Barriers and supportive factors in engaging cancer patients in physical activity programmes – a literature review

Česká verzia

Authors: I. Burešová ¹; J. Halámková ²; I. Kiss ²; K. Kapounková ³; I. Hrnčiříková ³
Authors place of work: Psychologický ústav, Filozofi cká fakulta, MU Brno ¹; Masarykův onkologický ústav, Brno ²; Katedra pohybových aktivit a zdraví, Fakulta sportovních studií, MU Brno ³
Published in the journal: Klin Onkol 2024; 38(3): 178-183
Category: Přehledy
doi: https://doi.org/10.48095/ccko2024178

Summary

Background: Regardless of cancer type or stage of treatment, physical activity (PA) has been shown to reduce the risk of cancer recurrence and death. It is associated with a range of positive effects on patients‘ physical and psychological well-being, particularly in the areas of aerobic fitness, fatigue, mental health and perceived overall quality of life. However, in current oncology practice, the combination of its indication with treatment is still relatively rare. At the same time, cancer patients‘ participation in regular physical activity is usually very low. However, as PA is an effective method to support cancer treatment and plays an important role in prevention, it is necessary to find effective strategies to involve patients more widely in physical activities. To this end, physical activity programmes organised directly by facilities providing comprehensive cancer care appear to be very suitable. Purpose: This literature review maps the main barriers and facilitators to cancer patients‘ participation in physical activity programmes. In particular, economic factors related to health policy, reflected in the availability of this type of supportive care for patients, the level of health literacy, the organization of PA programs, health care providers – both physicians and health care workers, social support and intrapsychic influences on the part of patients play a major role. Since the implementation of physical activity programmes into the existing cancer care system is a rather challenging process, the paper also deals with the possibilities of using the Health Belief Model. In the given context, this model allows the prediction and identification of barriers and supportive factors to patients‘ involvement in PA programs in order to maximize their effectiveness and adapt them to the needs of patients and, at the same time, to the capabilities of a specific medical facility.

Keywords:

Patients – Physical activity – cancer – barriers – supporting factors

Zdroje

1. Can G, Erol O, Aydiner A et al. Non-pharmacological interventions used by cancer patients during chemotherapy in Turkey. Eur J Oncol Nurs 2011; 15 (2): 178–184. doi: 10.1016/j.ejon.2010.07.005.

2. Ginzac A, Passildas J, Gadéa E et al. Treatment-induced cardiotoxicity in breast cancer: a review of the interest of practicing a physical activity. Oncology 2019; 96 (5): 223–234. doi: 10.1159/000499383.

3. Misiąg W, Piszczyk A, Szymańska-Chabowska A et al. Physical activity and cancer care: a review. Cancers (Basel) 2022; 14 (17): 4154. doi: 10.3390/cancers14174154.

4. Parker NH, Arlinghaus KR, Johnston CA. Integrating physical activity into clinical cancer care. Am J Lifestyle Med 2018; 12 (3): 220–223. doi: 10.1177/1559827618759478.

5. Lugo D, Pulido AL, Mihos CG et al. The effects of physical activity on cancer prevention, treatment and prognosis: a review of the literature. Complement Ther Med 2019; 44: 9–13. doi: 10.1016/j.ctim.2019.03.013.

6. National Cancer Institute. Cancer survivors and physical activity. [online]. Available from: https: //progressreport.cancer.gov/after/physical_activity.

7. Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act 2021; 18 (1): 50. doi: 10.1186/s12966-021-01116-9.

8. Avancini A, Pala V, Trestini I et al. Exercise levels and preferences in cancer patients: a cross-sectional study. Int J Environ Res Public Health 2020; 17 (15): 5351. doi: 10.3390/ijerph17155351.

9. Gildea GC, Spence RR, Jones TL et al. Barriers, facilitators, perceptions and preferences influencing physical activity participation, and the similarities and differences between cancer types and treatment stages: a systematic rapid review. Prev Med Rep 2023; 34: 102255. doi: 10.1016/j.pmedr.2023.102255.

10. Granger CL, Connolly B, Denehy L et al. Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer 2017; 25 (3): 983–999. doi: 10.1007/s00520-016-34 84-8.

11. Haier J, Schaefers J. Economic perspective of cancer care and its consequences for vulnerable groups. Cancers (Basel) 2022; 14 (13): 3158. doi: 10.3390/cancers14133 158.

12. IJsbrandy C, Hermens RPMG, Boerboom LWM et al. Implementing physical activity programs for patients with cancer in current practice: patients’ experienced barriers and facilitators. J Cancer Surviv 2019; 13 (5): 703–712. doi: 10.1007/s11764-019-00789-3.

13. Maarse H, Jeurissen P, Ruwaard D. Results of the market-oriented reform in the Netherlands: a review. Health Econ Policy Law 2016; 11 (2): 161–178. doi: 10.1017/S1744133115000353.

14. Kučera Z, Pelikan J, Šteflová A. Health literacy in Czech population results of the comparative representative research. Cas Lek Cesk 2016; 155 (5): 233–241.

15. Housten AJ, Gunn CM, Paasche-Orlow MK et al. Health literacy interventions in cancer: a systematic review. J Cancer Educ 2021; 36 (2): 240–252. doi: 10.1007/s13187-020-01915-x.

16. Blaney JM, Lowe-Strong A, Rankin-Watt J et al. Cancer survivors’ exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire-survey. Psychooncology 2013; 22 (1): 186–194. doi: 10.1002/pon.2072.

17. Ottenbacher AJ, Day RS, Taylor WC et al. Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer 2012; 20 (10): 2483–2489. doi: 10.1007/s00520-011-1370-y.

18. Roscoe CMP, Pringle A, Chandler C et al. The role of physical activity in cancer recovery: an exercise practitioner’s perspective. Int J Environ Res Public Health 2022; 19 (6): 3600. doi: 10.3390/ijerph19063600.

19. Arora NK, Finney Rutten LJ, Gustafson DH et al. Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer. Psychooncology 2007; 16 (5): 474–486. doi: 10.1002/pon.1084.

20. Rutledge TL, Kano M, Guest D et al. Optimizing endometrial cancer follow-up and survivorship care for rural and other underserved women: patient and provider perspectives. Gynecol Oncol 2017; 145 (2): 334–339. doi: 10.1016/j.ygyno.2017.03.009.

21. Farrance C, Tsofliou F, Clark C. Adherence to community-based group exercise interventions for older people: a mixed-methods systematic review. Prev Med 2016; 87: 155–166. doi: 10.1016/j.ypmed.2016.02.037.

22. Eng L, Pringle D, Su J et al. Patterns, perceptions, and perceived barriers to physical activity in adult cancer survivors. Support Care Cancer 2018; 26 (11): 3755–3763. doi: 10.1007/s00520-018-4239-5.

23. Felser S, Behrens M, Lampe H et al. Motivation and preferences of cancer patients to perform physical training. Eur J Cancer Care (Engl) 2020; 29 (4): e13246. doi: 10.1111/ecc.13246.

24. Ungar N, Wiskemann J, Sieverding M. Physical activity enjoyment and self-efficacy as predictors of cancer patients’ physical activity level. Front Psychol 2016; 7: 898. doi: 10.3389/fpsyg.2016.00898.

25. Jones CL, Jensen JD, Scherr CL et al. The health belief model as an explanatory framework in communication research: exploring parallel, serial, and moderated mediation. Health Commun 2015; 30 (6): 566–576. doi: 10.1080/10410236.2013.873363.

26. Shafieian M, Kazemi A. A randomized trial to promote physical activity during pregnancy based on health belief model. J Educ Health Promot 2017; 6: 40. doi: 10.4103/jehp.jehp_19_15.

27. Wu S, Feng X, Sun X. Development and evaluation of the health belief model scale for exercise. Int J Nurs Sci 2020; 7 (Suppl 1): 23–30. doi: 10.1016/j.ijnss.2020. 07.006.

28. Zyzniewska-Banaszak E, Kucharska-Mazur J, Mazur A. Physiotherapy and physical activity as factors improving the psychological state of patients with cancer. Front Psychiatry 2021; 12: 772694. doi: 10.3389/fpsyt.2021.772694.