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Adamczak BB, Kuźnik Z, Makles S, Wasilewski A, Kosendiak AA. Physical Activity, Alcohol, and Cigarette Use in Urological Cancer Patients over Time since Diagnosis. Healthcare (Basel) 2023; 12:59. [PMID: 38200965 PMCID: PMC10779175 DOI: 10.3390/healthcare12010059] [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: 11/05/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
Urological cancers represent a substantial global public health concern, exerting far-reaching effects on both individuals and their families. There is an urgent need to comprehensively understand the transformations in patients' lifestyles and behaviors, given their critical role in the treatment process and overall well-being. This study, involving 128 urological cancer patients, aims to investigate changes in physical activity levels, problematic drinking behaviors assessed through the Alcohol Use Disorders Identification Test (AUDIT), and smoking habits assessed using the Fagerström Test for Nicotine Dependence (FTND) over four distinct time intervals over the subsequent three years from the time of diagnosis and among individuals diagnosed more than three years ago. The results reveal a significant decrease in physical activity levels between study intervals (p < 0.0001), declining from 69% to 45% between the first and second post-diagnosis assessments. Furthermore, the highest levels of problematic substance use, indicated by mean scores, were noted in the first year following diagnosis (AUDIT: 4.20, p = 0.01; FTND: 4.83, p = 0.08). Given the significant impact of physical activity on the prospects of recovery, it is imperative to delve more deeply into the factors contributing to this decline and devise targeted interventions for its improvement. In the context of substance use, it is essential to ascertain whether the initially high levels are a result of coping with the cancer diagnosis or represent a turning point at which patients modify their behaviors and cease their addiction. A more thorough understanding of this phenomenon would enhance the effectiveness of precisely focused interventions.
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Affiliation(s)
- Bartosz Bogusz Adamczak
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Zofia Kuźnik
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Szymon Makles
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Andrzej Wasilewski
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
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Boesenecker SJ, Mathies V, Buentzel J, Huebner J. How can counselling by family physicians on nutrition and physical activity be improved: trends from a survey in Germany. J Cancer Res Clin Oncol 2023; 149:3335-3347. [PMID: 35932301 PMCID: PMC10314832 DOI: 10.1007/s00432-022-04233-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Cancer and its therapy causes severe symptoms, most of which are amendable to nutrition and physical activity (PA). Counselling on nutrition and PA empowers patients to take part more actively in their treatment. Many cancer patients are yet in need of information on these topics. In this study, we investigate the perception of family physicians (FP) on nutrition and PA in cancer patient care and assess barriers and steps to improve their involvement in counselling on these topics. METHODS Based on qualitative content analysis of 5 semi-structured interviews with FP, a questionnaire was developed and completed by 61 German FP. RESULTS Most of the FP acknowledged the importance of nutrition and PA during (91.4%) and after (100%) cancer therapy. While many participants were involved in cancer patient care, 65.6% of FP viewed themselves as primary reference person to address these topics. However, a third (32.8%) of FP were unfamiliar with information thereof. Some were unsatisfied regarding timely updates on their patient's treatment course via discharge letters (25.0%) or phone calls (36.2%). FP would like to dedicate more consultation time addressing nutrition and PA than they currently do (p < 0.001). CONCLUSION Communication btween healthcare practitioners about mutual cancer patient's treatment must be improved, e.g. utilising electronic communication to quicken correspondence. Acquisition of information on nutrition and PA in cancer patient care needs to be facilitated for FP, approachable by compiling reliable information and their sources. Involvement of FP in structured treatment programs could benefit cancer patient care. TRIAL REGISTRATION NUMBER (May 7, 2021): 2021-2149-Bef.
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Affiliation(s)
- S J Boesenecker
- Clinic for Internal Medicine II, University Hospital, Bachstraße 18, 07743, Jena, Germany.
| | - V Mathies
- University Tumor Center, University Hospital, Jena, Germany
| | - J Buentzel
- Clinic for Otorhinolaryngology, Head Neck Surgery, Suedharz Klinikum, Nordhausen, Germany
| | - J Huebner
- Clinic for Internal Medicine II, University Hospital, Bachstraße 18, 07743, Jena, Germany
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Ha DM, Nunnery MA, Klocko RP, Haverhals LM, Bekelman DB, New ML, Randhawa SK, Stevens-Lapsley JE, Studts JL, Prochazka AV, Keith RL. Lung cancer survivors' views on telerehabilitation following curative intent therapy: a formative qualitative study. BMJ Open 2023; 13:e073251. [PMID: 37355268 PMCID: PMC10314696 DOI: 10.1136/bmjopen-2023-073251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/09/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES To inform personalised home-based rehabilitation interventions, we sought to gain in-depth understanding of lung cancer survivors' (1) attitudes and perceived self-efficacy towards telemedicine; (2) knowledge of the benefits of rehabilitation and exercise training; (3) perceived facilitators and preferences for telerehabilitation; and (4) health goals following curative intent therapy. DESIGN We conducted semi-structured interviews guided by Bandura's Social Cognitive Theory and used directed content analysis to identify salient themes. SETTING One USA Veterans Affairs Medical Center. PARTICIPANTS We enrolled 20 stage I-IIIA lung cancer survivors who completed curative intent therapy in the prior 1-6 months. Eighty-five percent of participants had prior experience with telemedicine, but none with telerehabilitation or rehabilitation for lung cancer. RESULTS Participants viewed telemedicine as convenient, however impersonal and technologically challenging, with most reporting low self-efficacy in their ability to use technology. Most reported little to no knowledge of the potential benefits of specific exercise training regimens, including those directed towards reducing dyspnoea, fatigue or falls. If they were to design their own telerehabilitation programme, participants had a predominant preference for live and one-on-one interaction with a therapist, to enhance therapeutic relationship and ensure correct learning of the training techniques. Most participants had trouble stating their explicit health goals, with many having questions or concerns about their lung cancer status. Some wanted better control of symptoms and functional challenges or engage in healthful behaviours. CONCLUSIONS Features of telerehabilitation interventions for lung cancer survivors following curative intent therapy may need to include strategies to improve self-efficacy and skills with telemedicine. Education to improve knowledge of the benefits of rehabilitation and exercise training, with alignment to patient-formulated goals, may increase uptake. Exercise training with live and one-on-one therapist interaction may enhance learning, adherence, and completion. Future work should determine how to incorporate these features into telerehabilitation.
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Affiliation(s)
- Duc M Ha
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mary A Nunnery
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Robert P Klocko
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Leah M Haverhals
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Division of Health Care Policy and Research, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - David B Bekelman
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Melissa L New
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Simran K Randhawa
- Surgical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Division of Thoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jennifer E Stevens-Lapsley
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Geriatric Research, Education, and Clinical Center, Research Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
| | - Jamie L Studts
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Allan V Prochazka
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Robert L Keith
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, Colorado, USA
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Machado P, Pimenta S, Garcia AL, Nogueira T, Silva S, Oliveiros B, Martins RA, Cruz J. Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial. J Clin Med 2023; 12:jcm12082971. [PMID: 37109307 PMCID: PMC10146369 DOI: 10.3390/jcm12082971] [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: 02/23/2023] [Revised: 03/16/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. METHODS We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4-5 weeks after surgery. RESULTS Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, -1.5; 95% CI, from -2.1 to -0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. CONCLUSION A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies.
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Affiliation(s)
- Pedro Machado
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
- Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
- Physioclem, Physical Therapy Clinics, 2460-042 Alcobaça, Portugal
| | - Sara Pimenta
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
| | - Ana Luís Garcia
- Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal
| | - Tiago Nogueira
- Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal
| | - Sónia Silva
- Pulmonology Department, Leiria Hospital Center, 2410-197 Leiria, Portugal
| | - Bárbara Oliveiros
- Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Raul A Martins
- Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
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Ulrich GR, Callan S, Ranby KW. Beliefs and interests in physical activity programs of cancer survivors and their romantic partners. J Cancer Surviv 2023; 17:160-173. [PMID: 33595753 PMCID: PMC7886842 DOI: 10.1007/s11764-021-00996-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/18/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Physical activity is associated with improved health outcomes for cancer survivors and their romantic partners, yet it is unclear if joint exercise programs for survivor-partner dyads are acceptable. This study examined demographic, relationship, exercise, and cancer history correlates of survivors' and their romantic partners' couples-based exercise beliefs and their preferences for program designs. METHODS All participants (survivors n=209, partners n=155, couples n=143) completed an online survey. Correlations and linear regression analyses were used to examine correlates of participants' importance of and interest in couples-based exercise and their likelihood of joining a couples-based exercise program. Intraclass correlations estimated shared variance at the couple level. RESULTS Most participants believed that couples-based exercise was highly important (51.8%) and were interested in a couples-based exercise program (61.5%), but fewer survivors believed their partner would be interested or would likely join a couples-based program. Across all outcomes, partner support for exercise was most strongly associated with participants' couples-based exercise beliefs (r = 0.19-0.54, p<.05), and couples were significantly aligned in their beliefs (ρ=0.20-0.31, p<.01). Participants were interested in exercise programs involving exercising together (67.3%) as well as exercising separately while sharing activity data on an app or website (48.0%). CONCLUSIONS This novel understanding of couples-based exercise beliefs provides a strong foundation upon which future exercise programs may be designed for survivors and their romantic partners. IMPACT FOR CANCER SURVIVORS Survivors' adoption and maintenance of exercise may be enhanced by the inclusion of romantic partners in exercise programs, and partners' inclusion is appealing to couples.
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Affiliation(s)
- G R Ulrich
- Department of Psychology, University of Colorado Denver, Denver, CO, USA.
| | - S Callan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - K W Ranby
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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Takemura N, Cheung DST, Fong DYT, Lin CC. Promoting moderate-to-vigorous physical activities in patients with advanced lung cancer: preferences and social cognitive factors, and the mediating roles. Support Care Cancer 2022; 30:7419-7429. [PMID: 35622150 PMCID: PMC9136819 DOI: 10.1007/s00520-022-07149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/13/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to assess the prevalence and preferences of moderate-to-vigorous physical activities (MVPA) in patients with advanced lung cancer, explore the social cognitive factors that were associated with MVPA and interest in PA counseling and program, and examine the mediating role of social cognitive factors. METHODS This was a cross-sectional study. Questionnaires on PA levels, PA counseling and programming preferences, and social cognitive variables (social support and self-efficacy) were administered to 105 patients with advanced lung cancer. Linear regression model was used to explore the social cognitive factors associated with MVPA, and logistic regression model was used to explore the factors associated with interest in PA counseling and program. Mediation analysis was used to examine the mediating role of self-efficacy on social support and MVPA. RESULTS Merely 30.5% of patients met the recommended level of MVPA; however, the majority of patients (89.5%) were interested in PA program. Social support (β = 0.60; p = 0.007) and self-efficacy (β = 1.06; p = 0.027) were positively associated with MVPA. Specifically, self-efficacy mediated the relationship between social support and MVPA (β = 0.63, p = 0.004). CONCLUSION The majority of the patients with advanced lung cancer did not meet the recommended level of MVPA; however, they are interested in receiving PA counseling and joining PA programs. Social support was key to promoting higher levels of MVPA, and the association was mediated by self-efficacy. The established mediating model provides insights into designing PA programs and targeting the mediating variable, self-efficacy, to enhance the level of MVPA.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, Hong Kong.
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Exercise in lung Cancer, the Healthcare providers Opinion (E.C.H.O.): results of the EORTC Lung Cancer Group (LCG) survey. Lung Cancer 2022; 169:94-101. [DOI: 10.1016/j.lungcan.2022.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 12/21/2022]
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Zhou W, Webster KE, Smith EL, Chen W, Veliz PT, Reddy RM, Larson JL. Physical activity in surgical lung cancer patients: a systematic review. Support Care Cancer 2022; 30:6473-6482. [PMID: 35384612 DOI: 10.1007/s00520-022-07018-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/25/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Perioperative exercise could improve health outcomes of surgical lung cancer patients, but less is known about their natural physical activity (PA) behavior before exercise interventions. This review aimed to synthesize evidence on PA, regarding the following: (1) proportion of patients meeting PA guidelines, (2) amount of PA, (3) PA trajectory following surgery, and (4) correlates of PA before or after surgery. METHODS We conducted a systematic review using PubMed, CINHAL, Scopus, and SPORTDiscus (July 2021). Observational or experimental studies that measure PA of lung cancer patients before/after surgery were included. We assessed methodological quality using the NIH Quality Assessment Tools and extracted data using a standardized form. RESULTS Seventeen studies (25 articles, N = 1737 participants) published between 2009 and 2021 were included. Fourteen studies had sample sizes less than 100. Thirteen studies were of fair quality and four studies were of good quality. Only 23-28% of patients met PA guideline (150 min/week moderate-vigorous PA) at 6 months-6 years after surgery. Patients took an average of 3822-10,603 daily steps before surgery and 3934-8863 steps at 1-3 months after surgery. Physical activity was lower at 1 day-3 months after surgery, compared with preoperative levels. Perioperative PA was positively associated with exercise capacity, quality of life and reduced postoperative complications. CONCLUSION This review suggests that PA is low among surgical lung cancer patients, and it may not recover within 3 months following surgery. Physical activity has the potential to improve postoperative outcomes. However, the existing evidence is weak, and future larger longitudinal studies are needed.
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Affiliation(s)
- Weijiao Zhou
- School of Nursing, University of Michigan, Ann Arbor, MI, USA.
| | | | - Ellen Lavoie Smith
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Philip T Veliz
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Rishindra M Reddy
- Department of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Janet L Larson
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Belloni S, Arrigoni C, Caruso R. Effects from physical exercise on reduced cancer-related fatigue: a systematic review of systematic reviews and meta-analysis. Acta Oncol 2021; 60:1678-1687. [PMID: 34396915 DOI: 10.1080/0284186x.2021.1962543] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cancer-related fatigue is one of the most prevalent and distressing symptoms among cancer patients, resulting in a great cancer research challenge. Numerous systematic reviews of physical training interventions have been conducted to find the most effective approach. However, evidence remains fragmented, and in which cancer population physical training is more effective than other populations is still unclear. Thus, this study critically appraised systematic reviews and meta-analyses on physical training to reduce adults' cancer-related fatigue. METHODS A systematic review of systematic reviews and meta-analysis (PROSPERO: CRD42020189049), assessing the efficacy of exercise training for reducing cancer-related fatigue in adults, was conducted in PubMed, CINAHL, Cochrane Database of Systematic Reviews, and the Database of Abstracts of Reviews of Effects, and Pedro. The selected studies (standardized mean difference, SMD; 95%CI), was quantitatively pooled using a random-effects model. Heterogeneity was tested using chi-squared (Q) and I-square statistics (I2). RESULTS Of 1438 identified articles, 11 met the inclusion criteria, and ten were meta-analyzed. The results yielded a positive effect of physical training on fatigue in all cancer populations, SMD = -0.33 (-0.43, -0.23). Subgroup analysis based on tumor localization showed a slightly higher physical training effect on fatigue in adults with breast cancer, SMD = -0.36 (-0.57, -0.15), and prostate cancer SMD = -0.34 (-0.45, -.0.22). CONCLUSIONS Our analysis demonstrated some potential improvement in cancer-related fatigue in adult patients undergoing physical training during and after cancer treatments, particularly in patients with breast or prostate cancer.
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Affiliation(s)
- Silvia Belloni
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy
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Mitchell KG, Bostock IC, Antonoff MB. Social Disparities in Thoracic Surgery Database Research: Implications and Impact. Thorac Surg Clin 2021; 32:83-90. [PMID: 34801199 DOI: 10.1016/j.thorsurg.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A complex relationship exists between health care disparities and large databases among the thoracic surgical patient population. Using the example of thoracic malignancies, the ability of investigations leveraging large databases and novel analytical approaches to highlight disparate access to care and discordant outcomes following treatment is illustrated. Large, widely used databases may not be representative of the thoracic surgical patient population as a whole, and caution must be used when interpreting and generalizing results gleaned from such database analyses. Ensuring appropriate representation of all relevant patient subgroups in research databases will improve external generalizability and scientific validity of future investigations.
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Affiliation(s)
- Kyle G Mitchell
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1489, Houston, TX 77030, USA
| | - Ian C Bostock
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1489, Houston, TX 77030, USA
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1489, Houston, TX 77030, USA.
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Jonsson M, Westerdahl E, Ahlsson A, Hurtig-Wennlöf A. Validation of two self-reported physical activity instruments against accelerometer data in patients undergoing lung cancer surgery. Physiother Theory Pract 2021; 38:3119-3125. [PMID: 34689680 DOI: 10.1080/09593985.2021.1994071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Finding ways of identifying patients with low levels of physical activity after lung cancer surgery would be beneficial when planning and providing interventions aimed at increasing physical activity. PURPOSE To validate two self-reported physical activity instruments against accelerometer data. METHODS Self-reported physical activity was assessed with the four category One Month Physical Activity Question (OMPAQ) and the International Physical Activity Questionnaire modified for the elderly (IPAQ-E). Objective measurement of physical activity was performed with the Actigraph GT3X+ accelerometer. All measurements were performed three months after lung cancer surgery. RESULTS Three months after surgery, 83 patients provided complete physical activity measurements. There were statistically significant correlations between both of the self-reported physical activity assessed by OMPAQ (r = 0.54, p < .01) as well as IPAQ-E (r = 0.50, p < .01) and objectively measured physical activity (steps/day). The correlations were consistently stronger for the higher intensities of physical activity. Both instruments could identify patients not reaching the recommended levels of physical activity. CONCLUSION Both OMPAQ and IPAQ-E give valid information on physical activity after lung cancer surgery, and might be used for screening patients in clinical settings. The OMPAQ provided stronger correlation and specificity than the IPAQ-E, and might be the preferred clinical choice.
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Affiliation(s)
- Marcus Jonsson
- Department of Physiotherapy, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Elisabeth Westerdahl
- Department of Physiotherapy, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anders Ahlsson
- Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Anita Hurtig-Wennlöf
- School of Health Sciences, Department of Medical Diagnostics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,The Biomedical Platform, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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12
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Cheung DST, Takemura N, Chau PH, Ng AYM, Xu X, Lin CC. Exercise levels and preferences on exercise counselling and programming among older cancer survivors: A mixed-methods study. J Geriatr Oncol 2021; 12:1173-1180. [PMID: 33985930 DOI: 10.1016/j.jgo.2021.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess exercise levels and exercise counselling /programming preferences among older cancer survivors. MATERIALS AND METHODS A mixed-methods study design was employed. Quantitative instruments on exercise levels, exercise counselling and programming preferences, frailty status, and cancer-related symptoms were administered to 290 post-treatment older cancer survivors aged ≥65. Twelve participants with different exercise levels and different views on exercise counselling and programming were purposively selected to participate in semi-structured interviews. RESULTS Overall, 58.3% of participants did not meet the recommended exercise guidelines, and 44.1% were not engaging in any vigorous or moderate exercise. Frail survivors were less likely to meet the guidelines (aOR = 0.194, 95%CI = 0.053, 0.712) compared to their robust counterparts. However, 66.9% and 62.8% of participants expressed a definite or possible interest in receiving exercise counselling and participating in an exercise program, respectively. Particularly, survivors who are male, did not receive chemotherapy, are less educated, and have higher symptom burden were less likely to show interest. Most preferred low-intensity exercise (59.8%) and wanted to start the exercise program after treatment (68.2%), which differs from the literature on general adult survivors. The major trigger to initiate and maintain exercise behaviors was the benefits of exercise and a common barrier to exercising was lack of time. CONCLUSION Most older cancer survivors did not meet the recommended exercise guidelines, but they were open to exercise counselling and programming. Reviewing education on the benefits of exercise is especially important after treatment completion to promote healthy lifestyles.
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Affiliation(s)
| | - Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Pui Hing Chau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Alina Yee Man Ng
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Xinyi Xu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chia Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; School of Nursing, College of Nursing, Taipei Medical University, Taiwan; Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong
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13
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Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act 2021; 18:50. [PMID: 33823832 PMCID: PMC8025326 DOI: 10.1186/s12966-021-01116-9] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients' PA participation. METHODS A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions. RESULTS Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients' PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs. CONCLUSIONS There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
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Affiliation(s)
- Sarah Elshahat
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Charlene Treanor
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
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14
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Ha DM, Prochazka AV, Bekelman DB, Stevens-Lapsley JE, Chan ED, Keith RL. Association of Leisure-Time Physical Activity With Health-Related Quality of Life Among US Lung Cancer Survivors. JNCI Cancer Spectr 2021; 5:pkaa118. [PMID: 35075444 PMCID: PMC7853156 DOI: 10.1093/jncics/pkaa118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/27/2020] [Accepted: 11/16/2020] [Indexed: 02/02/2024] Open
Abstract
Background Physical activity and exercise improve function, symptom control, and health-related quality of life (QoL) for many cancer survivors; however, the evidence is limited and inconsistent in lung cancer. We examined the relationship between leisure-time physical activity (LTPA) and health-related QoL in a national sample of US lung cancer survivors. Methods We conducted a cross-sectional study using the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System. We defined LTPA as a self-report of engaging in any physical activity or exercise such as running, calisthenics, golf, gardening, or walking for exercise in the past 30 days, health-related QoL as the number of days of having poor physical or mental health in the past 30 days, and general health status. We analyzed using multivariable logistic regressions with 95% confidence intervals (CIs). Results Among 614 lung cancer survivors, 316 (51.5%) reported engaging in LTPA. The counts (and proportions) of participants who engaged in LTPA vs no LTPA were, respectively, 135 (42.7%) vs 63 (21.1%) for 0 days of poor physical health, 222 (70.3%) vs 174 (58.4%) for 0 days of poor mental health, and 158 (50.0%) vs 77 (25.8%) for good to excellent general health. In multivariable analyses, participating in LTPA was associated with odds ratios of 2.64 (95% CI = 1.76 to 3.96) and 1.43 (95% CI = 0.97 to 2.10) for 0 days of poor physical and mental health, respectively, and 2.61 (95% CI = 1.74 to 3.91) for good to excellent general health. Conclusions Participating in LTPA was associated with improved health-related QoL. Interventions to promote LTPA and/or exercise-based rehabilitation may improve QoL among lung cancer survivors.
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Affiliation(s)
- Duc M Ha
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Allan V Prochazka
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David B Bekelman
- Division of General Internal Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Jennifer E Stevens-Lapsley
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Geriatric Research, Education and Clinical Center, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Edward D Chan
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Medicine and Academic Affairs, National Jewish Health, Denver, CO, USA
| | - Robert L Keith
- Section of Pulmonary and Critical Care, Medical Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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15
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Exercise Levels and Preferences in Cancer Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155351. [PMID: 32722265 PMCID: PMC7432474 DOI: 10.3390/ijerph17155351] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/22/2022]
Abstract
Background: Despite the benefits related to physical exercise, large numbers of cancer patients are not sufficiently active. Methods: To investigate exercise levels and preferences in cancer patients, a cross-sectional study was conducted on a random sample of 392 cancer outpatients who anonymously completed a questionnaire investigating general and medical characteristics, and expressed willingness to participate in exercise programs. Current exercise levels were estimated with the Leisure Score Index (LSI). Results: Most patients (93%) were insufficiently active but 80% declared an interest in exercise programs. Patients preferred oncologist-instructed programs and specified particular exercise needs. Multivariate logistic regression showed that willingness to exercise was associated with education (OR: 1.87; 95% CI: 1.15–3.04 beyond age 14 years vs. up to 14 years) and current physical activity (OR: 1.92; 95% CI: 1.92–3.63 for sweat-inducing activity >2 times/week vs. <1 time/week). Patients given chemotherapy were less inclined to exercise (OR: 0.45; 95% CI: 0.23–0.86) than those who did not. LSI was lower if cancer stage was advanced (β: -0.36; 95% CI: −0.75 to −0.02) than if it was in remission. High LSI was also associated with longer education, lower BMI, and longer time after diagnosis. Conclusion: Cancer patients are insufficiently active but are willing to participate in personalized exercise programs. Information from this survey may help in designing personalized interventions so these patients will achieve sufficient exercise.
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16
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Jonsson M, Ahlsson A, Hurtig-Wennlöf A, Vidlund M, Cao Y, Westerdahl E. In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer Surgery: A Randomized Controlled Trial. Integr Cancer Ther 2020; 18:1534735419876346. [PMID: 31530046 PMCID: PMC6751530 DOI: 10.1177/1534735419876346] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Lung cancer is the most frequently diagnosed cancer and one of the leading causes of cancer deaths. Surgery is the primary approach for curative treatment. Postoperative complications are common, and physiotherapy is often routinely provided for their prevention and treatment, even though the evidence is limited. The aim of this study was to examine the effect of in-hospital physiotherapy on postoperative physical capacity, physical activity, and lung function among patients undergoing lung cancer surgery. Methods. A total of 107 patients undergoing elective thoracic surgery were included in a single-blinded randomized controlled trial, and randomized to a study group, receiving in-hospital physiotherapy treatment, or a control group, not receiving in-hospital physiotherapy treatment. The patients were assessed preoperatively and 3 months after surgery. The in-hospital physiotherapy treatment consisted of early mobilization, ambulation, breathing exercises, and thoracic range of motion exercises. Physical capacity was assessed with the 6-minute walk test. Level of physical activity was objectively assessed with an accelerometer and subjectively assessed with the International Physical Activity Questionnaire Modified for the Elderly. Results. Physical capacity for the whole sample was significantly decreased 3 months postoperatively compared with preoperative values (P = .047). There were no statistically significant differences between the groups regarding physical capacity, physical activity, spirometric values, or dyspnea. However, patients in the study group increased their level of self-reported physical activity from preoperatively to 3 months postoperatively, while the patients in the control group did not. Conclusions. No difference in physical capacity, physical activity, or lung function was found 3 months postoperatively in lung cancer surgery patients receiving in-hospital physiotherapy compared with control patients.
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Affiliation(s)
| | | | | | | | - Yang Cao
- Örebro University, Örebro, Sweden.,Karolinska Institutet, Stockholm, Sweden
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17
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The association of physical function and quality of life on physical activity for non-small cell lung cancer survivors. Support Care Cancer 2020; 28:4847-4856. [PMID: 31980896 DOI: 10.1007/s00520-020-05302-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Our study aimed to assess the association between physical function and quality of life (QOL) with physical activity among non-small cell lung cancer (NSCLC) survivors. METHODS Participants were 92 NSCLC survivors. Physical activity was assessed by a self-report with physiatrist's interview and the Korean version of the short form of the International Physical Activity Questionnaire (IPAQ-SF). All participants were required to perform three standardized fitness tests. The Korean version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) was used to assess QOL. Factors associated with physical functioning and QOL were determined using multiple linear regression. RESULTS A significant correlation between metabolic equivalent task minutes per week (MET-min/wk) and aerobic fitness was found (r = 0.277, p = 0.008). Factors associated with aerobic fitness include gender, age, and MET-min/wk. The meeting physical activity guideline group was also a factor associated with aerobic fitness. In the QOL aspect, a significant correlation between MET-min/wk and some QOL score was found. The meeting physical activity guideline group was a factor associated with QOL (global health status, physical function, and role function), not total MET-min/wk. CONCLUSIONS Increased physical activity was associated with higher aerobic fitness and QOL. Engagement in physical activity that met physical activity guidelines was a factor related to aerobic fitness and better QOL in some domains. To improve aspects of aerobic fitness and QOL, we may consider the pattern of physical activity, including regular participation and intensity, rather than total physical activity including basal activity.
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18
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Jonsson M, Hurtig-Wennlöf A, Ahlsson A, Vidlund M, Cao Y, Westerdahl E. In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial. Physiotherapy 2019; 105:434-441. [DOI: 10.1016/j.physio.2018.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/04/2018] [Indexed: 02/07/2023]
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19
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Schneeberger D, Golubíc M, Moore HCF, Weiss K, Abraham J, Montero A, Doyle J, Sumego M, Roizen M. Lifestyle Medicine-Focused Shared Medical Appointments to Improve Risk Factors for Chronic Diseases and Quality of Life in Breast Cancer Survivors. J Altern Complement Med 2018; 25:40-47. [PMID: 30256657 DOI: 10.1089/acm.2018.0154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Poor lifestyle choices play a significant role in the development and progression of preventable chronic diseases, including cancer. In this study, we evaluate the effectiveness of a comprehensive lifestyle medicine intervention on chronic disease risk factors and quality of life in breast cancer survivors. DESIGN This is a retrospective review of a clinical program from January 2016 to July 2017. SETTINGS/LOCATION It includes seven 2-h group medical visits held every other week at an outpatient wellness facility. SUBJECTS Eligible participants are breast cancer survivors who have completed treatment, including those who remain on hormonal therapy. INTERVENTION Patients receive education and experience in nutrition, culinary medicine, physical activity, and stress relief practices. OUTCOME MEASURES Participants' weight, body mass index (BMI), body fat mass, lean body mass, and percent body fat were measured at visit 1 and visit 7. Standard validated questionnaires were used to measure perceived stress, depression, patient activation, physical and mental quality of life, dietary fat consumption, and dietary fruit, vegetable, and fiber consumption. RESULTS A total of 31 patients participated in the group visits. Pre-post comparison data were not available for 10 patients. More than three-quarters of the 21 breast cancer survivors who attended 5 or more of the 7 group visits and provided data at the first and the last group visit decreased their body weight. On average, patients lost 4.9 pounds (-2.6%, p < 0.01), and their BMI decreased by 0.8 kg/m2 (-2.5%, p < 0.01). Changes in psychosocial variables of perceived stress, depression, patient activation, and quality of life trended in a positive direction, but did not reach statistical significance. Patients reported a significant decrease in average weekly fat consumption (-31.5%, p < 0.01). Most patients found the program educational and enjoyable, and nearly half of them described it as life changing. CONCLUSIONS Breast cancer survivors could employ the prescribed lifestyle modifications to produce clinically relevant health benefits. Interdisciplinary teams of health care professionals may help breast cancer survivors with chronic diseases implement evidence-based, individualized, and effective lifestyle prescription through group medical visits.
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Affiliation(s)
- Dana Schneeberger
- 1 Center for Integrative and Lifestyle Medicine, Wellness Institute, Cleveland Clinic, Lyndhurst, OH
| | - Mladen Golubíc
- 1 Center for Integrative and Lifestyle Medicine, Wellness Institute, Cleveland Clinic, Lyndhurst, OH
| | | | - Kenneth Weiss
- 3 Regional Oncology, Cleveland Clinic, Twinsburg, OH
| | - Jame Abraham
- 2 Hematology & Oncology, Cleveland Clinic, Cleveland, OH
| | | | - Jonathan Doyle
- 1 Center for Integrative and Lifestyle Medicine, Wellness Institute, Cleveland Clinic, Lyndhurst, OH
| | | | - Michael Roizen
- 1 Center for Integrative and Lifestyle Medicine, Wellness Institute, Cleveland Clinic, Lyndhurst, OH
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20
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Wong JN, McAuley E, Trinh L. Physical activity programming and counseling preferences among cancer survivors: a systematic review. Int J Behav Nutr Phys Act 2018; 15:48. [PMID: 29879993 PMCID: PMC5992647 DOI: 10.1186/s12966-018-0680-6] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 05/20/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) participation and adherence among cancer survivors is low, despite research indicating numerous physical, psychological and emotional health benefits of exercise. Tailoring exercise programs specific to the PA preferences in cancer survivors has merit for increasing PA participation and adherence to accrue these benefits. This systematic review identifies and differentiates PA programming and counseling preferences of adult cancer survivors across various cancer survivor groups. METHODS PubMed, SPORTDiscus, Scopus, PsycINFO, EMBASE, Web of Science and CINAHL were electronically searched (inception to Oct 2017) and articles were identified using PRISMA guidelines. Two reviewers independently assessed identified articles to determine eligibility and then individually performed a quality assessment on all final studies. Extracted and analyzed data included participant characteristics, interest in exercise counseling and programming, as well as specific exercise and counseling preferences (e.g. location, timing, intensity). RESULTS Forty-one articles were included in this systematic review. Most studies assessed mixed cancer survivor groups or breast cancer survivors. Most cancer survivors felt able and interested in participating in a PA program, though starting a PA program after or before treatment was preferred. Walking was the strongest PA modality preference, and most cancer survivors preferred moderate intensity PA. Cancer survivors also indicated preferences for home-based PA that could take place in the morning. Slight preferences were found towards physical activity counseling delivered by a fitness expert from a cancer center. Both quantitative and qualitative studies were found to be of moderate to high quality based on the Appraisal Tool for Cross-Sectional Studies (AXIS) and the Consolidated Criteria for Reporting Qualitative Research (COREQ), respectively. CONCLUSION Cancer survivors have an interest in participating in PA programs with walking as the primary modality. Additionally, morning-based PA programs that can be tapered to home-based programs are desirable. However, there was wide variation in other PA preference variables, suggesting multiple program options would be beneficial. Many cancer survivors felt interested and able to participate in PA, and therefore designing PA programs that are tailored to cancer survivors is integral for optimizing recruitment and adherence, as well as enhancing health outcomes in cancer survivors.
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Affiliation(s)
- Jaime N. Wong
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL USA
| | - Linda Trinh
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6 Canada
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21
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Edbrooke L, Denehy L, Parry SM, Astin R, Jack S, Granger CL. How is physical activity measured in lung cancer?A systematic review of outcome measures and their psychometric properties. Respirology 2017; 22:263-277. [PMID: 28102971 DOI: 10.1111/resp.12975] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 08/02/2016] [Accepted: 11/10/2016] [Indexed: 12/18/2022]
Abstract
Physical activity (PA) levels are low in patients with lung cancer. Emerging evidence supports the use of interventions to increase PA in this population. We aimed to (1) identify and synthesize outcome measures which assess PA levels in patients with lung cancer and (2) to evaluate, synthesize and compare the psychometric properties of these measures. A systematic review of articles from searches was conducted of five electronic databases and personal records. Eligible studies were those which assessed PA using either performance-based or patient-reported measures. For aim 2, studies identified in aim 1 reporting on at least one psychometric property (validity, reliability, responsiveness or measurement error) were included. Two independent reviewers assessed eligibility and risk of bias with the COnsensus-based Standards for the selection of health status Measurement INstruments. Thirty-four studies using 21 different measures of PA were identified. Seventeen studies used performance-based measures. The Godin Leisure Time Exercise Questionnaire (GLTEQ) was the most frequently used patient-reported measure. Psychometric properties were reported for 13 of these measures and most frequently for movement sensors. Two studies reported on properties of the GLTEQ. Quality ratings for risk of bias were low. There is significant heterogeneity amongst studies regarding method of PA measurement along the lung cancer continuum. Greater consensus could be achieved by using a consensus approach such as a Delphi process. Future studies should include assessment of psychometric properties of the measurement tool being used. Currently, it is recommended where feasible, both performance-based and patient-reported measurements of PA should be undertaken.
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Affiliation(s)
- Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep, Melbourne, Victoria, Australia
| | - Selina M Parry
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ronan Astin
- Institute for Human Health and Performance, University College London, London, UK
| | - Sandy Jack
- University Hospital Southampton, Southampton, UK
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Institute for Breathing and Sleep, Melbourne, Victoria, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Peddle-McIntyre CJ, Baker MK, Lee YCG, Galvão DA, Cormie P, Graham V, Newton RU. The feasibility of a pragmatic distance-based intervention to increase physical activity in lung cancer survivors. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28597947 DOI: 10.1111/ecc.12722] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to investigate the feasibility and preliminary efficacy of a pragmatic distance-based intervention designed to increase physical activity (PA) participation in lung cancer survivors. Fourteen lung cancer survivors were recruited via invitation from the State Cancer Registry to join a 12-week PA intervention of print materials paired with brief telephone follow-up. Outcome measures of feasibility, PA participation and quality of life (QoL) were assessed at baseline, post-intervention and follow-up via telephone interview. Eligibility, recruitment and attrition rates were 16%, 58% and 29% respectively. No adverse events were reported; however, pain scores worsened following the intervention (median change -3.6, IQR -8.0, 0.0). Average intervention adherence was 91% with low median ratings of participation burden (i.e., all items 1/7) and high trial evaluation (i.e., all items 7/7). Post-intervention, median change in self-reported moderate and vigorous PA was 84 min (IQR -22, 188), and several domains of QoL improved. However, for both of these outcomes, improvements were not maintained at follow-up. Our findings suggest that this pragmatic distance-based intervention was safe, had good adherence rates, and indicate potential for improving short-term PA and QoL in lung cancer survivors. Additional strategies are needed to improve other indicators of feasibility, particularly recruitment, retention and long-term maintenance of improvements. Australian New Zealand Clinical Trials Registration: ACTRN12612000085875.
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Affiliation(s)
- C J Peddle-McIntyre
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - M K Baker
- School of Exercise Science, Australian Catholic University, Strathfield, NSW, Australia
| | - Y C G Lee
- Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - D A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - P Cormie
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,Institute for Health and Aging, Australian Catholic University, Melbourne, Vic., Australia
| | - V Graham
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia
| | - R U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia.,UQ Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia
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Smith L, Croker H, Fisher A, Williams K, Wardle J, Beeken RJ. Cancer survivors’ attitudes towards and knowledge of physical activity, sources of information, and barriers and facilitators of engagement: A qualitative study. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12641] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 12/23/2022]
Affiliation(s)
- L. Smith
- Department of Life Sciences; The Cambridge Centre for Sport and Exercise Science; Anglia Ruskin University; Cambridge UK
| | - H. Croker
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - A. Fisher
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - K. Williams
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - J. Wardle
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
| | - R. J. Beeken
- Department of Epidemiology and Public Health; Health Behaviour Research Centre; University College London; London UK
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Granger CL, Connolly B, Denehy L, Hart N, Antippa P, Lin KY, Parry SM. Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer 2016; 25:983-999. [PMID: 27900549 DOI: 10.1007/s00520-016-3484-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/01/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Despite evidence and clinical practice guidelines supporting physical activity (PA) for people with lung cancer, this evidence has not translated into clinical practice. This review aims to identify, evaluate and synthesise studies examining the barriers and enablers for patients with lung cancer to participate in PA from the perspective of patients, carers and health care providers (HCPs). METHODS Systematic review of articles using electronic databases: MEDLINE (1950-2016), CINAHL (1982-2016), EMBASE (1980-2016), Scopus (2004-2016) and Cochrane (2016). Quantitative and qualitative studies, published in English in a peer-reviewed journal, which assessed the barriers or enablers to PA for patients with lung cancer were included. Registered-PROSPERO (CRD4201603341). RESULTS Twenty-six studies (n = 9 cross-sectional, n = 4 case series, n = 11 qualitative) including 1074 patients, 23 carers and 169 HCPs were included. Barriers and enablers to PA were identified (6 major themes, 18 sub-themes): Barriers included patient-level factors (physical capability, symptoms, comorbidities, previous sedentary lifestyle, psychological influences, perceived relevance), HCP factors (time/knowledge to deliver information) and environmental factors (access to services, resources, timing relative to treatment). Enablers included anticipated benefits, opportunity for behaviour change and influences from HCPs and carers. CONCLUSION This systematic review has identified the volume of literature demonstrating that barriers and enablers to PA in lung cancer are multidimensional and span diverse factors. These include patient-level factors, such as symptoms, comorbidities, sedentary lifestyle, mood and fear, and environmental factors. These factors should be considered to identify and develop suitable interventions and clinical services in attempt to increase PA in patients with lung cancer.
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Affiliation(s)
- Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia. .,Department of Physiotherapy, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia. .,Institute for Breathing and Sleep, Bowen Centre, 145 Studley Road, Hiedelberg, VIC, 3084, Australia.
| | - Bronwen Connolly
- Guy's and St. Thomas' NHS Foundation Trust and King's College London National Institute of Health Research Biomedical Research Centre, Strand, London, WC2R 2LS, UK.,Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St. Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.,Centre of Human and Aerospace Physiological Sciences, King's College London, Strand, London, WC2R 2LS, UK
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia.,Institute for Breathing and Sleep, Bowen Centre, 145 Studley Road, Hiedelberg, VIC, 3084, Australia
| | - Nicholas Hart
- Guy's and St. Thomas' NHS Foundation Trust and King's College London National Institute of Health Research Biomedical Research Centre, Strand, London, WC2R 2LS, UK.,Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St. Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.,Division of Asthma, Allergy and Lung Biology, King's College London, Strand, London, WC2R 2LS, UK
| | - Phillip Antippa
- Department of Thoracic Surgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia
| | - Kuan-Yin Lin
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia.,Department of Physiotherapy, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC, 3050, Australia
| | - Selina M Parry
- Department of Physiotherapy, The University of Melbourne, Level 7 Alan Gilbert Building, 161 Barry Street, Parkville, VIC, 3010, Australia
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Increasing physical activity and exercise in lung cancer: reviewing safety, benefits, and application. J Thorac Oncol 2016; 10:861-71. [PMID: 25831230 DOI: 10.1097/jto.0000000000000536] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lung cancer continues to be a difficult disease frequently diagnosed in late stages with a high mortality and symptom burden. In part because of frequent lung comorbidity, even lung cancer survivors often remain symptomatic and functionally limited. Though targeted therapy continues to increase treatment options for advanced-stage disease, symptom burden remains high with few therapeutic options. In the last several decades, exercise and physical activity have arisen as therapeutic options for obstructive lung disease and lung cancer. To date, exercise has been shown to reduce symptoms, increase exercise tolerance, improve quality of life, and potentially reduce length of stay and postoperative complications. Multiple small trials have been performed in perioperative non-small-cell lung cancer patients, although fewer studies are available for patients with advanced-stage disease. Despite the increased interest in this subject over the last few years, a validated exercise regimen has not been established for perioperative or advanced-stage disease. Clinicians underutilize exercise and pulmonary rehabilitation as a therapy, in part because of the lack of evidence-based consensus as to how and when to implement increasing physical activity. This review summarizes the existing evidence on exercise in lung cancer patients.
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Karvinen KH, Vallance J, Walker PR. Newly diagnosed lung cancer patients' preferences for and beliefs about physical activity prior to chemotherapy. PSYCHOL HEALTH MED 2016; 21:593-600. [PMID: 26813963 DOI: 10.1080/13548506.2016.1139739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Physical activity has been found to have a number of benefits for lung cancer patients yet very little information is available concerning physical activity beliefs and preferences for this population. The purpose of the study was to explore physical activity programming and counseling preferences and beliefs about physical activity in newly diagnosed lung cancer patients scheduled to receive chemotherapy. A total of 43 new diagnosed lung cancer patients completed a researcher-administered survey prior to commencing chemotherapy. Results indicated that only 7 participants (17%) reported meeting public health recommendations for physical activity yet the majority of participants (n = 28) indicated interest or possible interest in physical activity counseling. Many participants also indicated interest or possible interest in an exercise program (n = 29) for lung cancer survivors, preferring it to start during chemotherapy (n = 20), for it to be home based (n = 21), and moderate in intensity (n = 22). The most common behavioral belief (advantage) of physical activity was to build/maintain strength (n = 26) and the most common control belief (barrier) was fatigue (n = 11). These data suggest that physical activity counseling and programming may be well received by newly diagnosed lung cancer patients. Information about physical activity and programming preferences and beliefs from this study may be useful for the design of optimal physical activity interventions for lung cancer patients.
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Affiliation(s)
- Kristina H Karvinen
- a School of Physical and Health Education, Nipissing University , North Bay, ON , Canada
| | - Jeff Vallance
- b Faculty of Health Disciplines , Athabasca University , Athabasca , AB , Canada
| | - Paul R Walker
- c Department of Internal Medicine , Brody School of Medicine at East Carolina University , Greenville , NC , USA
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Karvinen K, Bruner B, Truant T. The Teachable Moment After Cancer Diagnosis: Perceptions From Oncology Nurses. Oncol Nurs Forum 2015; 42:602-9. [DOI: 10.1188/15.onf.602-609] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mas S, Quantin X, Ninot G. Barriers to, and Facilitators of Physical Activity in Patients Receiving Chemotherapy for Lung Cancer: An exploratory study. J Palliat Care 2015. [PMID: 26201210 DOI: 10.1177/082585971503100204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM Physical activity (PA) has a positive effect on the cardiorespiratory fitness, lung cancer symptoms, and quality of life of lung cancer patients. The aim of our study was to identify barriers to, and facilitators of PA in lung cancer patients. METHODS We collected data from five patients diagnosed with primary, advanced non-small-cell lung cancer (NSCLC) who were receiving chemotherapy. Choosing a qualitative approach, we conducted an exploratory analysis using the thematic analysis technique to process the data. RESULTS Seven barriers to, and facilitators of PA were identified and grouped into four categories. We found that psychological and social factors affect patients' willingness and ability to engage in PA, while physiological and environmental factors have an impact on the duration, intensity, and regularity of their PA. CONCLUSION Our study highlighted some of the effects that the barriers to PA have on the practice of it in our patient group. Our findings may be used by professionals to design adapted PA programs.
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Demark-Wahnefried W, Rogers LQ, Alfano CM, Thomson CA, Courneya KS, Meyerhardt JA, Stout NL, Kvale E, Ganzer H, Ligibel JA. Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA Cancer J Clin 2015; 65:167-89. [PMID: 25683894 DOI: 10.3322/caac.21265] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Answer questions and earn CME/CNE The importance of expanding cancer treatment to include the promotion of overall long-term health is emphasized in the Institute of Medicine report on delivering quality oncology care. Weight management, physical activity, and a healthy diet are key components of tertiary prevention but may be areas in which the oncologist and/or the oncology care team may be less familiar. This article reviews current diet and physical activity guidelines, the evidence supporting those recommendations, and provides an overview of practical interventions that have resulted in favorable improvements in lifestyle behavior change in cancer survivors. It also describes current lifestyle practices among cancer survivors and the role of the oncologist in helping cancer patients and survivors embark upon changes in lifestyle behaviors, and it calls for the development of partnerships between oncology providers, primary care providers, and experts in nutrition, exercise science, and behavior change to help positively orient cancer patients toward longer and healthier lives.
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Affiliation(s)
- Wendy Demark-Wahnefried
- Professor of Nutrition Sciences, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Laura Q Rogers
- Professor of Nutrition Sciences, Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Catherine M Alfano
- Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
| | - Cynthia A Thomson
- Professor of Health Promotion Sciences, Department of Health Promotion Sciences, University of Arizona, Tucson, Arizona
| | - Kerry S Courneya
- Professor, Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | | | - Nicole L Stout
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, Maryland
| | - Elizabeth Kvale
- Associate Professor of Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Jennifer A Ligibel
- Assistant Professor, Dana-Farber Cancer Institute, Boston, Massachusetts
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