The Cancer Rehabilitation Journey: Barriers to and Facilitators of Exercise Among Patients With Cancer-Related Fatigue
The Cancer Rehabilitation Journey: Barriers to and Facilitators of Exercise Among Patients With Cancer-Related Fatigue
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DOI：
10.2522/ptj.20090278
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发表时间：
2010-08-01
期刊：
影响因子：
3.2
通讯作者：
Gracey, Jackie
中科院分区：
文献类型：
--
作者：
Blaney, Janine;Lowe-Strong, Andrea;Gracey, Jackie
背景尽管有证据支持运动是癌症相关性疲劳（CRF）患者的有效管理策略，但许多一般癌症人群都是久坐不动的。本研究的目的是探讨CRF患者的混合样本中运动的障碍和促进因素。采用探索性、描述性、定性设计。目的抽样方法用于招募代表癌症轨迹的CRF患者，即癌症幸存者和最近诊断并接受治疗的姑息治疗患者。焦点小组讨论逐字转录和分析使用扎根理论的方法。较低层次的概念被确定并按子类别排序。然后将相关的子类别分组形成主类别，主类别与核心类别相联系。五个焦点小组进行了26名参与者。在癌症康复之旅的核心类别中有3个主要类别：（1）运动障碍，（2）运动促进者，（3）运动动机。运动障碍主要与治疗副作用有关，特别是疲劳。疲劳与其他障碍有关，如身体失调、社会孤立和难以使锻炼成为常规。环境因素和运动开始的时间也是障碍。运动促进者包括一个基于小组的运动计划，监督，单独定制，并逐步进行。运动动机与感知的运动益处有关。CRF患者在治疗期间和治疗后都有许多运动障碍。本研究中确定的运动促进者为这些障碍提供了解决方案，并可能有助于运动计划的吸收和维持。这些发现将有助于物理治疗师为CRF患者设计适当的运动计划。
Background. Despite the evidence to support exercise as an effective management strategy for patients with cancer-related fatigue (CRF), many of the general cancer population are sedentary.Objective. The aim of this study was to explore the barriers to and facilitators of exercise among a mixed sample of patients with CRF.Design. An exploratory, descriptive, qualitative design was used.Methods. Purposive sampling methods were used to recruit patients with CRF who were representative of the cancer trajectory, that is, survivors of cancer and patients in palliative care who were recently diagnosed and undergoing treatment. Focus group discussions were transcribed verbatim and analyzed using a grounded theory approach. Lower-level concepts were identified and ordered into subcategories. Related subcategories then were grouped to form the main categories, which were linked to the core category.Results. Five focus groups were conducted with 26 participants. Within the core category of the cancer rehabilitation journey were 3 main categories: (1) exercise barriers, (2) exercise facilitators, and (3) motivators of exercise. Exercise barriers were mainly related to treatment side effects, particularly fatigue. Fatigue was associated with additional barriers such as physical deconditioning, social isolation, and the difficulty of making exercise a routine. Environmental factors and the timing of exercise initiation also were barriers. Exercise facilitators included an exercise program being group-based, supervised, individually tailored, and gradually progressed. Exercise motivators were related to perceived exercise benefits.Conclusions. Individuals with CRF have numerous barriers to exercise, both during and following treatment. The exercise facilitators identified in this study provide solutions to these barriers and may assist with the uptake and maintenance of exercise programs. These findings will aid physical therapists in designing appropriate exercise programs for patients with CRF.