Physical Activity Enjoyment and Self-Efficacy As Predictors of Cancer Patients' Physical Activity Level

Abstract

Background: Physical activity (PA) can support cancer patients during medical treatment by reducing side-effects and increasing quality of life. However, PA levels mostly decline after diagnosis. Which factors can explain if patients are able to remain or even increase their PA level? Self-efficacy is an important cognitive factor that has been linked to cancer patients' PA across many studies. In contrast, affective factors such as PA enjoyment have rarely been examined. We compare the influence of self-efficacy and PA enjoyment on cancer patients' PA levels after completion of an exercise or stress-management intervention.Methods: Outpatient cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34%, 15%)] were enrolled in the MOTIVACTION study, a 4-week intervention (1 h counseling followed by weekly phone calls), with pre-test (T1), post-test (T2), and a 10-week follow-up (T3). Participants were randomized to either an exercise intervention (emphasizing self-regulatory strategies for behavior change) or to a stress management intervention (coping and relaxation techniques). Sixty-seven patients remained in the study and completed the SQUASH assessment of PA, a measure of maintenance self-efficacy (7 items, Cronbach's α = 0.88) and PA enjoyment (2 items, Cronbach's α = 0.89). Regression analyses were calculated with PA level (at T2 and T3) as dependent variable and relative weight analyses were conducted. The study was registered at clinicalTrials.gov (unique identifier:NCT01576107; URL: https://clinicaltrials.gov/ct2/show/NCT01576107?term=motivaction&rank=1).Results: Baseline self-efficacy and change in PA enjoyment significantly predicted cancer patients' PA level at T2 adjusting for baseline PA and type of intervention. Relative weight (RW) analysis revealed that PA enjoyment (baseline and change together) explained 34.3% of the dependent variable, self-efficacy (baseline and change) explained 38.4%. At follow-up, self-efficacy was still a significant predictor of PA (RW = 74.6%), whereas PA enjoyment was no longer a relevant factor (RW = 5.2%).Conclusion: The affective factor PA enjoyment was equally important as self-efficacy for predicting cancer patient' PA level directly after completion of the intervention. Reasons for the reduced relevance at follow-up and a broader range of affective factors should be analyzed in future studies on cancer patients' PA level.

Feasibility of a home-based exercise intervention with remote guidance for patients with stable grade II and III gliomas: a pilot randomized controlled trial

“…Third, patients were allowed, within certain limits, to choose their own activities. Current evidence suggests that exercise enjoyment is an important determinant of physical activity and exercise self-efficacy [28, 29]. These elements are aimed at implementation of regular exercise in patients’ daily routines and may aid continuing to exercise after the intervention period had ended [27, 30].…”

Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study

“…Cancer patients face further obstacles on account of their condition (e.g., cancer-related fatigue, muscle weakness, nausea, sleep disorders) [22,23]. To develop a successful exercise intervention, cancer patients' barriers and preferences must be considered, allowing them to pick the activities they perceive as beneficial and enjoyable [23][24][25][26]. International studies investigated the preferences and determinants of exercise levels in cancer patients and survivors [18,[27][28][29][30][31][32][33], but data on the Italian population are lacking.…”

Long Term Effects of Behavioural Interventions to Increase Exercise Among Breast Cancer Patients After Medical Rehabilitation: secondary Analysis of a Randomized Controlled Trial

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