Barriers to physical activity participation in colorectal cancer patients during chemotherapy treatment: A qualitative study

Romero-Elías, María; Beltrán-Carrillo, Vicente J.; González‐Cutre, David; Jiménez-Loaisa, Alejandro

doi:10.1016/j.ejon.2020.101769

Cited by 17 publications

(23 citation statements)

References 27 publications

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“…One significant psychosocial barrier revealed in this review was low social support and encouragement by significant others and healthcare professionals who provided limited PA advice and guidance. The main focus on therapeutic treatment and discharge planning in cancer settings with little attention given to PA education and exercise-based rehabilitation is a common issue in healthcare services in Western countries [103]. Healthcare providers in Europe and the US reported that time pressure in clinics limited their ability to support and guide cancer patients on PA engagement for improving their health outcomes [85,128].…”

Section: Discussionmentioning

confidence: 99%

“…Lack of social support was a key barrier to PA participation among patients across cancer types in separate quantitative and qualitative studies (Table 4). Cancer patients delineated that discouragement by family members and limited support/guidance by clinicians impeded their PA engagement [69,103]. Family responsibility was a significant barrier to PA participation among cancer patients, particularly women who prioritized their family/children over self.…”

Section: Psychosocial and Cultural Factorsmentioning

confidence: 99%

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Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review

Elshahat

Treanor

Donnelly

2021

Int J Behav Nutr Phys Act

134

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Background It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients’ PA participation. Methods A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions. Results Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients’ PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs. Conclusions There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.

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Section: Discussionmentioning

confidence: 99%

Section: Psychosocial and Cultural Factorsmentioning

confidence: 99%

Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review

Elshahat

Treanor

Donnelly

2021

Int J Behav Nutr Phys Act

134

View full text Add to dashboard Cite

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“…Forty-seven barriers were described in 23 [69,69,71,71,73]. A survey of 120 oncology care providers revealed that at least 77% (n = 85) rated their knowledge as "poor" regarding how to counsel based on exercise guidelines and knowing when, how and which patients to refer to a supervised exercise program [73], with only 13% (n = 16) providing specific information to patients.…”

Section: Individual Professionalmentioning

confidence: 99%

“…Twenty-five barriers were described in 15 studies [44,53,55,59,71,74,39,32,57,36,40,45,60,63,75]. Patient barriers were described in relation to their knowledge about exercise.…”

Section: Patientmentioning

confidence: 99%

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Implementation barriers to integrating exercise as medicine in oncology: an ecological scoping review

et al. 2021

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Purpose While calls have been made for exercise to become standard practice in oncology, barriers to implementation in real-world settings are not well described. This systematic scoping review aimed to comprehensively describe barriers impeding integration of exercise into routine oncology care within healthcare systems. Methods A systematic literature search was conducted across six electronic databases (since 2010) to identify barriers to implementing exercise into real-world settings. An ecological framework was used to classify barriers according to their respective level within the healthcare system. Results A total of 1,376 results were retrieved; 50 articles describing implementation barriers in real-world exercise oncology settings were reviewed. Two hundred and forty-three barriers were identified across all levels of the healthcare system. Nearly 40% of barriers existed at the organizational level (n = 93). Lack of structures to support exercise integration and absence of staff/resources to facilitate its delivery were the most common issues reported. Despite the frequency of barriers at the organizational level, organizational stakeholders were largely absent from the research. Conclusions Implementing exercise into routine cancer care is hindered by a web of interrelated barriers across all levels of the healthcare system. Organizational barriers are central to most issues. Future work should take an interdisciplinary approach to explore best practices for overcoming implementation barriers, with organizations as a central focus. Implications for Cancer Survivors This blueprint of implementation barriers highlights critical issues that need to be overcome to ensure people with cancer have access to the therapeutic benefits of exercise during treatment and beyond.

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Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies

Doughty

Hill

Riley

et al. 2023

Support Care Cancer

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Purpose Physical activity can improve health outcomes for cancer patients; however, only 30% of patients are physically active. This review explored barriers to and facilitators of physical activity promotion and participation in patients living with and beyond cancer. Secondary aims were to (1) explore similarities and differences in barriers and facilitators experienced in head and neck cancer versus other cancers, and (2) identify how many studies considered the influence of socioeconomic characteristics on physical activity behaviour. Methods CINAHL Plus, MEDLINE, PsycINFO, Scopus and Cochrane (CDSR) were searched for qualitative and mixed methods evidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool and a Critical Appraisal Skills Programme Tool. Thematic synthesis and frequency of reporting were conducted, and results were structured using the Capability-Opportunity-Motivation-Behaviour model and Theoretical Domains Framework. Results Thirty qualitative and six mixed methods studies were included. Socioeconomic characteristics were not frequently assessed across the included studies. Barriers included side effects and comorbidities (physical capability; skills) and lack of knowledge (psychological capability; knowledge). Having a dry mouth or throat and choking concerns were reported in head and neck cancer, but not across other cancers. Facilitators included improving education (psychological capability; knowledge) on the benefits and safety of physical activity. Conclusion Educating patients and healthcare professionals on the benefits and safety of physical activity may facilitate promotion, uptakeand adherence. Head and neck cancer patients experienced barriers not cited across other cancers, and research exploring physical activity promotion in this patient group is required to improve physical activity engagement.

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Barriers to physical activity participation in colorectal cancer patients during chemotherapy treatment: A qualitative study

Cited by 17 publications

References 27 publications

Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review

Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review

Implementation barriers to integrating exercise as medicine in oncology: an ecological scoping review

Barriers to and facilitators of physical activity in adults living with and beyond cancer, with special emphasis on head and neck cancer: a systematic review of qualitative and mixed methods studies

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