Patients with established cancer cachexia lack the motivation and self-efficacy to undertake regular structured exercise

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Author
Wasley, David
Gale, Nichola
Roberts, Sioned
Backx, Karianne
Nelson, Annmarie
van Deursen, Robert
Byrne, Anthony
Date
2017-07-31Acceptance date
2017-07-21
Type
Article
Publisher
Wiley
Metadata
Show full item recordAbstract
Objectives
Patients with advanced cancer frequently suffer a decline in activities associated with involuntary loss of weight and muscle mass (cachexia). This can profoundly affect function and quality of life. Although exercise participation can maintain physical and psychological function in patients with cancer, uptake is low in cachectic patients who are underrepresented in exercise studies. To understand how such patients’ experiences are associated with exercise participation we investigated exercise history, self-confidence and exercise motivations in patients with established cancer cachexia, and relationships between relevant variables.
Methods
Lung and gastrointestinal cancer outpatients with established cancer cachexia (n=196) completed a questionnaire exploring exercise history and key constructs of the Theory of Planned Behaviour relating to perceived control, psychological adjustment and motivational attitudes.
Results
Patients reported low physical activity levels and few undertook regular structured exercise. Exercise self-efficacy was very low with concerns it could worsen symptoms and cause harm. Patients showed poor perceived control and a strong need for approval but received little advice from healthcare professionals. Preferences were for low intensity activities, on their own, in the home setting. Regression analysis revealed no significant factors related to the independent variables.
Conclusions
Frequently employed higher intensity, group exercise models do not address the motivational and behavioural concerns of cachectic cancer patients in this study. Developing exercise interventions which match perceived abilities and skills are required to address challenges of self-efficacy and perceived control identified. Greater engagement of health professionals with this group is required to explore potential benefits of exercise.
Journal/conference proceeding
Psycho-Oncology;
Citation
Wasley, D., Gale, N., Roberts, S., Backx, K., Nelson, A., van Deursen, R., Byrne, A. (2018) 'Patients with established cancer cachexia lack the motivation and self-efficacy to undertake regular structured exercise', Psycho-Oncology, 27 (2) pp. 458-464
Description
This article was published in Psycho-Oncology on 31 July 2017 (Accepted manuscript online) available at http://dx.doi.org/10.1002/pon.4512
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
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