Development of a questionnaire to assess the determinants of exercise among breast cancer survivors in Puerto Rico

Abstract

The Theory of Planned Behavior (TPB) serves to understand determinants that predict the intention to exercise. According to this theory, attitudes, subjective norms, and perceptions of behavioral control determine intention. This is the first theory-based tool designed to measure the determinants of exercise among women in Puerto Rico who are breast cancer survivors. Understanding the determinants will assist in planning theory based interventions. The purpose of this study was to develop a TPB-based questionnaire to assess the determinants of exercise of breast cancer survivors in Puerto Rico and to evaluate its psychometric properties. Quantitative and qualitative methods were used for questionnaire development and psychometric testing. Three independent samples were recruited for the phases of item generation, pilot testing, and evaluation of psychometric properties. An initial 97-item questionnaire was constructed. Test–retest reliability was assessed for the indirect subscales; six items were found unreliable and removed. For the direct subscales, seven items with item-to-total correlations <0.30 were removed. The final version consisted of 84 items, with Cronbach’s α ranging from 0.65 to 0.89. Construct validity was demonstrated by significant, fair-to-moderate correlations of all but one of the direct subscales and the multiplied scores of the indirect subscales of similar constructs.

Psychosocial factors associated with the intention of breast cancer survivors to regularly practise moderate physical activity

“…The same belief was identified as significant in a previous study using the TPB to predict breast cancer survivors' intention to exercise (Vallance et al, 2008). This finding may be useful as a recommendation, in that many survivors indicated in previous studies that lack of time was a barrier (Kokts-Porietis et al, 2019;Mulero-Portela et al, 2013). Accordingly, by working PA into their routine, female breast cancer survivors have a dedicated time set aside for exercise, which, in turn, contributes to their overall quality of life.…”

“…Few survivors follow these recommendations because of the consequences of the disease and the short-and long-term side effects of cancer treatment, as well as their deconditioning, fatigability and pain (Institut national du cancer, 2017). There are a number of barriers to PA in the target population: lack of time, fatigue related to past treatments (Mulero-Portela et al, 2013), musculoskeletal and neuropathic pain (Vallance et al, 2012), and fear of injuring the arm on the operated side or developing lymphedema (Sander et al, 2012). In Washington State in the U.S., 260 breast cancer survivors took part in a study, the conclusion of which was that fewer than 15% of survivors actually followed PA guidelines (Boyle et al, 2016).…”

Facteurs psychosociaux associés à l’intention de pratiquer régulièrement des activités physiques modérées chez les survivantes du cancer du sein

“…Ainsi, il est possible d'affirmer que les survivantes ne suivent que peu ces recommandations en raison des conséquences de la maladie et des effets secondaires à court et à long terme des traitements oncologiques, de leur déconditionnement, de leur fatigabilité et de leur douleur (Institut national du cancer, 2017). On trouve plusieurs barrières à l'AP dans la population cible : le manque de temps, la fatigue liée aux traitements antérieurs (Mulero-Portela et al, 2013), les douleurs musculosquelettiques et neuropathiques (Vallance et al, 2012), la peur de blesser le bras du côté opéré et la crainte du lymphoedème (Sander et al, 2012). D'ailleurs, aux États-Unis, dans l'État de Washington, 260 survivantes d'un cancer du sein ont participé à une étude ayant conclu que moins de 15 % des survivantes suivaient les lignes directrices en matière d'AP (Boyle et al, 2016).…”

“…D'ailleurs, la même croyance a été significative dans une étude précédente ayant utilisé la TCP pour prédire l'intention de faire de l'exercice chez les survivantes du cancer du sein (Vallance et al, 2008). Ce résultat pourra servir de recommandation, car plusieurs survivantes ont indiqué dans des études précédentes que le manque de temps était une barrière (Kokts-Porietis et al, 2019;Mulero-Portela et al, 2013). Ainsi, intégrer à l'horaire la pratique de (Courneya et al, 2009;Kampshoff et al, 2016;Sander et al, 2012).…”