Breast cancer survivors' barriers and motives for participating in a group-based physical activity program offered in the community

Amanda Wurz, Anik St-Aubin, Jennifer Brunet, Amanda Wurz, Anik St-Aubin, Jennifer Brunet

Abstract

Purpose: The purpose of this qualitative study was to explore the barriers and motives experienced by women attending an 8-week group-based physical activity program offered in the community following treatment for breast cancer.

Methods: Seven women were interviewed during the first and last week of the program. Data were analyzed using thematic analysis.

Results: Factors that hindered women's continued participation could be subdivided into situational barriers, which encompassed community (i.e., distance of center and traffic) and institutional factors (i.e., competing roles and responsibilities), and internal barriers, which consisted of cancer-specific limitations. Motives for initial and continued participation were situational (i.e., gaining social support, networking, and being around similar others) and internal (i.e., feeling a sense of personal fulfillment, acquiring health benefits, and recovering from cancer).

Conclusions: The findings contribute to a deeper understanding of women's motives to engage in a group-based physical activity program after treatment for breast cancer. Further, they underscore the necessity of considering situational and internal barriers when developing group-based physical activity programs to increase regular participation, optimize adherence, and reduce drop-out.

References

    1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;2:69–90. doi: 10.3322/caac.20107.
    1. Siegel R, DeSantis C, Virgo K, Stein K, Mariotto A, Smith T, Cooper D, Gansler T, Lerro C, Fedewa S et al (2012) Cancer treatment and survivorship statistics. CA Cancer J Clin 62:220–241
    1. Ganz PA, Kwan L, Stanton AL, Bower JE, Belin TR. Physical and psychosocial recovery in the year after primary treatment of breast cancer. J Clin Oncol. 2011;29(9):1101–1109. doi: 10.1200/JCO.2010.28.8043.
    1. Compas BE, Lueken L. Psychological adjustment to breast cancer. Curr Dir Psychol Sci. 2002;11(3):111–114. doi: 10.1111/1467-8721.00180.
    1. Hooning MJ, Botma A, Aleman BM, Baaijens MH, Bartelink H, Klijn JG, Taylor CW, van Leeuwen FE. Long-term risk of cardiovascular disease in 10-year survivors of breast cancer. J Natl Cancer Inst. 2007;99(5):365–375. doi: 10.1093/jnci/djk064.
    1. Matesich SM, Shapiro CL. Second cancers after breast cancer treatment. Semin Oncol. 2003;30(6):740–748. doi: 10.1053/j.seminoncol.2003.08.022.
    1. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat. 2010;123(3):627–635. doi: 10.1007/s10549-010-0990-0.
    1. Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM. Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst. 2012;104(11):815–840. doi: 10.1093/jnci/djs207.
    1. Loprinzi PD, Cardinal BJ. Effects of physical activity on common side effects of breast cancer treatment. Breast Cancer. 2012;19(1):4–10. doi: 10.1007/s12282-011-0292-3.
    1. Schmitz K. Physical activity and breast cancer survivorship. Recent Results Cancer Res Fortschr Krebsforschung Progres dans les Rech sur le Cancer. 2011;186:189–215.
    1. Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, Snyder C. Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev. 2012;8:CD007566.
    1. Brunet J, Sabiston CM, Meterissian S. Physical activity and breast cancer survivorship: evidence-based recommendations. Am J Life Med. 2012;6:224–240. doi: 10.1177/1559827611421460.
    1. Harrison S, Hayes SC, Newman B. Level of physical activity and characteristics associated with change following breast cancer diagnosis and treatment. Psycho–Oncology. 2009;18:387–394. doi: 10.1002/pon.1504.
    1. Irwin ML, McTiernan A, Bernstein L, Gillilan FD, Baumgartner R, Baumgartner K, Ballard-Barbash R. Physical activity levels among breast cancer survivors. Med Sci Sports Exerc. 2004;36:1484–1491.
    1. Lynch BM (2010) Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms. Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 19(11):2691–2709
    1. Emslie C, Whyte F, Campbell A, Mutrie N, Lee L, Ritchie D, Kearney N. ‘I wouldn’t have been interested in just sitting round a table talking about cancer’; exploring the experiences of women with breast cancer in a group exercise trial. Health Educ Res. 2007;22(6):827–838. doi: 10.1093/her/cyl159.
    1. Rajotte EJ, Yi JC, Baker KS, Gregerson L, Leiserowitz A, Syrjala KL. Community-based exercise program effectiveness and safety for cancer survivors. J Cancer Surviv : Res Pract. 2012;6(2):219–228. doi: 10.1007/s11764-011-0213-7.
    1. Mutrie N, Campbell AM, Whyte F, McConnachie A, Emslie C, Lee L, Kearney N, Walker A, Ritchie D. Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. Brit Med J. 2007;334:517–523. doi: 10.1136/.
    1. Naumann F, Munro A, Martin E, Magrani P, Buchan J, Smith C, Piggott B, Philpott M. An individual-based versus group-based exercise and counselling intervention for improving quality of life in breast cancer survivors. A feasibility and efficacy study. Psycho-Oncology. 2012;21(10):1136–1139. doi: 10.1002/pon.2015.
    1. Sabiston CM, McDonough MH, Crocker PRE. Psycho-social experiences of breast cancer survivors involved in a dragon boat program: exploring links to positive psychological growth. J Sports Exerc Psychol. 2007;29:419–438.
    1. Mitchell T, Nielson E. Living life to the limits: dragon boaters and breast cancer. Can Women Stud. 2002;21:50–57.
    1. Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S (2006) A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psycho-Oncology 15(10):891–897
    1. Burke SM, Sabiston CM. The meaning of the mountain: exploring breast cancer survivors’ lived experiences of subjective well being during a climb on Mt.Kilimanjaro. Qual Res Sport Exerc. 2010;2:1–16. doi: 10.1080/19398440903510137.
    1. Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2005;14:1588–1595. doi: 10.1158/1055-9965.EPI-04-0703.
    1. Craig CL, Russell SL, Cameron C, Beaulieu A. Foundation for joint action: reducing physical inactivity. Ottawa: Canadian Fitness and Lifestyle Research Institute; 1999.
    1. Brawley L, Culos-Reed N, Angoen J, Hoffman-Goetz J. Understanding the barriers to physical activity for cancer patients. J Psychol Oncol. 2003;20(4):1–21. doi: 10.1300/J077v20n04_01.
    1. Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health. 1998;13:623–649. doi: 10.1080/08870449808407422.
    1. Sallis JF, Bauman A, Pratt M. Environmental and policy interventions to promote physical activity. Am J Prev Med. 1998;15(4):379–397. doi: 10.1016/S0749-3797(98)00076-2.
    1. Andajani-Sutjahjo S, Ball K, Warren N, Inglis V, Crawford D. Perceived personal, social and environmental barriers to weight maintenance among young women: a community survey. Int J Behav Nutr Phys Act. 2004;1(1):15. doi: 10.1186/1479-5868-1-15.
    1. Nies MA, Vollman M, Cook T. African American women’s experiences with physical activity in their daily lives. Public Health Nurs. 1999;16(1):23–26. doi: 10.1046/j.1525-1446.1999.00023.x.
    1. Popkin BM, Duffey K, Gordon-Larsen P. Environmental influences on food choice, physical activity and energy balance. Physiol Behav. 2005;86(5):603–613. doi: 10.1016/j.physbeh.2005.08.051.
    1. Pucher J, Buehler R, Seinen M. Bicycling renaissance in North America? An update and re-appraisal of cycling trends and policies. Transp Res A Policy Pract. 2011;45(6):451–457. doi: 10.1016/j.tra.2011.03.001.
    1. Chan CB, Ryan DA. Assessing the effects of weather conditions on physical activity participation using objective measures. Int J Environ Res Publ Health. 2009;6(10):2639–2654. doi: 10.3390/ijerph6102639.
    1. Crombie IK, Irvine L, Williams B, McGinnis AR, Slane PW, Alder EM, McMurdo ME. Why older people do not participate in leisure time physical activity: a survey of activity levels, beliefs and deterrents. Age Ageing. 2004;33(3):287–292. doi: 10.1093/ageing/afh089.
    1. Justine M, Azizan A, Hassan V, Salleh Z, Manaf H. Barriers to participation in physical activity and exercise among middle-aged and elderly individuals. Singap Med J. 2013;54(10):581–586. doi: 10.11622/smedj.2013203.
    1. Hefferon K, Murphy H, McLeod J, Mutrie N, Campbell A. Understanding barriers to exercise implementation 5-year post-breast cancer diagnosis: a large-scale qualitative study. Health Educ Res. 2013;28(5):843–856. doi: 10.1093/her/cyt083.
    1. Brunet J, Taran S, Burke S, Sabiston CM (2013) A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer. Disability Rehab, Published online ahead of print: doi: 10.3109/09638288.2013.802378
    1. Ottenbacher AJ, Day RS, Taylor WC, Sharma SV, Sloane R, Snyder DC, Kraus WE, Demark-Wahnefried W. Exercise among breast and prostate cancer survivors–what are their barriers? J Cancer Surviv: Res Pract. 2011;5(4):413–419. doi: 10.1007/s11764-011-0184-8.
    1. Husebo AM, Dyrstad SM, Soreide JA, Bru E. Predicting exercise adherence in cancer patients and survivors: a systematic review and meta-analysis of motivational and behavioural factors. J Clin Nurs. 2013;22(1–2):4–21. doi: 10.1111/j.1365-2702.2012.04322.x.
    1. Pardee RL (1990) Motivation Theories of Maslow, Herzberg, McGregor & McClelland. A Literature review of selected theories dealing with job satisfaction and motivation. In: Educational Resources Information Center (ERIC)
    1. Juarbe T, Turok XP, Perez-Stable EJ. Perceived benefits and barriers to physical activity among older Latina women. West J Nurs Res. 2002;24(8):868–886. doi: 10.1177/019394502237699.
    1. Rasinaho M, Hirvensalo M, Leinonen R, Lintunen T, Rantanen T. Motives for and barriers to physical activity among older adults with mobility limitations. J Aging Phys Act. 2007;15(1):90–102.
    1. Husebo AM, Karlsen B, Allan H, Soreide JA, Bru E (2014) Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. J Clin Nurs (in press)
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. doi: 10.1191/1478088706qp063oa.
    1. Creswell JW. Qualitative inquiry & research design: choosing among five approaches. 3. USA: Sage Publications; 2013.
    1. Heath GW (2013) Behavioral approaches to physical activity promotion. In: Clinical Exercise Physiology. 3 edn. Edited by Ehrman JK, Gordon, P.M., Visich, P.S., Keteyian, S.J. Champaign, IL: Human Kinetics 29–30
    1. Courneya KS, McKenzie DC, Reid RD, Mackey JR, Gelmon K, Friedenreich CM, Ladha AB, Proulx C, Lane K, Vallance JK, et al. Barriers to supervised exercise training in a randomized controlled trial of breast cancer patients receiving chemotherapy. Ann Behav Med. 2008;35(1):116–122. doi: 10.1007/s12160-007-9009-4.
    1. Rogers LQ, Courneya KS, Robbins KT, Malone J, Seiz A, Koch L, Rao K. Physical activity correlates and barriers in head and neck cancer patients. Support Care Cancer. 2008;16(1):19–27. doi: 10.1007/s00520-007-0293-0.
    1. Costello E, Kafchinski M, Vrazel J, Sullivan P. Motivators, barriers, and beliefs regarding physical activity in an older adult population. J Geriatr Phys Ther. 2011;34(3):138–147. doi: 10.1519/JPT.0b013e31820e0e71.
    1. Barber FD. Social support and physical activity engagement by cancer survivors. Clin J Oncol Nurs. 2012;16(3):E84–E98. doi: 10.1188/12.CJON.E84-E98.
    1. McNeill LH, Kreuter MW, Subramanian SV. Social environment and physical activity: a review of concepts and evidence. Soc Sci Med. 2006;63(4):1011–1022. doi: 10.1016/j.socscimed.2006.03.012.
    1. Peterson JA, Yates BC, Hertzog M. Heart and soul physical activity program: social support outcomes. Am J Health Behav. 2008;32(5):525–537. doi: 10.5993/AJHB.32.5.8.
    1. Resnick B, Luisi D, Vogel A. Testing the Senior Exercise Self-efficacy Project (SESEP) for use with urban dwelling minority older adults. Public Health Nurs. 2008;25(3):221–234. doi: 10.1111/j.1525-1446.2008.00699.x.
    1. Hefferon K, Grealy M, Mutrie N. The perceived influence of an exercise class intrevention on the process and outcomes of post-traumatic growth. Ment Health Phys Act. 2008;1:32–39. doi: 10.1016/j.mhpa.2008.06.003.
    1. Kolden GG, Strauman TJ, Ward A, Kuta J, Woods TE, Schneider KL, Heerey E, Sanborn L, Burt C, Millbrandt L et al (2002) A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psycho-Oncology 11(5):447–456
    1. McDonough MH, Sabiston CM, Crocker RE. An interpretative phenomenological examination of psychosocial changes among breast cancer survivors in their first season of dragon boating. J Appl Sports Psychol. 2008;20:425–440. doi: 10.1080/10413200802241857.

Source: PubMed

3
Se inscrever