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The role of illness perceptions and exercise beliefs in exercise engagement during treatment for cancer

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Abstract

Objectives

This study examined whether exercise beliefs and illness perceptions were associated with changes in exercise behaviour following a cancer diagnosis.

Design

This study uses a cross-sectional survey of 366 adults with a diagnosis of cancer, who were currently receiving treatment.

Main outcome measures

The main outcome measures are symptom severity, pre- and post-morbid exercise levels, exercise beliefs, and illness perceptions.

Results

The majority of participants decreased their level of exercise after diagnosis (Decreasers; 58.1%). Approximately a third increased participation (Increasers; 30.4%) and a small group maintained (Maintainers; 9.2%) their pre-diagnosis exercise levels. After controlling for symptom severity and time since cancer diagnosis, Decreasers reported lower Self-Efficacy for exercise, higher levels of belief in the Negative Impact on Cancer of exercise, lower levels of Personal Control, and less Emotional Representation of their illness, than Increasers. Decreasers also reported lower levels of Self-Efficacy for exercise than Maintainers.

Conclusion

The results suggest that identifying unhelpful beliefs about the relationship between exercise and illness during cancer treatment and improving confidence and control of exercise through psycho-educational intervention could be an effective strategy for preventing cancer patients decreasing exercise following their diagnosis.

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Data availability

Data is not available, due to the nature of this research; participants of this study did not agree for their data to be shared publicly.

Code availability

SPSS syntax can be obtained by emailing Dr. Cole.

References

  1. Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, McCarthy AL, Murnane A, Patchell S, Adams D (2018) Clinical Oncology Society of Australia position statement on exercise in cancer care. Med J Aust 209(4):184–187

    Article  Google Scholar 

  2. Courneya KS, Mackey JR, McKenzie DC (2002) Exercise for breast cancer survivors: research evidence and clinical guidelines. Phys Sportsmed 30(8):33–42

    Article  Google Scholar 

  3. McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175(1):34–41

    Article  Google Scholar 

  4. Adamsen L, Midtgaard J, Andersen C, Quist M, Moeller T, Roerth M (2004) Transforming the nature of fatigue through exercise: qualitative findings from a multidimensional exercise programme in cancer patients undergoing chemotherapy. Eur J Cancer Care (Engl) 13(4):362–370

    Article  CAS  Google Scholar 

  5. Husebø AML, Dyrstad SM, Mjaaland I, Søreide JA, Bru E (2014) Effects of scheduled exercise on cancer-related fatigue in women with early breast cancer. Sci World J Jan 1(2014):1–9

    Google Scholar 

  6. Husebø AML, Karlsen B, Allan H, Søreide JA, Bru E (2015) 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 24(3-4):500–510

    Article  Google Scholar 

  7. Blaney J, Lowe-Strong A, Rankin J, Campbell A, Allen J, Gracey J (2010) The cancer rehabilitation journey: barriers to and facilitators of exercise among patients with cancer-related fatigue. Phys Ther 90(8):1135–1147

    Article  Google Scholar 

  8. Irwin ML, Crumley D, McTiernan A, Bernstein L, Baumgartner R, Gilliland FD, Kriska A, Ballard-Barbash R (2003) Physical activity levels before and after a diagnosis of breast carcinoma. Cancer 97:1746–1757

    Article  Google Scholar 

  9. Hardcastle SJ, Maxwell-Smith C, Kamarova S, Lamb S, Millar L, Cohen PA (2018) Factors influencing non-participation in an exercise program and attitudes towards physical activity amongst cancer survivors. Support Care Cancer 26(4):1289–1295

    Article  Google Scholar 

  10. Gecht MR, Connell KJ, Sinacore JM, Prohaska TR (1996) A survey of exercise beliefs and exercise habits among people with arthritis. Arthritis Rheum 9(2):82–88

    Article  CAS  Google Scholar 

  11. Marcus BH, Rakowski W, Rossi JS (1992) Assessing motivational readiness and decision making for exercise. Health Psychol 11(4):257–261

    Article  CAS  Google Scholar 

  12. Husebø AML, Dyrstad SM, Søreide JA, Bru E (2013) Predicting exercise adherence in cancer patients and survivors: a systematic review and meta-analysis of motivational and behavioural factors. J Clin Nurs 22(1-2):4–21

    Article  Google Scholar 

  13. Kampshoff C, Mechelen W, Schep G, Nijziel M, Witlox L, Bosman L, Chinapaw M, Brug J, Buffart L (2016) Participation in and adherence to physical exercise after completion of primary cancer treatment. Int J Behav Nutr Phys Act 13(1):100–112

    Article  Google Scholar 

  14. Downs DS, Ulbrecht JS (2006) Understanding exercise beliefs and behaviors in women with gestational diabetes mellitus. Diabetes Care 29(2):236–240

    Article  Google Scholar 

  15. Ungar N, Sieverding M, Ulrich CM, Wiskemann J (2015) What explains the intention to be physically active in cancer patients? Different determinants for active and insufficiently active patients. J Psychosoc Oncol 33(1):15–33

    Article  Google Scholar 

  16. Midtgaard J, Baadsgaard MT, Møller T, Rasmussen B, Quist M, Andersen C, Rørth M, Adamsen L (2009) Self-reported physical activity behaviour; exercise motivation and information among Danish adult cancer patients undergoing chemotherapy. Eur J Oncol Nurs 13(2):116–121

    Article  Google Scholar 

  17. van Waart H, van Harten WH, Buffart LM, Sonke GS, Stuiver MM, Aaronson NK (2016) Why do patients choose (not) to participate in an exercise trial during adjuvant chemotherapy for breast cancer? Psychooncology 25(8):964–970

    Article  Google Scholar 

  18. Rogers L, Courneya K, Shah P, Dunnington G, Hopkins-Price P (2007) Exercise stage of change, barriers, expectations, values and preferences among breast cancer patients during treatment: a pilot study. Eur J Cancer Care (Engl) 16(1):55–66

    Article  CAS  Google Scholar 

  19. Hagger MS, Koch S, Chatzisarantis NL, Orbell S (2017) The common sense model of self-regulation: meta-analysis and test of a process model. Psychol Bull 143(11):1117–1154

    Article  Google Scholar 

  20. Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D (2002) The revised illness perception questionnaire (IPQ-R). Psychol Health 17(1):1–16

    Article  Google Scholar 

  21. Orbell S, O'Sullivan I, Parker R, Steele B, Campbell C, Weller D (2008) Illness representations and coping following an abnormal colorectal cancer screening result. Soc Sci Med 67(9):1465–1474

    Article  Google Scholar 

  22. Mosleh SM, Almalik MM (2016) Illness perception and adherence to healthy behaviour in Jordanian coronary heart disease patients. Eur J Cardiovasc Nurs 15(4):223–230

    Article  Google Scholar 

  23. Zoeckler N, Kenn K, Kuehl K, Stenzel N, Rief W (2014) Illness perceptions predict exercise capacity and psychological well-being after pulmonary rehabilitation in COPD patients. J Psychosom Res 76(2):146–151

    Article  Google Scholar 

  24. Godin G, Shephard R (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10(3):141–146

    CAS  Google Scholar 

  25. Richardson LA, Jones GW (2009) A review of the reliability and validity of the Edmonton Symptom Assessment System. Curr Oncol 16(1):55

    Article  CAS  Google Scholar 

  26. Littman AJ, Tang M-T, Rossing MA (2010) Longitudinal study of recreational physical activity in breast cancer survivors. J Cancer Surviv 4(2):119–127

    Article  Google Scholar 

  27. Cheville AL, Dose AM, Basford JR, Rhudy LM (2012) Insights into the reluctance of patients with late-stage cancer to adopt exercise as a means to reduce their symptoms and improve their function. J Pain Symptom Manag 44(1):84–94

    Article  Google Scholar 

  28. Rozema H, Völlink T, Lechner L (2009) The role of illness representations in coping and health of patients treated for breast cancer. Psychooncology 18(8):849–857

    Article  Google Scholar 

  29. Lan M, Zhang L, Zhang Y, Yan J (2019) The relationship among illness perception, coping and functional exercise adherence in Chinese breast cancer survivors. J Adv Nurs 75(1):75–84

    Article  Google Scholar 

  30. 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. Psychooncology 27(2):458–464

    Article  Google Scholar 

  31. Richardson EM, Schüz N, Sanderson K, Scott JL, Schüz B (2017) Illness representations, coping, and illness outcomes in people with cancer: a systematic review and meta-analysis. Psycho-Oncology 26(6):724–737

    Article  Google Scholar 

  32. Ntoumanis N, Edmunds J, Duda JL (2009) Understanding the coping process from a self-determination theory perspective. Br J Health Psychol 14(2):249–260

    Article  Google Scholar 

  33. Michie S, Atkins L, West R (2014) The behaviour change wheel: a guide to designing interventions. Needed: Physician Leaders. Silverback Publishing, London

    Google Scholar 

  34. Courneya KS, Friedenreich CM (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3(3):215–226

    Article  CAS  Google Scholar 

  35. Moss-Morris R, Humphrey K, Johnson MH, Petrie KJ (2007) Patients’ perceptions of their pain condition across a multidisciplinary pain management program: do they change and if so does it matter? Clin J Pain 23(7):558–564

    Article  Google Scholar 

  36. Mehnert A, Veers S, Howaldt D, Braumann K-M, Koch U, Schulz K-H (2011) Effects of a physical exercise rehabilitation group program on anxiety, depression, body image, and health-related quality of life among breast cancer patients. Oncol Res Treat 34(5):248–253

    Google Scholar 

  37. Fingeret MC, Teo I, Epner DE (2014) Managing body image difficulties of adult cancer patients: lessons from available research. Cancer 120(5):633–641

    Article  Google Scholar 

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Acknowledgements

We gratefully acknowledge the cancer survivors who participated in this research. Some of these participants were recruited from Breast Cancer Network Australia’s (BCNA) Review & Survey Group, a national, online group of Australian women living with breast cancer who are interested in receiving invitations to participate in research. We also gratefully acknowledge the help of Prostate Cancer Foundation Australia in advertising this study through the Pathfinder Prostate Cancer Research Register.

Author information

Authors and Affiliations

  1. Olivia Newton-John Cancer Wellness & Research Centre, Austin Hospital, Melbourne, Australia

    Siân F. Cole, Gemma Skaczkowski & Carlene Wilson

  2. School of Psychology, Charles Sturt University, Bathurst, Australia

    Siân F. Cole

  3. Heidelberg, Australia

    Siân F. Cole

  4. School of Psychology and Public Health, La Trobe University, Melbourne, Australia

    Gemma Skaczkowski & Carlene Wilson

  5. Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia

    Gemma Skaczkowski

Authors
  1. Siân F. Cole
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  2. Gemma Skaczkowski
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  3. Carlene Wilson
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Contributions

Dr. S. Cole conceived of the presented idea, with guidance from Dr. Gemma Skaczkowski and Prof. Carlene Wilson. SC reviewed the literature, complied the survey, and collected the data. SC ran the data analysis with guidance from GS and CW. All authors discussed the results and contributed to the final manuscript.

Corresponding author

Correspondence to Siân F. Cole.

Ethics declarations

Ethics approval

The study was approved by the Austin Health Human Research Ethics Committee (HREC) (HREC/52285/Austin-2019) and registered with Charles Sturt University HREC (H19188).

Consent to participate

Consent was collected by all participants using Patient Information and Consent Form (PICF).

Consent for publication

The abovementioned PICF also collected consent of unidentified data being published.

Conflict of interest

The authors report no conflict of interest.

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Cole, S.F., Skaczkowski, G. & Wilson, C. The role of illness perceptions and exercise beliefs in exercise engagement during treatment for cancer. Support Care Cancer 29, 5065–5073 (2021). https://doi.org/10.1007/s00520-021-06055-6

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  • DOI: https://doi.org/10.1007/s00520-021-06055-6

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