’ transforming process while undergoing chemotherapy

et al. 2017

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ObjectiveTo explore physically inactive breast and colon cancer patients’ prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy.DesignAn explorative qualitative study guided the interpretive analysis of semistructured, open-ended interviews conducted at initiation of chemotherapy and after 12 weeks. The study was embedded in a pilot randomised controlled trial.SettingParticipants were recruited from the Oncological Department at a hospital in Copenhagen, Denmark.Participants33 patients with cancer, median age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist’s PA recommendation and exercise, cancer nurse specialist’s counselling prior to allocation to PA interventions or waitlist control group.ResultsPrediagnosis exercise had been excluded from patients’ daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients to reconsider their attitudes and behaviour by accepting recruitment and participation in PA interventions during chemotherapy. Despite extensive side effects, most patients adhered to their PA commitment due to their perception of the bodily, emotional and social benefits and support of healthcare professionals, peers and family.ConclusionThe patients’ attitude towards exercise transformed from having no priority in patients’ daily lives prediagnosis to being highly prioritised. This study identified four important phases in the exercise transformation process during the patients’ treatment trajectory of relevance to clinicians in identifying, motivating and supporting physically inactive patients with cancer at long-term risk. Clinicians should address young, highly educated patients with cancer at onset of adjuvant chemotherapy due to their specific risk of a sedentary lifestyle resulting from being in stressful, ambitious careers.Trial registration numberCurrent Controlled Trials (ISRCTN24901641), Stage: Qualitative results.

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Section: Introductionmentioning

confidence: 99%

Rethinking exercise identity: a qualitative study of physically inactive cancer patients’ transforming process while undergoing chemotherapy

et al. 2017

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“…Patients mentioned mainly fatigue, nausea, and not feeling well on the day of the chemotherapy administration as barriers to physical activity, since it interfered with their ability to exercise. Nevertheless, it should be considered that before treatment initiation patients can have comorbidities that affect their ability to engage in physical activity [83]. In addition to this, the notion of self-image should also be considered.…”

Section: Barriers and Facilitators To Practice: How Can Physical Actimentioning

confidence: 99%

“…Organizational barriers are the second theme among limitations to physical activity practice. Firstly, the distance between home or the workplace and the sports facility frequently appears as a considerable limitation [83, 86-88]. What is more, infrastructures are often located in cities, so access is more difficult for those who live in the countryside.…”

Section: Barriers and Facilitators To Practice: How Can Physical Actimentioning

confidence: 99%

“…First of all, receiving information about the benefits of physical activity during treatment is highly important [83]. Some studies have shown that patients who are aware of the benefits of exercise during treatment are more active than those who do not have this information [96].…”

Section: Barriers and Facilitators To Practice: How Can Physical Actimentioning

confidence: 99%

“…Finally, a personal background of physical activity is also important, because it is easier for patients to continue a physical activity practice during treatment if they were already active before. For other patients, diagnosis appears to be a trigger and a motivational factor that encouragess them to take care of themselves [83]. …”

Section: Barriers and Facilitators To Practice: How Can Physical Actimentioning

confidence: 99%

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Treatment-Induced Cardiotoxicity in Breast Cancer: A Review of the Interest of Practicing a Physical Activity

et al. 2019

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Physical activity is known to prevent the occurrence of cancer and decrease the risk of breast cancer. At diagnosis of breast cancer, fewer than half of the patients reach the international recommendation for physical activity. However, breast cancer patients, and particularly HER2+ breast cancer patients, are exposed to treatment-induced cardiotoxicity because of a side effect of 2 molecules used in standard therapy to treat these tumors, i.e., anthracycline and trastuzumab. Cardiotoxicity can sometimes lead to discontinuation of the treatment and even to the development of cardiovascular diseases. Exercise is known to protect the cardiovascular system in the healthy population. Consequently, being physically active during treatment appears to be a way to prevent the negative impact of cancer treatment on the heart in this population. In particular, aerobic exercising could have a protective effect against treatment-induced cardiotoxicity. A supervised physical activity program seems to be the best way for breast cancer patients to be active during treatment. However, there is very little information, and in particular a lack of guidelines, on exercising available to patients. The interventional trials that have been conducted on this topic are very heterogeneous and no standard recommendations have been made available for cancer patients thus far. An effective physical activity program needs to take each patient’s barriers and motivations into account in order to encourage the practice of physical activity throughout treatment. To ensure the success of the program, it is essential to facilitate adherence and especially maintain motivation. Further studies are needed to determine what practice guidelines oncologists should give their patients.

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Barriers and facilitators to participating in physical activity for adults with breast cancer receiving adjuvant treatment: A qualitative metasynthesis

et al. 2019

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Objective Physical activity can improve the health and well‐being of individuals receiving adjuvant treatment for breast cancer, but engagement in physical activity can be low. This review synthesises the barriers and facilitators to engaging with and participating in physical activity whilst receiving treatment. Methods The metasynthesis of qualitative studies is reported in line with the PRISMA statement. We systematically searched eight databases (MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, British Library, OpenGrey, and Conference Proceedings Citation Index) from inception to November 30, 2017. A total of 1276 abstracts were retrieved and screened by two reviewers independently. Data from eligible studies were extracted and critically appraised. As this review concerns qualitative studies only, a CER‐QUAL GRADE assessment was completed. Results A total of 13 studies were included. Four clear themes emerged (side effects of treatment, beliefs about physical activity, focus on health not illness, and social factors) each containing both barriers and facilitators. Key facilitators to participating in physical activity during adjuvant treatment included positive physical benefits, improvements in psychological well‐being, and increased self‐esteem and empowerment. Further, having a knowledgeable instructor, tailored information, and a supportive environment were important to women undergoing treatment. Main barriers included fatigue and pain, as well as work and caring responsibilities. Conclusions Incorporating physical activity into treatment regimens is important. Focusing on being less sedentary and providing accurate, tailored information should be prioritised within future interventions. Having a supportive environment and accounting for the particular barriers or facilitators to engagement identified here should aid the success of future interventions.

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Perceived barriers to and facilitators of being physically active during adjuvant cancer treatment

Cited by 61 publications

References 26 publications

Rethinking exercise identity: a qualitative study of physically inactive cancer patients’ transforming process while undergoing chemotherapy

Rethinking exercise identity: a qualitative study of physically inactive cancer patients’ transforming process while undergoing chemotherapy

Treatment-Induced Cardiotoxicity in Breast Cancer: A Review of the Interest of Practicing a Physical Activity

Barriers and facilitators to participating in physical activity for adults with breast cancer receiving adjuvant treatment: A qualitative metasynthesis

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