Barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer

Abstract

Purpose Ovarian cancer is the leading cause of death among gynecological cancers, with low survival rates and a high disease burden. Despite the known benefits, most women reduce their participation in physical activity following diagnosis. Little is known about ovarian cancer survivors’ experiences of physical activity. The primary aim of this study was to explore the barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. Methods A qualitative descriptive study design was conducted via semi-structured interviews with nine women diagnosed with ovarian cancer (stages I–IV; 40–77 years). The interviews took place at the participant’s home via telephone or online video conferencing software Coviu©. An inductive thematic approach was used. The organization and coding of data were completed using NVivo computer software (Version 12.6.0, QSR International Pty Ltd.). Weekly discussions occurred among the research team to ensure that themes accurately represented participant views. The consolidated criteria for reporting qualitative studies (COREQ) 32-item checklist were followed. Results The main barriers to physical activity participation that emerged were (i) the lack of referral to an exercise professional within the multidisciplinary cancer team, (ii) fear of injury after surgery and during treatment, and (iii) treatment-related side effects. However, many of the participants perceived benefits of physical activity related to (i) enhanced physical and psychological health, (ii) improved cancer outcomes, and (iii) social benefits as key enablers of physical activity participation. Conclusions Physical activity interventions for women with ovarian cancer should address the modifiable barriers identified in this study. A key focus should be to streamline timely referral pathways within the multidisciplinary team, including exercise professionals, dietitians, psychologists, and specialists nurses following a diagnosis of ovarian cancer. Further research and service development are needed to optimize supported self-management through (i) education about the importance of physical activity to both healthcare professionals and women alike, (ii) enhanced symptom management for women, which was identified as a barrier to participation, and (iii) the development of shared care plans and patient center goals to address any fears or concerns. Implications for cancer survivors People diagnosed with ovarian cancer have low participation levels of physical activity. Cancer care professionals’ support could increase physical activity uptake and reduce some of the burden of an ovarian cancer diagnosis.

What are the mechanisms underlying the delivery of survivorship care information in Australia? A realist review

“…Twenty-three studies contributed to the theory that dedicated survivorship staff can ensure that survivors receive quality survivorship information that addresses their needs. 22,24,25,27,[33][34][35][36][37][38]41,42,[44][45][46][47][48][49][50][51][52][53][54] In several studies, healthcare professionals reported that due to their high caseloads and competing priorities, limited time is dedicated to the provision of survivorship information; particularly at times where the survivor is undergoing active treatment and communications tend to focus on clinical issues. 24,33,37,50 Crawford-Williams and colleagues examined experiences of rural Australian cancer survivors and found that due to the limited consultation time dedicated to survivorship, survivors experienced difficulties in processing and retaining this information and felt their emotional needs were overlooked.…”

“…Eleven studies contributed to the generation of this theory on the importance of providing multiple modalities of survivorship information. 28,30,31,34,35,41,42,51,54,60,62 Consultations with healthcare professionals, either in-person or phone-based, are valued and regularly utilized by cancer survivors. 30,35,41,42 Indeed, in the study by Herrmann and colleagues, some cancer survivors suggested providing face-to-face information and support sessions at multiple geographical locations to improve accessibility.…”