Perceived facilitators and barriers by esophageal cancer survivors participating in a post-treatment exercise program
van Vulpen, Jonna K; Witlox, Lenja; Methorst-de Haan, Alida C; Hiensch, Anouk E; van Hillegersberg, Richard; Ruurda, Jelle P; Nieuwenhuijzen, Grard A P; Kouwenhoven, Ewout A; Siersema, Peter D; May, Anne M
(2023) Supportive Care in Cancer, volume 31, issue 6, pp.
(Article)
Abstract
Purpose: Participation in a post-treatment exercise program improves cardiorespiratory fitness and aspects of quality of life for esophageal cancer survivors. For optimal effects, high adherence to the exercise intervention is important. We assessed which facilitators and barriers to exercise adherence are perceived by esophageal cancer survivors, who participate in a
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post-treatment exercise program. Methods: The current qualitative study was performed within the randomized controlled PERFECT trial, in which we investigated effects of a 12-week supervised exercise program with moderate-to-high intensity and daily physical activity advice. Semi-structured interviews were conducted with patients randomized to the exercise group. A thematic content approach was used to derive perceived facilitators and barriers. Results: Thematic saturation was reached after inclusion of sixteen patients. Median session attendance was 97.9% (IQR 91.7–100%), and relative dose intensity (compliance) to all exercises was ≥90.0%. Adherence to the activity advice was 50.0% (16.7–60.4%). Facilitators and barriers were captured in seven themes. The most important facilitators were patients’ own intention to engage in exercise and supervision by a physiotherapist. Barriers were mainly experienced in completion of the activity advice, and included logistic factors and physical complaints. Conclusions: Esophageal cancer survivors are well capable to attend a moderate-to-high intensity post-treatment exercise program, and to fulfill the exercises according to protocol. This is facilitated by patients’ own intention to engage in exercise and supervision of the physiotherapist, and only minimally affected by barriers as logistic factors and physical complaints. Implications for cancer survivors: When implementing postoperative exercise programs in clinical care, it can be useful to be aware of perceived facilitators and barriers of cancer survivors in order to achieve optimal exercise adherence and maximize beneficial exercise effects.
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Keywords: Cancer Survivors, Esophageal Neoplasms/therapy, Exercise, Exercise Therapy/methods, Humans, Quality of Life, Survivors, Adherence, Facilitators and barriers, Esophageal cancer, Cancer survivorship, Quality of life, Oncology, Randomized Controlled Trial, Journal Article
ISSN: 0941-4355
Publisher: Springer-Verlag
Note: Funding Information: We would like to thank all participants, physiotherapists, and the professional staff at UMC Utrecht, Utrecht; Hospital Group Twente (ZGT), Almelo; and Catharina Hospital, Eindhoven for their invaluable participation in this trial. Funding Information: The PERFECT study was funded by the World Cancer Research Fund, The Netherlands (WCRF NL, project number 2013/997). They had no role in the study design, collection, analysis, or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Publisher Copyright: © 2023, The Author(s).
(Peer reviewed)