Attitudes towards physical activity and exercise in older patients with advanced cancer during oncological treatment – A qualitative interview study. (August 2019)

• Record Type: Journal Article
• Authors: Mikkelsen, Marta Kramer; Nielsen, Dorte Lisbet; Vinther, Anders; Lund, Cecilia Margareta; Jarden, Mary
• Is Part Of: European journal of oncology nursing. Volume 41(2019)
• Page Start: 16
• Page End: 23
• Publication Date: 2019-08
• Subjects: Advanced cancer -- Barriers -- Exercise -- Facilitators -- Motivation -- Older -- Physical activity -- Preferences -- Qualitative interviews; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2019.04.005
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: Older patients with cancer are underrepresented in exercise-based trials. To engage older patients in physical activity (PA), it is necessary to consider age-related decline in health, comorbidities and practicalities. The study aim was to explore attitudes towards PA and exercise among older patients with cancer to inform future exercise-based interventions. Method: Individual interviews (N = 23) were conducted in patients ≥ 65 years with advanced lung, biliary tract and pancreatic cancer receiving palliative oncological treatment. Patients were recruited with a purposive sampling strategy. A semi-structured interview guide focusing on attitudes towards PA and exercise, including barriers, facilitators and motivators, was used. Data on the informants' medical history, demographics and PA level was collected. Results: Identified themes were: 1) a general positive perception of physical activity is expressed 2) comorbidities and external circumstances prevent physical activity, 3) fatigue overshadows life, 4) social support is key to short and long-term motivation, 5) fixed conditions keep one focused, 6) familiarity raises confidence and motivation. Conclusions: Even though perceptions of PA were positive among older patients with cancer, most struggled to stay physically active during oncological treatment. Several factors related to cancer and aging were identified as barriers; most profoundly was the overwhelming feeling of fatigue. Improving physical and mental well-being, fixed conditions (e.g. group-based exercise and supervision) and social support were identified as motivators and facilitators. Preferences for PA varied, but activities that were familiar increased motivation. Exercise programs for older patients with cancer must be adjustable to each patient's limitations, needs and personal resources. Highlights: A general positive perception of physical activity and exercise. It is difficult for older patients with cancer to stay physically active during oncological treatment. Fatigue is the greatest barrier towards physical activity and exercise. Other barriers to exercise include comorbidities, declines in health and practicalities. Fixed conditions, familiar activities and social support are important motivators for physical activity.