The experience of cancer‐related fatigue, exercise and exercise adherence among women breast cancer survivors: Insights from focus group interviews

Abstract

Aims and objectives To identify the experience of breast cancer survivors regarding cancer‐related fatigue, exercise and exercise adherence. Background Cancer‐related fatigue is a common symptom among cancer survivors that limits quality of life. Despite exercise being recommended as a viable solution to manage cancer‐related fatigue, relatively few research studies on the experience of cancer‐related fatigue and exercise adherence have been conducted. Design This was a qualitative study to identify breast cancer survivors’ experience of cancer‐related fatigue, exercise and exercise adherence. This paper adhered to the COREQ checklist in reporting. Methods Four focus group interviews were conducted with 16 breast cancer survivors who had fatigue score of 4 out of 10 (moderate fatigue) or greater. Ethical approval was obtained and participants met for focus group interview discussion. The interview guide included questions on cancer‐related fatigue, barriers and facilitators of exercising, strategies for exercise adherence and suggestions for a supportive programme. Results Four themes were identified through thematic analysis: (a) The insidious and overpowering nature of cancer‐related fatigue; (b) exercising when experiencing fatigue surrounded by prevailing myths; (c) multiple barriers to exercise; and (d) facilitative factors to continue exercising despite fatigue. Conclusions Participants’ experience of moderate or greater cancer‐related fatigue prevented them from exercising, despite knowing its importance, and limited them to passive activities. Misconceptions that exercise is associated with lymphedema and risk of recurrence, poor psychosocial self‐image and lack of clear knowledge and exercise programmes for cancer survivors further limited adherence to exercise. In contrast, finding comfort and strength through exercising and interacting with other breast cancer survivors were facilitative factors. Relevance to clinical practice The insights shared by breast cancer survivors experiencing cancer‐related fatigue can contribute to developing an exercise adherence programme as a way to manage and alleviate fatigue and establish healthy survivorship care.

Development of an exercise adherence program for breast cancer survivors with cancer-related fatigue—an intervention mapping approach

“…From the four focus group interviews [16], the 17 BCS were within 5 years of diagnosis, their age ranged from 20 to 69 years, and all had finished surgery and chemotherapy. At clinical stages 1-3, they had moderate or higher fatigue scores (four points or higher on a numerical rating scale of 10).…”

“…For the focus group interviews, 17 BCS were convenience sampled to investigate the exercise experiences of BCS with moderate or greater fatigue. Using a semi-structured interview protocol, interviews took 1-2 h in each group, and recorded interviews were transcribed and analyzed [16].…”

The effect of therapeutic exercise in the prevention of lymphoedema secondary to breast cancer: a systematic review

“…In the field of lymphoedema treatment in female breast cancer survivors, there are several research works in which the benefits of exercise treatment in reducing lymphoedema have been collected [36][37][38][39]. In the studies of DiSipo et al [9] and Baumann et al [25] subjective improvements in the quality of life of the patients, anxiety (as occurs in other pathologies that alter the quality of life [40,41]), the decrease in lymphoedema (evaluated with volumetry) and, equally important, the non-appearance of adverse effects in the study population, are revealed.…”

Role of physiotherapy in supporting recovery from breast cancer treatment: a qualitative study embedded within the UK PROSPER trial

“… 6 Lack of knowledge about exercise and the experience of cancer-related fatigue were identified by individuals with cancer as obstacles to exercise in a recent Korean study. 13 A recent systematic review of the qualitative literature identified six studies of mixed quality reporting the experiences of women living beyond breast cancer participating in a supervised exercise intervention. 14 These studies all reported on group interventions, and the findings suggest that the group element may be beneficial.…”