Popular theories of health behavior have often been criticized for neglecting an affective component to behavioral engagement. This study reviewed affective judgment (AJ) constructs employed in physical activity research to assess the relationship with behavior. Studies were eligible if they included: (a) a measure of physical activity; (b) a distinct measure of AJ (e.g., affective attitude, enjoyment, intrinsic motivation); and (c) involved participants with a mean age of 18 years or older. Literature searches were concluded in September, 2009 among five key search engines. This search yielded a total of 10,631 potentially relevant records; of these, 102 passed the eligibility criteria. Random effects meta-analysis procedures with correction for sampling and measurement bias were employed in the analysis. Articles were published between 1989 and 2009, with sample sizes ranging from 15 to 6,739. Of the studies included, 82 were correlational and 20 were experimental, yielding 114 independent samples. The majority of the correlational samples reported a significant positive correlation between AJ and physical activity (83 out of 85), with a summary r of 0.42 (95% CI 0.37 to 0.46) that was invariant across the measures employed, study quality, population sampled and cultural variables. Experimental studies demonstrated that persuasive, information-based, and self-regulatory interventions failed to change AJ; by contrast, environmental and experiential interventions showed promise in their capability to influence AJ. The results point to a medium-effect size relationship between AJ and physical activity. Interventions that change AJ are scarce despite their potential for changing physical activity. Future experimental work designed to evaluate the causal impact of AJ on physical activity is required.

A Review and Meta-Analysis of Affective Judgments and Physical Activity in Adult Populations

Objective. To explore the nondisclosure of complementary and alternative medicine (CAM) use among cancer patients, including reasons for and outcomes from nondisclosure of CAM use, within the context of patient-doctor communication. Method. A systematic review was conducted exploring investigations surrounding the communication of CAM use for patients with cancer published until August 2011. Results.Atotalof21studieswerelocated,whichreporteda prevalence of CAM use among patients with cancer ranging between11%and95%;ofthesepatients,20%to77%didnot disclose their CAM use. The main reasons for nondisclosure werethedoctor’slackofinquiry;patient’santicipationofthe doctor’s disapproval, disinterest, or inability to help; and patient’s perception that disclosure of CAM use is irrelevant to their conventional care. There is some evidence to suggest that patient-doctor communication about the use of CAM was associated with an enhanced patient-doctor relationship and higher patient satisfaction. Conclusions. Although the use of CAM by patients with

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Cancer Patient Disclosure and Patient-Doctor Communication of Complementary and Alternative Medicine Use: A Systematic Review

https://www.jpsmjournal.com/article/S0885-3924(11)00207-7/pdf

Body composition, physical fitness, functional performance, quality of life, and fatigue benefits of exercise for prostate cancer patients: a systematic review.

Summary Every year, more than 10 million people are diagnosed with cancer worldwide. In view of the substantial improvements in early detection and treatment, even more patients can expect to be alive 5 years after diagnosis. With improvements in longevity, the late-occurring adverse effects of cancer and its treatment are becoming increasingly apparent. Healthy lifestyle behaviours that encompass regular exercise, weight control, healthy nutrition, and some complementary practices—eg, support groups, imagery—have the potential to greatly reduce cancer-treatment-associated morbidity and mortality in cancer survivors and can enhance quality of life. Here, we aim to review the strength of evidence for recommendations for exercise, weight management, nutritional practices, and related complementary therapies; assess the perceived needs of cancer survivors for health information and how they can access this information; and discuss the resources available to oncology care providers and patients about healthy lifestyle behaviours. Overall, this review provides important information to oncology care providers who counsel their patients on preventive lifestyle practices to maximise health and longevity after a diagnosis of cancer.

https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(06)70976-7.pdf

Diet, exercise, and complementary therapies after primary treatment for cancer

Background Women with a diagnosis of breast cancer may experience short- and long-term disease and treatment-related adverse physiological and psychosocial outcomes. These outcomes can negatively impact prognosis, health-related quality of life (HRQoL), and psychosocial and physical function. Physical activity may help to improve prognosis and may alleviate the adverse effects of adjuvant therapy. Objectives To assess effects of physical activity interventions after adjuvant therapy for women with breast cancer. Search methods We searched the Cochrane Breast Cancer Group (CBCG) Specialised Registry, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Physiotherapy Evidence Database (PEDro), SPORTDiscus, PsycINFO, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform, on 18 September 2015. We also searched OpenGrey and Healthcare Management Information Consortium databases. Selection criteria We searched for randomised and quasi-randomised trials comparing physical activity interventions versus control (e.g. usual or standard care, no physical activity, no exercise, attention control, placebo) after adjuvant therapy (i.e. after completion of chemotherapy and/or radiation therapy, but not hormone therapy) in women with breast cancer. Data collection and analysis Two review authors independently selected studies, assessed risk of bias, and extracted data. We contacted trial authors to ask for additional information when needed. We calculated an overall effect size with 95% confidence intervals (CIs) for each outcome and used GRADE to assess the quality of evidence for the most important outcomes. Main results We included 63 trials that randomised 5761 women to a physical activity intervention (n = 3239) or to a control (n = 2524). The duration of interventions ranged from 4 to 24 months, with most lasting 8 or 12 weeks (37 studies). Twenty-eight studies included aerobic exercise only, 21 involved aerobic exercise and resistance training, and seven used resistance training only. Thirty studies described the comparison group as usual or standard care, no intervention, or control. One-fifth of studies reported at least 20% intervention attrition and the average physical activity adherence was approximately 77%.No data were available on effects of physical activity on breast cancer-related and all-cause mortality, or on breast cancer recurrence. Analysis of immediately postintervention follow-up values and change from baseline to end of intervention scores revealed that physical activity interventions resulted in significant small-to-moderate improvements in HRQoL (standardised mean difference (SMD) 0.39, 95% CI 0.21 to 0.57, 22 studies, 1996 women; SMD 0.78, 95% CI 0.39 to 1.17, 14 studies, 1459 women, respectively; low-quality evidence), emotional function (SMD 0.21, 95% CI 0.10 to 0.32, 26 studies, 2102 women, moderate-quality evidence; SMD 0.31, 95% CI 0.09 to 0.53, 15 studies, 1579 women, respectively; low-quality evidence), perceived physical function (SMD 0.33, 95% CI 0.18 to 0.49, 25 studies, 2129 women; SMD 0.60, 95% CI 0.23 to 0.97, 13 studies, 1433 women, respectively; moderate-quality evidence), anxiety (SMD -0.57, 95% CI -0.95 to -0.19, 7 studies, 326 women; SMD -0.37, 95% CI -0.63 to -0.12, 4 studies, 235 women, respectively; low-quality evidence), and cardiorespiratory fitness (SMD 0.44, 95% CI 0.30 to 0.58, 23 studies, 1265 women, moderate-quality evidence; SMD 0.83, 95% CI 0.40 to 1.27, 9 studies, 863 women, respectively; very low-quality evidence).Investigators reported few minor adverse events.Small improvements in physical activity interventions were sustained for three months or longer postintervention in fatigue (SMD -0.43, 95% CI -0.60 to -0.26; SMD -0.47, 95% CI -0.84 to -0.11, respectively), cardiorespiratory fitness (SMD 0.36, 95% CI 0.03 to 0.69; SMD 0.42, 95% CI 0.05 to 0.79, respectively), and self-reported physical activity (SMD 0.44, 95% CI 0.17 to 0.72; SMD 0.51, 95% CI 0.08 to 0.93, respectively) for both follow-up values and change from baseline scores.However, evidence of heterogeneity across trials was due to variation in intervention components (i.e. mode, frequency, intensity, duration of intervention and sessions) and measures used to assess outcomes. All trials reviewed were at high risk of performance bias, and most were also at high risk of detection, attrition, and selection bias. In light of the aforementioned issues, we determined that the evidence was of very low, low, or moderate quality. Authors' conclusions No conclusions regarding breast cancer-related and all-cause mortality or breast cancer recurrence were possible. However, physical activity interventions may have small-to-moderate beneficial effects on HRQoL, and on emotional or perceived physical and social function, anxiety, cardiorespiratory fitness, and self-reported and objectively measured physical activity. The positive results reported in the current review must be interpreted cautiously owing to very low-to-moderate quality of evidence, heterogeneity of interventions and outcome measures, imprecision of some estimates, and risk of bias in many trials. Future studies with low risk of bias are required to determine the optimal combination of physical activity modes, frequencies, intensities, and durations needed to improve specific outcomes among women who have undergone adjuvant therapy.

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Physical activity for women with breast cancer after adjuvant therapy

It is estimated that as many as 80% of adult cancer patients use at least one form of Complementary and Alternative Medicine (CAM) during or after conventional treatment. Studies of physician-patient communication about the use of CAM have concluded that patients frequently do not tell their oncologists about their use of CAM and physicians consistently underestimate the numbers of their patients using CAM. The purpose of this multi-site study was to assess newly diagnosed cancer patients' and oncologists' communication practices with regard to complementary therapies. Patients (106 breast and 82 prostate) indicated which of 45 complementary therapies they were using while physicians at their institutions indicated which they supported. It is noted that, although we use the popular acronym “CAM,” all patients surveyed were receiving conventional medical treatment. Thus, the survey addressed complementary therapies only. A large majority (84%) indicated they were using at least one therapy with th...

Patient-Physician Communication Regarding Use of Complementary Therapies During Cancer Treatment

Background: Exercise is associated with an improved quality of life among cancer survivors. Previous research has highlighted the utility of the theory of planned behavior in understanding cancer s...

https://journals.sagepub.com/doi/pdf/10.1177/1534735406288742

Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention.

Purpose: The purpose of this study was to compare the use of complementary therapies (CT) among breast and prostate cancer patients during active cancer treatment. The authors compared use and beliefs about the role of CT in cancer recovery. Methods: A self-report survey was completed by 126 breast cancer patients and 82 prostate cancer patients as part of a multisite research project. The self-report questionnaire inquired about the use of various CTs, sources of information about CT, reasons for using CT, beliefs about the benefits and risks of CT, demographic characteristics, and cancer treatment history. Results: Most of the respondents were older than 50 years, Caucasian, married, had attended or completed college, and were less than 1 year postdiagnosis. Prostate cancer patients were significantly older than the breast cancer patients (P < .001). Several differences emerged between the groups. Compared to the prostate cancer patients, significantly more of the breast cancer patients reported using CT because they wanted to reduce the risk of recurrence (P < .01), play a more active role in recovery (P < .01), help manage stress (P < .01), take a more holistic approach (P < .01), or boost the immune system (P < .01). More of the prostate cancer patients reported using CT to have more control of their recovery (P < .05). The 2 groups also differed significantly (P < .01) on several beliefs about the potential benefits and risks of using CT. Conclusions: Most of the patients in this study had used some form of CT since the time of their diagnosis. Differences among breast and prostate cancer patients with regard to their use of CT during cancer treatment should be considered by oncology professionals who are discussing this topic with their patients.

https://journals.sagepub.com/doi/pdf/10.1177/1534735405282109

Jane Ruiterman

Papers

Patient-Physician Communication Regarding Use of Complementary Therapies During Cancer Treatment

Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention.

Use of Complementary Therapies Among Breast and Prostate Cancer Patients During Treatment: A Multisite Study