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. 2017 Aug 23;7(8):e016689.
doi: 10.1136/bmjopen-2017-016689.

Rethinking exercise identity: a qualitative study of physically inactive cancer patients' transforming process while undergoing chemotherapy

Lis Adamsen  1   2 , Christina Andersen  1 , Christian Lillelund  1 , Kira Bloomquist  1 , Tom Møller  1   2
Affiliations

Rethinking exercise identity: a qualitative study of physically inactive cancer patients' transforming process while undergoing chemotherapy

Lis Adamsen et al. BMJ Open. .

Abstract

Objective: To explore physically inactive breast and colon cancer patients' prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy.

Design: An explorative qualitative study guided the interpretive analysis of semistructured, open-ended interviews conducted at initiation of chemotherapy and after 12 weeks. The study was embedded in a pilot randomised controlled trial.

Setting: Participants were recruited from the Oncological Department at a hospital in Copenhagen, Denmark.

Participants: 33 patients with cancer, median age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist's PA recommendation and exercise, cancer nurse specialist's counselling prior to allocation to PA interventions or waitlist control group.

Results: Prediagnosis exercise had been excluded from patients' daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients to reconsider their attitudes and behaviour by accepting recruitment and participation in PA interventions during chemotherapy. Despite extensive side effects, most patients adhered to their PA commitment due to their perception of the bodily, emotional and social benefits and support of healthcare professionals, peers and family.

Conclusion: The patients' attitude towards exercise transformed from having no priority in patients' daily lives prediagnosis to being highly prioritised. This study identified four important phases in the exercise transformation process during the patients' treatment trajectory of relevance to clinicians in identifying, motivating and supporting physically inactive patients with cancer at long-term risk. Clinicians should address young, highly educated patients with cancer at onset of adjuvant chemotherapy due to their specific risk of a sedentary lifestyle resulting from being in stressful, ambitious careers.

Trial registration number: Current Controlled Trials (ISRCTN24901641), Stage: Qualitative results.

Keywords: breast tumours; chemotherapy; gastrointestinal tumours; qualitative research; rehabilitation medicine; sports medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Overview of recruitment, study period and qualitative interviews. ECNS, exercise cancer nurse specialist; FOLFOX, oxaliplatin, 5-flourouracil and folinic acid; PA, physical activity; WCG, waitlist control group
Figure 2
Figure 2
Model of the exercise transforming process for physically inactive cancer patients.
See this image and copyright information in PMC

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References

    1. The Danish Health Data Authority. Cancer Incidence in Denmark: Danish cancer registry 2015. Copenhagen: The Danish Health Data Authority; 2016.
    1. Schmitz KH, Courneya KS, Matthews C, et al. . American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 2010;42:1409–26. 10.1249/MSS.0b013e3181e0c112 - DOI - PubMed
    1. Mishra SI, Scherer RW, Snyder C, et al. . Exercise interventions on health-related quality of life for people with cancer during active treatment. Clin Otolaryngol 2012;37:390–2. 10.1111/coa.12015 - DOI - PubMed
    1. Fong DY, Ho JW, Hui BP, et al. . Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ 2012;344:e70 10.1136/bmj.e70 - DOI - PMC - PubMed
    1. Furmaniak AC, Menig M, Markes MH. Exercise for women receiving adjuvant therapy for breast cancer. Cochrane Database Syst Rev 2016;9:CD005001 10.1002/14651858.CD005001.pub3 - DOI - PMC - PubMed