Preliminary study of the lived experience of exercise for cancer survivors

doi:10.1016/j.ejon.2004.08.003

European Journal of Oncology Nursing

Volume 9, Issue 2, June 2005, Pages 155-166

https://doi.org/10.1016/j.ejon.2004.08.003 Get rights and content

Summary

There is a growing body of evidence indicating the physical and psychosocial health benefits of exercising during cancer rehabilitation. However, physical activity levels of cancer survivors are generally low. This study adopted a qualitative approach to increase understanding of the lived experience of exercise for cancer survivors. Semi-structured interviews were carried out with six female cancer survivors who had taken part in the 2003 Race for Life fundraising event for Cancer Research UK. Following verbatim transcription of interviews, data reduction was carried out using Van Manen's method of thematic content analysis. Assimilation of central themes forms the basis of the final report. The essence of cancer survivors’ experience of exercise was determined as ‘going forward’—to move on, physically and mentally following treatment, to rebuild social networks, and to restore a positive, confident outlook towards the future. The central theme of ‘going forward’ was identified in aspects of participants’ physical and mental recovery, and their future intentions for exercise. Race for Life represented a positive focus for participants after cancer treatment, and proved to be an appropriate starting point for initiating, or returning to exercise following cancer. The results of the study support the suggestion that advice regarding exercise should be included in rehabilitation care for some cancer patients.

Zusammenfassung

Die Anzahl der Berichte für die positiven physischen wie auch psychosozialen Auswirkungen von körperlicher Bewegung während der Krebs-Rehabilitation nimmt ständig zu. Das Ausmaß an körperlicher Aktivität bei Krebsüberlebenden ist trotzdem im Allgemeinen gering. In dieser Studie wurde eine qualitative Herangehensweise gewählt, um die von Krebsüberlebenden gemachten Erfahrungen mit körperlicher Bewegung besser zu verstehen. Zum Teil strukturierte Interviews wurden mit sechs weiblichen Krebsüberlebenden geführt, die an der von Cancer Research UK organisierten Wohltätigkeitsveranstaltung Race for Life 2003 teilgenommen hatten. Anschließend an die wörtliche Niederschrift der Interviews wurde nach der Van-Manen-Methode der thematisch geordneten Inhaltsanalyse eine Datenreduktion vorgenommen. Die Integration der zentralen Themen stellt die Grundlage des endgültigen Berichtes dar. Der Kernpunkt der Erfahrungen von Krebsüberlebenden mit körperlicher Bewegung wurde als „Going Forward“ beschrieben–sich physisch und psychisch nach der Behandlung weiterzubewegen, soziale Netze wiederaufzubauen und eine positive, zuversichtliche Zukunftsperspektive wiederherzustellen. Der Slogan „Going Forward“ wurde als zentrales Thema in vielen Aspekten der physischem und psychischen Erholung der Teilnehmer beschrieben und diente auch als Leitmotiv bei den Plänen zur zukünftigen körperlichen Bewegung. Race for Life stellte einen positiven Fokus für Teilnehmer nach der Krebsbehandlung dar und erwies sich als ein angemessener Ausgangspunkt für die Aufnahme oder Wiederaufnahme von körperlicher Aktivität nach der Krankheit. Die Ergebnisse der Studie bekräftigen den Vorschlag, dass die Rehabilitationsmaßnahmen für einige Krebspatienten Informationen über körperliche Bewegung beinhalten sollten.

Section snippets

Background

Cancer diagnosis and treatment can be associated with a range of unfavourable outcomes that can have a negative impact on quality of life. Physical problems may include diminished physical fitness and strength, limited mobility, nausea, fatigue, pain and sleep problems (Cleeland et al., 2000; Ringdal et al., 1994). Psychological consequences include anxiety, stress, depression, loneliness, anger, reduced self-esteem, poor body image and loss of perceived control (Spiegel, 1997; Zabora et al.,

Methods

This study used a phenomenological approach to explore the lived experience of exercise for cancer survivors (Van Manen, 1990). Phenomenology was chosen as the method of research in this qualitative, semi-structured interview study because the research aimed to uncover the lived experience of exercise for cancer survivors: what it is like, and what it means to individuals (Van Manen, 1990). The aim of phenomenology is to acquire understanding of the meaning of phenomena within individuals’

Participant characteristics

Of the 24 women invited to be interviewed for the study, 18 declined to participate. The six women who completed interviews had a mean age of 41.6±13.4 years (range 30–55 years). Mean time since diagnosis was 7±11 years (range 1–18 years). Primary cancer diagnoses were breast cancer ( $n = 4$ ), skin cancer ( $n = 1$ ) and leukaemia ( $n = 1$ ). Three women worked full-time, two worked part-time, and one participant was unemployed. All were of British nationality. Sociodemographic information for the

Discussion

This study contributes to the existing literature on exercise and cancer rehabilitation by focusing on the lived experience of exercise for cancer survivors taking part in Race for Life. The theme of ‘going forward’ emerged from the analyses to encapsulate the essence of the experience of exercise during cancer survivorship. This impression of ‘going forward’ through exercise was evident during the period of recovery from treatment for patients, and in facilitating a return to normality.

Conclusion

This study of cancer survivors’ lived experience of exercise suggests that exercise makes an important contribution to physical and psychosocial recovery from cancer treatment in some individuals. Race for Life had an important role in motivating the cancer survivors in this study to initiate and continue with exercise.

Acknowledgements

We would like to thank Kate Stocken from Cancer Research UK for helping to recruit participants for this study and Dr Jim McKenna for his advice on data analysis. Furthermore, we greatly appreciate the time given up by all those who agreed to be interviewed and their willingness to share their experiences. Clare Stevinson is funded by Cancer Research UK [CUK] grant number C3875/A3887. Elizabeth Hennessy won the Hewlett Packard MSc Dissertation of the Year award for 2003/2004 in Exercise and

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The women in our study reported that PA gave them a sense of trust in their body, pride and a belief in themselves, it gave them a sense of mental strength; rather than sliding into self-pity but instead, to look forward. PA during cancer treatment has previously been demonstrated to be important the for recovery process, to move forward and facilitate a return to a normal life (Hennessy et al., 2005; Bulmer et al., 2012; Luoma et al., 2014) findings which support our results. The majority of the women in the present study described that they would not be doing any PA during the chemotherapy treatment if they had not been invited to do this in this controlled and supportive way.
The aim of this study was to explore how women with breast cancer experience physical activity (PA) during adjuvant chemotherapy treatment.
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Physical activity has recently become a safe and feasible adjunct therapy during and after cancer treatment by providing patients with a higher physical and psychological quality of life (Biddle, Fox, Boutcher & Faulkner, 2000; Campbell, Mutrie, White, McGuire, & Kearney, 2004; Courneya, 2003; Courneya, Mackey, & Jones, 2000; Courneya, Mackey, & McKenzie, 2002; Mutrie et al., 2007; Weert et al., 2005). The reported advantages of group exercise training are not only the enhanced physical benefits but the social aspects of group exercise which increase the enjoyment of the intervention (Emslie et al., 2007; Hennessy, Stevinson, & Fox, 2005; Sabiston, McDonough, & Crocker, 2007; Stevinson & Fox, 2006). Emslie et al. (2007) outlined that the benefits of this type of group intervention are that they offer a non-pressurised supportive environment and the freedom with which to self-disclose without the pressure and expectations that other group therapies may induce.
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The role of social support has not been explicitly addressed, which may have a very important role in exercise adherence, feelings of confidence to participate in exercise, and general psychological well-being. Social support helps survivors rebuild social networks and has been related to improvement in QOL.35,65 Social support can motivate survivors to engage in exercise and encourage continued participation.
To review the evidence of the effects of exercise interventions in patients with cancer in each of four quality-of-life domains: physical, psychological, social, and spiritual.
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There is sufficient evidence to support exercise as an intervention to enhance a cancer patient's physical functioning and psychological well-being. Nurses should be encouraged to integrate physical activity recommendations into practice, tailored to the individual's health condition and mutual goal setting.
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Supervised Physical Activity Quickly Improves Social Dimension of Quality of Life in Breast Cancer Patients
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View full text

Preliminary study of the lived experience of exercise for cancer survivors

Summary

Zusammenfassung

Section snippets

Background

Methods

Participant characteristics

Discussion

Conclusion

Acknowledgements

Psychosomatics

Patient Education Counseling

Qualitative Research for EducationAn Introduction to Theory and Methods

Noncancer deaths in white adult cancer patients

Journal of the National Cancer Institute

Assessing symptom distress in cancer patients

Cancer

Exercise interventions during cancer treatmentbiopsychosocial outcomes

Exercise and Sports Science Reviews

Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors

Journal of Alternative Complementary Medicine

Coping with cancer. Can exercise help?

The Physician and Sportsmedicine

Exercise for breast cancer survivorsresearch evidence and clinical guidelines

The Physician and Sportsmedicine

Randomized controlled trial of exercise training in postmenopausal breast cancer survivorscardiopulmonary and quality of life outcomes

Journal of Clinical Oncology

The group psychotherapy and home-based physical exercise (GROUP-HOPE) trial in cancer survivors, physical fitness and quality of life outcomes

Psycho-Oncology

The lived experience of self-transcendence in women with advanced breast cancer

Nursing Science Quarterly

Current health behaviours and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas

Cancer

Aerobic exercise in the rehabilitation of cancer patients after high dose chemotherapy and autologous peripheral stem cell transplantation

Cancer

Effects of exercise on cancer-related fatigue

Cancer

The Cancer Wellness Manual

Quality of life in long-term cancer survivors

Oncology Nursing Forum

Breast cancer survivors give voicea qualitative analysis of spiritual factors in long term adjustment

Psycho-Oncology

Exercise counselling and programming preferences of cancer survivors

Cancer Practice