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Ibrahim AA, Gabr Ali AMM, Fadulelmulla IA, Ragab MMM, Aldemery AA, Mohamed AR, Dewir IM, Hakami HA, Hussein HM. Using Inspiratory Muscle Training to Improve Respiratory Strength, Functional Capacity, Fatigue, and Stress in Breast Cancer Patients Undergoing Surgery. J Multidiscip Healthc 2024; 17:1931-1941. [PMID: 38706507 PMCID: PMC11070168 DOI: 10.2147/jmdh.s463961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose The main aim of the trial was to assess the effectiveness of inspiratory muscle training on respiratory muscle strength, functional capacity, fatigue, and stress in post-surgical breast cancer survivors. Methods Forty-seven females who had undergone unilateral post-mastectomy were randomly assigned to an intervention group (IG; n = 24) and a control group (CG; n = 23). Both groups received aerobic exercise training. In addition, the intervention group received inspiratory muscle training 3 days a week for 8 weeks. Maximum inspiratory and expiratory pressure (Pimax) (Pemex), 6-minute walk test, Handgrip strength by hand-held dynamometer, Fatigue Assessment Scale (FAS), and Perceived Stress Scale pss 10 values were measured before the training and then at the eighth week for both groups. Results No differences were detected between the groups in terms of sample and clinical characteristics 8 weeks post-intervention. In favor of the intervention group, a significant difference with medium to high effect size was found in terms of Pimax, Pemax, FAS, PS, and 6MWT (p < 0.05). However, there was no difference in terms of handgrip strength (p-value: 0.072), with a medium effect size (0.070). Regarding within-group comparisons, IG exhibited substantial differences in all outcome measures (p < 0.05) compared to CG, with the exception of PImax and 6MWT. Conclusion In post-operative breast cancer survivors, respiratory muscle training combined with aerobic training increases respiratory muscle strength and functional ability while lowering stress and tiredness.
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Affiliation(s)
- Ahmed Abdelmoniem Ibrahim
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | | | | | | | | | - Amany Raafat Mohamed
- Department of Physical Therapy for Internal Medicine & Geriatrics, Faculty of Physical Therapy, Suez University, Suez, Egypt
| | - Ibrahim Metwally Dewir
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Hamad Ali Hakami
- Department of Physical Therapy, Jazan General Hospital, Jazan, Saudi Arabia
| | - Hisham Mohamed Hussein
- Department of Physical Therapy, College of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
- Department of Basic Sciences for Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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2
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Tock WL. Motivation for Health Promotion in Cancer Survivors: An Evolutionary Concept Analysis. ANS Adv Nurs Sci 2024; 47:202-217. [PMID: 34693911 DOI: 10.1097/ans.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Motivation for health promotion is an essential concept in health care research, as it pertains to an individual's ability to adapt to the adversity of chronic illnesses, including cancer. Adopting Rodgers' evolutionary method of concept analysis, the objective of this article is to clarify the concept based on its existing operationalization noted in cancer survivorship literature. Through a close examination of the construction of the concept, this article facilitates the understanding of concept as it relates to the field of cancer survivorship care, which in turn helps provide guidance for developing health promotion intervention targeted at cancer survivors.
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Affiliation(s)
- Wing Lam Tock
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Quebec, Canada
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3
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Malchrowicz-Mośko E. Recreational Running Motivations among Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15500. [PMID: 36497576 PMCID: PMC9741478 DOI: 10.3390/ijerph192315500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Lifestyle-associated factors play an important role in prevention of such malignancies as breast cancer (BC), prostate cancer, or colon cancer. Physical activity (PA) before, during, and after diagnosis improves outcomes for BC. People after BC live with numerous side effects and PA has potential to reduce some of them. Unfortunately, few cancer survivors exercise regularly. The aim of this study was to ascertain motivations for running among BC survivors (in comparison with the motivations of healthy women) in order to better manage their attitudes in terms of PA and active lifestyle. A total of 317 Polish women took part in the study: 152 BC women (age 46.49 ± 7.83; BMI 24.78 ± 3.50) and 165 healthy runners (control group (age 36.91 ± 9.68; BMI 23.41 ± 3.94)) using the diagnostic survey method with the Motivation for Marathoners Scale (MOMS) questionnaire. Study results show that healthy runners had higher scores for health orientation, personal goal achievement, and affiliation compared to the group of BC survivors. The scores for weight concern, recognition, psychological coping, life meaning, and self-esteem were lower than those of BC survivors. These results should be included in the management of PA attitudes among BC survivors.
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Affiliation(s)
- Ewa Malchrowicz-Mośko
- Department of Kinesiology, Faculty of Sport Sciences, Poznan University of Physical Education, 61-871 Poznan, Poland
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4
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Kokkonen K, Kellokumpu-Lehtinen PL, Kankaanpää M, Nikander R, Penttinen HM, Utriainen M, Vehmanen L, Huovinen R, Kautiainen H, Blomqvist C, Saarto T. Factors predicting long-term physical activity of breast cancer survivors. 5-year-follow-up of the BREX exercise intervention study. Acta Oncol 2022; 61:1200-1208. [PMID: 35881067 DOI: 10.1080/0284186x.2022.2103388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The benefits of exercise training are well documented among breast cancer (BC) survivors. Patients decrease their physical activity during treatment, and many fail to regain their previous exercise levels. There is therefore a need to define factors supporting long-term physical activity behavior in this patient group, to target supporting interventions aimed at preventing the decline in physical activity (PA). AIM The aim of this study was to determine physical and psychosocial factors explaining long-term physical activity after the adjuvant treatments in BC survivors. METHODS Four-hundred forty-six BC survivors followed for 5-years within a randomized exercise trial participated. Factors explaining (1) physical activity after the adjuvant treatments and (2) changes in physical activity in long-term were analyzed using linear regression models and general estimating equation models. Pretreatment leisure-time physical activity (LTPA), demographic, and treatment factors, physical fitness, and quality of life (Qol) at baseline were independent factors. RESULTS Exercise levels increased during the first year, and thereafter remained mostly stable. Higher LTPA, higher fitness level, better Qol and older age at baseline were associated with higher physical activity level after adjuvant treatments (p < .001) in multivariate analysis. Higher levels of fatigue (p < .008) and better emotional functioning (p = .017) at baseline were the main factors associated with increased physical activity during the follow-up. CONCLUSION Previous exercise habits and Qol after adjuvant chemo-, and radiotherapy were the strongest determinants of long-term physical activity levels in breast cancer survivors. Patients with better emotional functioning increased their exercise activity most as did those patients with higher fatigue levels at baseline. Patients suffering from fatigue after adjuvant treatment managed to increase their exercise levels, in contrast to patients with low emotional functioning, and may benefit from physical exercise interventions. Emotionally deprived patients may benefit from psychosocial support to regain their previous exercise levels.
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Affiliation(s)
| | | | - Markku Kankaanpää
- Department of Physiatry and Rehabilitation Medicine, Tampere University Hospital, Tampere, Finland
| | - Riku Nikander
- Faculty of Sport and Health Sciences, University of Jyväskylä; Central Finland Health Care District; GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland
| | | | - Meri Utriainen
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Leena Vehmanen
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Riikka Huovinen
- Turku University Hospital, Department of Oncology, University of Turku, Faculty of Medicine, Turku, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, Finland and Folkhälsan Research Center, Helsinki, Finland
| | - Carl Blomqvist
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
| | - Tiina Saarto
- Helsinki University Hospital, Comprehensive Cancer Centre, and University of Helsinki, Faculty of Medicine, Helsinki, Finland
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5
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Shin J, Harris C, Oppegaard K, Kober KM, Paul SM, Cooper BA, Hammer M, Conley Y, Levine JD, Miaskowski C. Worst Pain Severity Profiles of Oncology Patients Are Associated With Significant Stress and Multiple Co-Occurring Symptoms. THE JOURNAL OF PAIN 2022; 23:74-88. [PMID: 34298161 PMCID: PMC10788964 DOI: 10.1016/j.jpain.2021.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/27/2021] [Accepted: 07/07/2021] [Indexed: 12/27/2022]
Abstract
Little is known about the associations between pain, stress, and co-occurring symptoms in oncology patients. Purpose was to identify subgroups of patients with distinct worst pain profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, as well as stress and symptom scores. Oncology outpatients (n = 1305) completed questionnaires prior to their second or third chemotherapy cycle. Worst pain intensity was assessed 6 times over 2 chemotherapy cycles using a 0 to 10 numeric rating scale. The 371 patients (28.4%) who had ≤1 occurrence of pain over the 6 assessments were classified as the None class. For the remaining 934 patients whose data were entered into the latent profile analysis, 3 distinct worst pain profiles were identified (ie Mild [12.5%], Moderate [28.6%], Severe [30.5%]). Compared to None class, Severe class had fewer years of education and a lower annual income; were less likely to be employed and married; less likely to exercise on a regular basis, had a higher comorbidity burden, and a worse functional status. Compared to None class, Severe class reported higher levels of general, disease-specific, and cumulative life stress and lower levels of resilience, as well as higher levels of depressive symptoms, anxiety, fatigue, sleep disturbance, and cognitive dysfunction. This study is the first to identify distinct worst pain profiles in a large sample of oncology patients receiving chemotherapy and associated risk factors. PERSPECTIVE: Unrelieved pain remains a significant problem for oncology patients receiving chemotherapy. High levels of stress and co-occurring symptoms contribute to a more severe pain profile in these patients.
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Affiliation(s)
- Joosun Shin
- School of Nursing, University of California, San Francisco, California
| | - Carolyn Harris
- School of Nursing, University of California, San Francisco, California
| | - Kate Oppegaard
- School of Nursing, University of California, San Francisco, California
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California
| | | | - Yvette Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, California; School of Medicine, University of California, San Francisco, California.
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6
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Effectiveness of a Home-Based Exercise Intervention in the Fitness Profile of Hispanic Survivors of Breast Cancer. REHABILITATION ONCOLOGY 2021; 39:175-183. [PMID: 34712520 DOI: 10.1097/01.reo.0000000000000253] [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: 11/26/2022]
Abstract
Background Home-based exercise interventions might be a desirable long-term option for breast cancer survivors to enhance compliance and long-term health benefits. Purpose To assess the effectiveness of a home-based intervention aimed at helping survivors of breast cancer meet the physical activity guidelines of the American College of Sports Medicine. Methods Eighty-nine women (age: 55.4 ± 10 years; BMI: 31 ± 6.5 kg/m2) from two cancer centers serving Hispanic women participated in this study. Women performed a baseline assessment of cardiorespiratory fitness, muscle endurance and strength, flexibility, range of motion, and extremity disability. After baseline measures, women were randomized into a control (C) or exercise (E) group. The exercise intervention consisted of a walking program, elastic band strengthening, and flexibility exercises performed at home. The outcome measures were reassessed 16 weeks after baseline measures. Results The intervention showed a strong effect of time on muscle strength and shoulder range of motion, and time and group for self-reported disability. There were no differences in sedentary behavior, physical fitness, and disability measures across intervention groups, including both exercise groups combined and changes over time between intervention groups. Conclusion It appears that a home-based intervention affects only upper body strength and related disability, indicating that other components might need closer monitoring for significant changes to occur across time.
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7
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Steel RP, Bishop NC, Taylor IM. The Relationship Between Multidimensional Motivation and Endocrine-Related Responses: A Systematic Review. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 16:614-638. [PMID: 33513308 PMCID: PMC8114335 DOI: 10.1177/1745691620958008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Multidimensional motivational theories postulate that the type of motivation is as important as the quantity of motivation, with implications for human functioning and well-being. An extensive amount of research has explored how constructs contained within these theories relate to the activation of the endocrine system. However, research is fragmented across several theories, and determining the current state of the science is complicated. In line with contemporary trends for theoretical integration, this systematic review aims to evaluate the association between multidimensional motivational constructs and endocrine-related responses to determine which theories are commonly used and what inferences can be made. Forty-one studies were identified incorporating five distinct motivation theories and multiple endocrine-related responses. There was evidence across several theories that high-quality motivation attenuated the cortisol response in evaluative environments. There was also evidence that motivational needs for power and affiliation were associated with lower and higher levels of salivary immunoglobulin A, respectively. The need for power may play a role in increasing testosterone when winning a contest; however, this evidence was not conclusive. Overall, this review can shape the future integration of motivational theories by characterizing the nature of physiological responses to motivational processes and examining the implications for well-being.
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Affiliation(s)
| | | | - Ian M. Taylor
- Department of Sport, Exercise, and Health Sciences, Loughborough University
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8
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Psychological Symptoms and Stress Are Associated With Decrements in Attentional Function in Cancer Patients Undergoing Chemotherapy. Cancer Nurs 2021; 43:402-410. [PMID: 30998605 DOI: 10.1097/ncc.0000000000000713] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Decrements in attentional function-perceived effectiveness in everyday functioning related to cognitive dysfunction-are frequently reported by cancer patients during treatment. However, patients vary widely in their experiences of changes in attentional function. OBJECTIVE The aim of this study was to understand differences in attentional function among cancer patients during chemotherapy. METHODS Patients (n = 1329) undergoing chemotherapy were assessed at 6 time points during 2 rounds of chemotherapy. Latent profile analysis was used to identify subgroups of patients based on patterns in changes on the Attentional Function Index. Differences among the subgroups in demographic and clinical characteristics, psychological symptoms, and stress were evaluated. RESULTS Three latent classes (ie, high, moderate, and low attentional function) were identified. Patients in the low and moderate classes were younger, more likely to be female, and less likely to be employed compared with those in the high class. Patients in the low class had higher levels of depressive and anxiety symptoms, cancer-related distress, and perceived stress compared with those in the moderate class, who, in turn, reported higher levels of these symptoms compared with those in the high class. CONCLUSIONS Different experiences of changes in self-perceived attentional function are associated with psychological symptoms in cancer patients. IMPLICATIONS FOR PRACTICE Relationships between changes in attentional function and psychological symptoms and stress suggest that clinicians should attend to the potential that patients' cognitive and psychological experiences may be closely linked and may need to be addressed as related phenomena. Clinical trials are needed that evaluate treatments for both attentional and psychological symptoms.
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9
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Sense of coherence as a mediator between perceived stress and depression in newly diagnosed breast cancer patients: a cross-sectional study. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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10
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Behzadnia B, Kiani A, Babaei S. Autonomy-supportive exercise behaviors promote breast cancer survivors' well-being. Health Promot Perspect 2020; 10:409-417. [PMID: 33312937 PMCID: PMC7722990 DOI: 10.34172/hpp.2020.60] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/07/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence)orientations, exercise motivation, and psychological well-being of breast cancer survivors. Methods: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) measured at baseline and post-intervention sessions. Results: As expected, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The results showed no difference in exercise motivation across conditions. Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.
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Affiliation(s)
- Behzad Behzadnia
- Department of Motor Behavior, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.,Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Arezou Kiani
- Neurophysiology Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Solmaz Babaei
- Faculty of Humanities, University of Maragheh, Maragheh, Iran
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11
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Zhao J, Ma Y, Tanimoto T, Ozaki A, Chen WL, Wang JY, Zhang YX, Chen LL, Wang JW, Yu JM. Effects of physical activity and stress on the relationship between social capital and quality of life among breast cancer survivors. Sci Rep 2020; 10:17746. [PMID: 33082389 PMCID: PMC7576207 DOI: 10.1038/s41598-020-74706-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 09/29/2020] [Indexed: 11/08/2022] Open
Abstract
This study aims to investigate the serial multiple mediation of physical activity and perceived stress in the relationship between individual social capital and quality of life (QOL) in breast cancer survivors (BCSs). This study was conducted among 520 BCSs between March and April 2017 in Shanghai, China. Data were collected using the Individual Social Capital Scale, the Health-Promoting Lifestyle Profile-II, the Perceived Stress Scale-14 and the EORTC QLQ-C30. Ordinary least-squares regression and the bootstrap method was used to test the significance of the serial multiple mediation model. The serial-multiple mediations of physical activity and perceived stress were found significant in the relationship of QOL with all five dimensions of individual social capital. The separate mediations of two single mediating variables were found significant in the relationship of QOL with control over life and feeling about the community. In the relationship of QOL with social participation, social network and social support, the separate mediation of physical activity was significant, while the separate mediation of perceived stress was not significant. A multidisciplinary team approach and a variety of delivery systems are needed to address the social, physical and psychological issues for improving QOL among BCSs.
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Affiliation(s)
- Jie Zhao
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
- Minhang Institute, School of Public Health, Fudan University, Shanghai, 201100, China
| | - Yong Ma
- Xujiahui Street Community Health Service Center, Xuhui District, Shanghai, 200235, China.
| | | | - Akihiko Ozaki
- Jyoban Hospital of Tokiwa Foundation, Fukuhsima, Japan
| | - Wan-Li Chen
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
- Minhang Institute, School of Public Health, Fudan University, Shanghai, 201100, China
| | - Jing-Ya Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
- Minhang Institute, School of Public Health, Fudan University, Shanghai, 201100, China
| | - Yu-Xin Zhang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
- Minhang Institute, School of Public Health, Fudan University, Shanghai, 201100, China
| | - Lin-Li Chen
- Center for Disease Control and Prevention of Minhang District, Shanghai, 201101, China.
- Minhang Institute, School of Public Health, Fudan University, Shanghai, 201100, China.
| | - Ji-Wei Wang
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.
- Minhang Institute, School of Public Health, Fudan University, Shanghai, 201100, China.
| | - Jin-Ming Yu
- Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, 130 Dong-An Road, Shanghai, 200032, China
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12
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Mama SK, Bhuiyan N, Smyth JM, Schmitz KH. Stress and Physical Activity in Rural Cancer Survivors: The Moderating Role of Social Support. J Rural Health 2020; 36:543-548. [PMID: 32472721 DOI: 10.1111/jrh.12455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Social support (SS) has been shown to moderate the relationship between psychological distress and physical activity (PA) in adults, including those with no history of cancer and cancer survivors (CS). The purpose of this study was to explore the relationship between stress and leisure-time PA and test if SS is a moderator of this relationship in rural CS. METHODS CS were recruited to Partnering to Prevent and Control Cancer (PPCC) and completed questionnaires assessing sociodemographics, leisure-time PA, perceived stress, and SS. Hierarchical multivariable linear regression was used to assess the moderating role of SS on the association between stress and PA. FINDINGS Cancer survivors (N = 219) were in their mid-60s (M age = 64.3 ± 12.5 years) and overweight/obese (M BMI = 29.5 ± 6.8 kg/m2 ); over half were women (60.7%) and insufficiently active (59.4%); and 42.1% reported moderate-to-high perceived stress. Perceived stress was negatively correlated with PA (r = -.183, P = .044) and SS (r = -.470, P < .001), and SS was positively correlated with PA (r = .205, P = .025). However, SS did not moderate the association between stress and PA. CONCLUSIONS Rural CS reported higher stress and less PA than previously reported by urban CS, potentially contributing to rural cancer health disparities. Although previous studies have shown success in building SS to reduce stress and promote PA in CS, our results do not support the stress-buffering hypothesis in rural cancer survivors. Further research is needed to understand factors related to PA in rural CS and determine strategies to reduce psychological distress and promote healthy behaviors in an effort to improve cancer survivorship.
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Affiliation(s)
- Scherezade K Mama
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania.,Penn State Cancer Institute, The Pennsylvania State University, Hershey, Pennsylvania
| | - Nishat Bhuiyan
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Joshua M Smyth
- Department of Biobehavioral Health , College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Kathryn H Schmitz
- Penn State Cancer Institute, The Pennsylvania State University, Hershey, Pennsylvania.,Department of Public Health Sciences , College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania
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13
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Yandrapalli S, Malik AH, Pemmasani G, Gupta K, Harikrishnan P, Nabors C, Aronow WS, Cooper HA, Panza JA, Frishman WH, Jain D. Risk Factors and Outcomes During a First Acute Myocardial Infarction in Breast Cancer Survivors Compared with Females Without Breast Cancer. Am J Med 2020; 133:444-451. [PMID: 31715170 DOI: 10.1016/j.amjmed.2019.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 09/06/2019] [Accepted: 10/09/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose of this research was to study the differences in epidemiology and outcomes of a first myocardial infarction in breast cancer survivors compared with the general female population in the United States. METHODS We retrospectively analyzed the US National Inpatient Sample years 2005-2015 to identify adult women with a first myocardial infarction. In this cohort, breast cancer survivors were identified. Outcomes evaluated were the differences in baseline demographics, comorbidities, and adjusted in-hospital mortality in women with and without breast cancer. RESULTS Among 1,644,032 first myocardial infarction cases in adult women, there were 56,842 (3.5%) breast cancer survivors. Compared with women without breast cancer, breast cancer survivors were 6 years older (mean age 77 vs 71 years, P < .001), had significantly higher prevalence of dyslipidemia and hypertension, and lower prevalence of obesity, diabetes mellitus, and smoking. Breast cancer survivors were more likely to have a non-ST segment elevation acute myocardial infarction and less likely to receive mechanical revascularization. In-hospital mortality was lower in breast cancer survivors (7.1%) compared with those without (7.9%, P < .001), findings that persisted after risk adjustment (odds ratio 0.89; 95% CI, 0.82-0.94). CONCLUSIONS Breast cancer survivors had a first acute myocardial infarction at an older age and had small but favorable differences in cardiovascular disease risk factors and outcomes compared with women without breast cancer. The favorable impact of health education, preventative medical care, greater motivation for a healthier lifestyle, and participation in cancer survivorship programs on these seemingly paradoxical findings in breast cancer survivors should be further explored.
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Affiliation(s)
| | - Aaqib H Malik
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY
| | | | | | | | - Christopher Nabors
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY
| | | | | | | | - William H Frishman
- Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY
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14
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Yee J, Davis GM, Hackett D, Beith JM, Wilcken N, Currow D, Emery J, Phillips J, Martin A, Hui R, Harrison M, Segelov E, Kilbreath SL. Physical Activity for Symptom Management in Women With Metastatic Breast Cancer: A Randomized Feasibility Trial on Physical Activity and Breast Metastases. J Pain Symptom Manage 2019; 58:929-939. [PMID: 31374368 DOI: 10.1016/j.jpainsymman.2019.07.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 12/22/2022]
Abstract
CONTEXT Physical activity for women with early-stage breast cancer is well recognized for managing cancer-related symptoms and improving quality of life. While typically excluded from interventions, women with metastatic breast cancer may also benefit from physical activity. OBJECTIVE To 1) determine the safety and feasibility of a physical activity program for women with metastatic breast cancer and 2) explore the efficacy of the program. METHODS Fourteen women with metastatic breast cancer were randomized to either a control group or an 8-week home-based physical activity intervention comprising twice weekly supervised resistance training and an unsupervized walking program. RESULTS The recruitment rate was 93%. Adherence to the resistance and walking components of the program was 100% and 25%, respectively. No adverse events were reported. When mean change scores from baseline to postintervention were compared, trends in favor of the exercise group over the control group were observed for the Functional Assessment of Chronic Illness Therapy-Fatigue score (+5.6 ± 3.2 vs. -1.8 ± 3.9, respectively), VO2max (+1.6 ml/kg/minute ±1.8 mL/kg/minute vs. -0.2 mL/kg/minute ±0.1 mL/kg/minute, respectively) and six-minute walk test (+40 m ± 23 m vs. -46 m ± 56 m, respectively). CONCLUSION A partially supervised home-based physical activity program for women with metastatic breast cancer is feasible and safe. The dose of the resistance training component was well tolerated and achievable in this population. In contrast, adherence and compliance to the walking program were poor. Preliminary data suggest a physical activity program, comprising predominantly resistance training, may lead to improvements in physical capacity and may help women to live well with their disease.
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Affiliation(s)
- Jasmine Yee
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Glen M Davis
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Daniel Hackett
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Jane M Beith
- The Chris O'Brien Lifehouse, Camperdown, Australia
| | - Nicholas Wilcken
- Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Lidcombe, Australia
| | - David Currow
- Faculty of Health Sciences, Flinders University, Daw Park, Australia
| | - Jon Emery
- General Practice and Primary Care Academic Centre, University of Melbourne, Parkville, Australia; General Practice, University of Western Australia, Crawley, Australia
| | - Jane Phillips
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Andrew Martin
- Clinical Trials Centre, University of Sydney, Camperdown, Australia
| | - Rina Hui
- Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Lidcombe, Australia
| | | | - Eva Segelov
- Monash Health and Monash University, Melbourne, Australia
| | - Sharon L Kilbreath
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia.
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Mazor M, Paul SM, Chesney MA, Chen LM, Smoot B, Topp K, Conley YP, Levine JD, Miaskowski C. Perceived stress is associated with a higher symptom burden in cancer survivors. Cancer 2019; 125:4509-4515. [PMID: 31503333 DOI: 10.1002/cncr.32477] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although multiple co-occurring symptoms are a significant problem for cancer survivors, to the authors' knowledge little is known regarding the phenotypic characteristics associated with a higher symptom burden. The objectives of the current study were to evaluate the occurrence, severity, and distress associated with 32 symptoms and examine the phenotypic and stress characteristics associated with a higher symptom burden. METHODS A total of 623 cancer survivors completed a demographic questionnaire, as well as measures of functional status, comorbidity, and global (Perceived Stress Scale) and cancer-related (Impact of Event Scale-Revised) stress. The Memorial Symptom Assessment Scale was used to evaluate symptom burden. Multiple linear regression analysis was used to determine the phenotypic characteristics associated with a higher symptom burden. RESULTS The mean number of symptoms was 9.1 (±5.2). The most common, severe, and distressing symptoms were lack of energy, problems with sexual interest/activity, and hair loss, respectively. Poorer functional status, a higher level of comorbidity, and a history of smoking as well as higher Perceived Stress Scale and Impact of Event Scale-Revised scores were associated with a higher symptom burden. The overall model explained approximately 45.6% of the variance in symptom burden. CONCLUSIONS Although cancer survivors report a high number of co-occurring symptoms of moderate severity and distress, in the current study, no disease or treatment characteristics were found to be associated with a higher symptom burden. Clinicians need to assess for general and disease-specific stressors and provide referrals for stress management interventions. Future studies need to examine the longitudinal relationships among symptom burden, functional status, and level of comorbidity, as well as the mechanisms that underlie the associations between stress and symptom burden.
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Affiliation(s)
- Melissa Mazor
- Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, California
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, California
| | - Margaret A Chesney
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Lee-May Chen
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Betty Smoot
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Kimberly Topp
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Yvette P Conley
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jon D Levine
- Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, California
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16
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Benton MJ, Schlairet MC, Graham HL. Physical activity-related quality of life in breast cancer survivors compared to healthy women. Eur J Cancer Care (Engl) 2019; 28:e13142. [PMID: 31465139 DOI: 10.1111/ecc.13142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/26/2019] [Accepted: 08/01/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To evaluate physical activity-related quality of life (PAQOL) in breast cancer survivors compared to healthy women. METHODS Physical activity level was measured as not active, somewhat active, active or very active. Intensity was reported as hours per week of light, moderate and vigorous activity. Physical activity-related quality of life was measured with the Vitality Plus Scale, a self-report instrument developed and validated to measure exercise-related health benefits. RESULTS Compared to healthy women (n = 23), breast cancer survivors (n = 23) were older (57.0 ± 2.3 vs. 49.0 ± 1.1 years; p < .01) and reported more light activity (4.1 ± 0.6 vs. 2.4 ± 0.5 hr/week; p < .05), but no differences in PAQOL. However, when grouped by physical activity level there were no differences in age, but inactive women (n = 30) had higher body mass index (29.3 ± 1.0 vs. 25.1 ± 1.1 kg/m2 ; p < .05) and reported less moderate (1.3 ± 0.4 vs. 3.6 ± 0.8 hr/week; p < .05) and vigorous (0.2 ± 0.1 vs. 1.9 ± 0.5 hr/week; p < .01) activity than active women (n = 16). Furthermore, active women reported higher overall PAQOL, greater energy levels and quicker sleep onset than inactive women (p < .05). CONCLUSIONS In these women, moderate and vigorous physical activity and PAQOL were not influenced by breast cancer survivorship. Despite diagnosis, active women who engaged in greater amounts of moderate and vigorous activity reported better PAQOL than inactive women.
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Affiliation(s)
| | - Maura C Schlairet
- Georgia Baptist College of Nursing, Mercer University, Atlanta, Georgia
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17
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Hulett JM, Fessele KL, Clayton MF, Eaton LH. Rigor and Reproducibility: A Systematic Review of Salivary Cortisol Sampling and Reporting Parameters Used in Cancer Survivorship Research. Biol Res Nurs 2019; 21:318-334. [PMID: 30857393 DOI: 10.1177/1099800419835321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Salivary cortisol is a commonly used biomarker in cancer survivorship research; however, variations in sampling protocols and parameter reporting limit comparisons across studies. Standardized practices to provide rigor and reproducibility of diurnal salivary cortisol sampling and reporting are not well established. Previous systematic reviews examining relationships between diurnal salivary cortisol and clinical outcomes have resulted in mixed findings. It remains unclear which sampling protocols and reporting parameters offer the greatest utility for clinical research. This review examines diurnal salivary cortisol sampling protocols and reporting parameters to evaluate whether a standardized approach is recommended. A comprehensive search of intervention studies among adult cancer survivors including diurnal salivary cortisol resulted in 30 articles for review. Sampling protocols ranged from 1 to 4 days with the majority of studies sampling cortisol for 2 days. Sampling instances ranged from 2 to 7 times per day, with the majority collecting at 4 time points per day. Diurnal cortisol slope and cortisol awakening response (CAR) were the most commonly reported parameters associated with clinical outcomes. Flattened cortisol slopes, blunted CARs, and elevated evening cortisol concentrations were associated with poorer psychosocial and physiological outcomes. Based on our review, we propose that a rigorous, standardized diurnal salivary cortisol sampling protocol should include sampling at key diurnal times across ≥3 consecutive days to report diurnal cortisol parameters (i.e., CAR and slope) and objective measures of participant protocol adherence. Diminishing budgetary resources and efforts to minimize participant burden dictate the importance of standardized cortisol sampling protocols and reporting parameters.
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Affiliation(s)
- Jennifer M Hulett
- 1 College of Nursing, University of South Carolina, Columbia, SC, USA
| | | | | | - Linda H Eaton
- 4 School of Nursing & Health Studies, University of Washington, Bothell, Bothell, WA, USA
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18
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Matias GHDL, Guerra ACCG, Souza Filho BABD, Lima JTDO, Carmo CND, Mattos IE. Repetibilidade e reprodutibilidade de um manual de exercícios físicos domiciliares. FISIOTERAPIA E PESQUISA 2018. [DOI: 10.1590/1809-2950/17010425022018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
RESUMO Verificou-se a reprodutibilidade e repetibilidade de um manual de exercícios físicos domiciliares em diferentes níveis de escolaridade em idosas com câncer de mama. Estudo seccional realizado entre agosto e novembro de 2016 no Instituto de Medicina Integral Professor Fernando Figueira (Imip), região metropolitana de Recife, Pernambuco. Vinte e duas idosas (idade 66.2±3.5 anos) diagnosticadas com câncer de mama em uso de hormonioterapia receberam um manual instrucional composto por 12 exercícios, a serem realizados de forma autônoma e independente em domicílio para melhoria das aptidões físicas. O manual foi entregue na primeira consulta e após seis semanas verificou-se sua reprodutibilidade por meio da avaliação de concordância em “certo” ou “errado” dos movimentos por um profissional de educação física e um fisioterapeuta. Os resultados foram analisados pelo coeficiente kappa de Cohen (k). Verificou-se uma relação interavaliadores de concordância “quase perfeita” (superior a 0,88) entre todos os 12 exercícios. Considerando a execução “certa” dos movimentos, verificou-se que seis exercícios apresentaram concordância interavaliadores com variação entre 68,2% e 90,9%; por outro lado, quando considerada a execução “errada”, observou-se variação entre 54,4% e 68,2%. Além disso, dois exercícios resultaram em 50% para “certo” e “errado”. Quanto ao nível de escolaridade, apenas o exercício 6 apresentou significância estatística (p-valor=0,03). O manual de exercícios físicos domiciliares parece ser reprodutível em idosas com câncer de mama em todos os níveis de escolaridade, para melhorar a aptidão física e promover o autocuidado funcional.
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19
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Miaskowski C, Mastick J, Paul SM, Abrams G, Cheung S, Sabes JH, Kober KM, Schumacher M, Conley YP, Topp K, Smoot B, Mausisa G, Mazor M, Wallhagen M, Levine JD. Impact of chemotherapy-induced neurotoxicities on adult cancer survivors' symptom burden and quality of life. J Cancer Surviv 2018; 12:234-245. [PMID: 29159795 PMCID: PMC5886787 DOI: 10.1007/s11764-017-0662-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/24/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE Limited information is available on the impact of chemotherapy (CTX)-induced neurotoxicity on adult survivors' symptom experience and quality of life (QOL). Purposes were to describe occurrence of hearing loss and tinnitus and evaluate for differences in phenotypic characteristics and measures of sensation, balance, perceived stress, symptom burden, and QOL between survivors who received neurotoxic CTX and did (i.e., neurotoxicity group) and did not (i.e., no neurotoxicity group) develop neurotoxicity. Neurotoxicity was defined as the presence of chemotherapy-induced neuropathy (CIN), hearing loss, and tinnitus. Survivors in the no neurotoxicity group had none of these conditions. METHODS Survivors (n = 609) completed questionnaires that evaluated hearing loss, tinnitus, stress, symptoms, and QOL. Objective measures of sensation and balance were evaluated. RESULTS Of the 609 survivors evaluated, 68.6% did and 31.4% did not have CIN. Of the survivors without CIN, 42.4% reported either hearing loss and/or tinnitus and 48.1% of the survivors with CIN reported some form of ototoxicity. Compared to the no neurotoxicity group (n = 110), survivors in the neurotoxicity group (n = 85) were older, were less likely to be employed, had a higher comorbidity burden, and a higher symptom burden, higher levels of perceived stress, and poorer QOL (all p < .05). CONCLUSIONS Findings suggest that CIN, hearing loss, and tinnitus are relatively common conditions in survivors who received neurotoxic CTX. IMPLICATIONS FOR CANCER SURVIVORS Survivors need to be evaluated for these neurotoxicities and receive appropriate interventions. Referrals to audiologists and physical therapists are warranted to improve survivors' hearing ability, functional status, and QOL.
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Affiliation(s)
- Christine Miaskowski
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
| | - Judy Mastick
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Steven M Paul
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Gary Abrams
- Schools of Medicine, University of California, San Francisco, CA, USA
| | - Steven Cheung
- Schools of Medicine, University of California, San Francisco, CA, USA
| | | | - Kord M Kober
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Mark Schumacher
- Schools of Medicine, University of California, San Francisco, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kimberly Topp
- Schools of Medicine, University of California, San Francisco, CA, USA
| | - Betty Smoot
- Schools of Medicine, University of California, San Francisco, CA, USA
| | - Grace Mausisa
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Melissa Mazor
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Margaret Wallhagen
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Jon D Levine
- Schools of Medicine, University of California, San Francisco, CA, USA
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20
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Ortiz A, Tirado M, Hughes DC, Gonzalez V, Song J, Mama SK, Basen-Engquist K. Relationship between physical activity, disability, and physical fitness profile in sedentary Latina breast cancer survivors. Physiother Theory Pract 2018; 34:783-794. [PMID: 29319387 DOI: 10.1080/09593985.2018.1424978] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. METHODS Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m2; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. RESULTS Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). CONCLUSION Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.
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Affiliation(s)
- Alexis Ortiz
- a School of Physical Therapy, Texas Woman's University - Houston Center - Physical Therapy , Houston TX USA
| | - Maribel Tirado
- b Puerto Rico Comprehensive Cancer Center , San Juan , Puerto Rico , USA
| | - Daniel C Hughes
- c Institute for Health Promotion Research, University of Texas Health Sciences Center , San Antonio , TX USA
| | - Velda Gonzalez
- d University of South Florida, School of Nursing , Tampa , FL USA
| | - JaeJoon Song
- e Department of Biostatistics , MD Anderson Cancer Center , Houston , TX USA
| | - Scherezade K Mama
- f Department of Kinesiology , Pennsylvania State University, University Park , PA , USA
| | - Karen Basen-Engquist
- g Center for Energy Balance in Cancer Prevention and Survivorship , Duncan Family Institute for Cancer Prevention and Risk Assessment, MD Anderson Cancer Center , Houston , TX , USA
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Hughes DC, Cox MG, Serice S, Baum G, Harrison C, Basen-Engquist K. Using rating of perceived exertion in assessing cardiorespiratory fitness in endometrial cancer survivors. Physiother Theory Pract 2017; 33:758-765. [PMID: 28820332 PMCID: PMC6087665 DOI: 10.1080/09593985.2017.1357150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
For cancer survivors, who also often present with co-existing health conditions, exercise testing is often performed using submaximal protocols incorporating linear heart rate response for estimating the cardiorespiratory capacity and assessing exercise tolerance. However, use of beta-blocker medications, during sub-maximal protocols based on linear HR response can be problematic. Rating of perceived exertion (RPE), which takes into account an individual's overall perception of effort, can be used as a complementary tool that does not rely solely on the heart rate response to increased workload. We compared heart rate response (VO2HR) and self-rating of perceived exertion (VO2RPE) in a graded submaximal exercise test (GXT) in 93 endometrial cancer survivors. The results of the GXT were stratified according to whether participants were taking beta-blocker (BB) medications or not (non-BB). Among non-BB participants, there was no difference between the mean VO2HR and the mean VO2RPE estimates of cardiorespiratory capacity (mlO2//kg/min) (20.4 and 19.3, respectively; p = 0.166). Among BB participants, the mean VO2HR approached significant difference than the mean VO2RPE (21.7 mlO2//kg/min and 17.6 mlO2//kg/min, respectively; p = 0.087). Bland-Altman plots for both methods showed a proportional bias for the non-BB group; but not the BB group. Our results suggest that sub-maximal protocols based on Borg's Rating of Perceived exertion (RPE) produce differing results from sub-maximal protocols based on HR response when applied to clinical population taking BB medications. Using RPE instead of HR for participants on BB medications may be a better method for assessing the exercise tolerance for estimating the cardiorespiratory capacity in sub-maximal exercise testing.
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Affiliation(s)
- Daniel C. Hughes
- Institute for Health Promotion Research, University of Texas Health Science Center – San Antonio, 7411 John Smith Dr., Suite 1000, San Antonio, TX 78229
| | - Matthew G. Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science University of Colorado
| | - Susan Serice
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - George Baum
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - Carol Harrison
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
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Kanera IM, Bolman CAW, Mesters I, Willems RA, Beaulen AAJM, Lechner L. Prevalence and correlates of healthy lifestyle behaviors among early cancer survivors. BMC Cancer 2016; 16:4. [PMID: 26732757 PMCID: PMC4702377 DOI: 10.1186/s12885-015-2019-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 12/15/2015] [Indexed: 02/01/2023] Open
Abstract
Background Healthy lifestyle behaviors have been demonstrated to be beneficial for positive health outcomes and the quality of life in cancer survivors. However, adherence to recommendations is low. More insight is needed in factors that may explain engagement in lifestyle behaviors to develop effective cancer aftercare interventions. This study assessed different factors, namely socio-demographic, cancer-related, psychological, social cognitive factors (attitude, social support, self-efficacy) and intention, in relationship to five lifestyle behaviors (smoking, physical activity, alcohol, and fruit and vegetable consumption). Methods Early survivors of various types of cancer were recruited from eighteen Dutch Hospitals (n = 255). Distal factors (socio-demographic, cancer related, psychological), proximal factors (social cognitive), intention and five lifestyle behaviors (smoking, physical activity, alcohol, fruit and vegetable consumption) were assessed through a self-reported questionnaire. Cross-sectional analyses (correlations and regression analyses) were conducted. Results The lifestyle of a small group (11 %) of the cancer survivors was coherent with all five health recommendations, the majority (>80 %) adhered to two, three of four recommendations, and only few (<7 %) adhered to one or none recommendation. The highest prevalence in followed recommendations have been detected in physical activity (87.4 %), refrain from smoking (82 %), and alcohol consumption (75.4 %). There was low adherence to the fruit recommendation (54.8 %) and to the vegetable recommendation (27.4 %). Only weak associations were found between the different behaviors. Each separate lifestyle behavior was influenced by different patterns of correlates. Self-efficacy, attitude, and intention were the strongest correlates in all examined behaviors, although with various contributions, while socio-demographic, cancer-related and psychological factors provided a much smaller contribution. Conclusions Outcomes of engagement in healthy lifestyle behaviors were more positive in this study compared to other research in cancer survivors; however, there is room for improvements in adherence to all five lifestyle behaviors. Especially fruit consumption was poor and vegetable consumption even worse. Our findings emphasized that all examined lifestyle behaviors need to be encouraged, with taken into account that each lifestyle behavior may be influenced by a specific set of mainly social cognitive factors or intention.
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Affiliation(s)
- Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, Maastricht, The Netherlands.
| | - Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Audrey A J M Beaulen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401, DL, Heerlen, The Netherlands.
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Vardar Yağlı N, Şener G, Arıkan H, Sağlam M, İnal İnce D, Savcı S, Çalık Kutukcu E, Altundağ K, Kaya EB, Kutluk T, Özışık Y. Do Yoga and Aerobic Exercise Training Have Impact on Functional Capacity, Fatigue, Peripheral Muscle Strength, and Quality of Life in Breast Cancer Survivors? Integr Cancer Ther 2015; 14:125-32. [DOI: 10.1177/1534735414565699] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim. The aim of the study was to compare the effects of aerobic exercise training and yoga on the functional capacity, peripheral muscle strength, quality of life (QOL), and fatigue in breast cancer survivors. Material and methods. A total of 52 patients with a diagnosis of breast cancer were included in the study. The patients were randomly assigned to 2 groups: aerobic exercise (n = 28) and yoga added to aerobic exercise (n = 24). Both groups participated in submaximal exercise 30 minutes/d, 3 d/wk for 6 weeks. The second group participated in a 1-hour yoga program in addition to aerobic exercise training. Functional capacity was assessed by the 6-Minute Walk Test (6MWT). Peripheral muscle strength was evaluated with a hand-held dynamometer. The fatigue severity level was assessed with the Fatigue Severity Scale (FSS). The QOL was determined by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire. Results. There were statistically significant increases in peripheral muscle strength, the 6MWT distance, and the perception of QOL in both groups ( P < .05). Additionally, the group with aerobic exercise and yoga showed marked improvement compared with the aerobic exercise group in fatigue perception ( P < .05). Conclusion. According to the data from this study, aerobic exercise training and yoga improved the functional capacity and QOL of breast cancer patients. Aerobic exercise programs can be supported by body mind techniques, such as yoga, in the rehabilitation of cancer patients for improving functional recovery and psychosocial wellness.
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Affiliation(s)
- Naciye Vardar Yağlı
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabiltation, Ankara, Turkey
| | - Gül Şener
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabiltation, Ankara, Turkey
| | - Hülya Arıkan
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabiltation, Ankara, Turkey
| | - Melda Sağlam
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabiltation, Ankara, Turkey
| | - Deniz İnal İnce
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabiltation, Ankara, Turkey
| | - Sema Savcı
- Dokuz Eylul University, Department of Physiotherapy and Rehabilitation, İzmir, Turkey
| | - Ebru Çalık Kutukcu
- Hacettepe University, Faculty of Health Sciences, Department of Physiotherapy and Rehabiltation, Ankara, Turkey
| | - Kadri Altundağ
- Hacettepe University, Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
| | - Ergun Barış Kaya
- Hacettepe University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Tezer Kutluk
- Hacettepe University, Faculty of Medicine, Department of Pediatric Oncology, Ankara, Turkey
| | - Yavuz Özışık
- Hacettepe University, Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey
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Kang J, Suh EE. The Influence of Stress, Spousal Support, and Resilience on the Ways of Coping among Women with Breast Cancer. ASIAN ONCOLOGY NURSING 2015. [DOI: 10.5388/aon.2015.15.1.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jiyoung Kang
- Graduate School of Nursing, Seoul National University, Seoul, Korea
| | - Eunyoung E. Suh
- College of Nursing, Research Institute of Nursing Science, Seoul National University , Seoul, Korea
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Ghosh S, Hughes D, Parma DL, Ramirez A, Li R. Association of obesity and circulating adipose stromal cells among breast cancer survivors. Mol Biol Rep 2014; 41:2907-16. [PMID: 24458825 DOI: 10.1007/s11033-014-3146-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 01/13/2014] [Indexed: 12/26/2022]
Abstract
A positive association of obesity with breast cancer incidence and mortality is well established. Recent reports indicate that adipose stromal cells (ASCs) play an important role in breast cancer development and progression by producing estrogens and tumor-promoting cytokines. Furthermore, circulating ASCs have been uniquely detected in obese individuals, which is likely due to increased tissue remodeling and cell mobilization. The number of circulating ASCs is even more prominent in obese patients with colon and prostate cancers, both of which are exacerbated by obesity. To determine whether a similar association exists for breast cancer, we collected blood samples from a cohort of breast cancer survivors and enumerated circulating ASCs by flow cytometry on the basis of the previously established ASC-associated immunophenotype (CD34+/CD31-/CD45-). We found significantly higher levels of circulating ASCs (p<0.001) in breast cancer survivors with body mass index (BMI)≥30 kg/m2 than their non-obese counterparts (BMI<30). We also compared circulating ASCs before and after exercise of only the obese subjects enrolled in a 6-month individualized exercise program, but found no statistically significant difference, likely due to limited number of subjects in the study. Our findings suggest that circulating ASCs can serve as a potential biomarker for future studies of the impacts of obesity and physical activity on breast cancer recurrence and survival.
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Affiliation(s)
- Sagar Ghosh
- Department of Molecular Medicine, Institute of Biotechnology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
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