Showing papers by "Kerry S. Courneya published in 2002"

Exercise Counseling and Programming Preferences of Cancer Survivors

Abstract: purpose: Exercise has emerged as an important quality-of-life intervention for cancer survivors, but exercise motivation is a challenge. The purpose of this study was to provide a comprehensive assessment of the exercise preferences of cancer survivors. description of study: A mailed, self-administered survey was completed by 307 survivors of prostate, breast, colorectal, or lung cancer. The survey contained questions on demographic and medical variables, past exercise, and various exercise counseling and programming preferences. results: For exercise counseling, 84% of participants said they preferred or maybe preferred to receive exercise counseling at some point during their cancer experience. Moreover, 85% preferred to receive exercise counseling face to face, and 77% preferred to receive it from an exercise specialist affiliated with a cancer center. For exercise programming, 98% preferred recreational exercises, 8!% preferred walking, 57% preferred unsupervised exercise (57%), and 56% preferred moderate-intensity exercise. In addition, 48% preferred to exercise in the morning, 44% preferred to exercise alone, 40% preferred to exercise at home, and 32% preferred to start their exercise program before treatment. Chi-square analyses revealed that a small number of exercise preferences were moderated by demographic, medical, and exercise variables. clinical implications: The results of this study indicate that cancer survivors have unique and varied exercise counseling and programming preferences. Fifty-six percent of cancer survivors preferred to exercise at moderate intensity rather than at high intensity. Moderate-intensity exercise has been shown previously to be relatively safe even for cancer survivors who are advanced in age. The key to success for inactive cancer survivors may be to provide reassurance that exercise is a safe and beneficial modality for cancer survivors and to prescribe an exercise program that builds their confidence by slowly increasing the level of exercise intensity.

Correlates of adherence and contamination in a randomized controlled trial of exercise in cancer survivors: an application of the theory of planned behavior and the five factor model of personality.

Abstract: In this study, we examined correlates of adherence and contamination in a randomized controlled trial (RCT) of exercise in cancer survivors using the theory of planned behavior and the Five Factor Model of personality (FFM). We randomly assigned cancer survivors in group psychotherapy classes to either a waiting-list control group (n = 45) or a home-based, moderate intensity exercise program (n = 51). At baseline, participants completed measures of the theory of planned behavior, the FFM, past exercise, physical fitness, medical variables, and demographics. We then monitored exercise over a 10-week period by weekly self-reports. Hierarchical multiple regression analyses indicated that the independent predictors of overall RCT exercise across both conditions were past exercise (β = .36, p > .001), assignment to experimental condition (β = .34, p > .001), sex (β = .30, p > .001), and intention (β = .14, p > .10). For exercise adherence in the exercise condition, the independent predictors were sex (β = .38, p > .01), extraversion (β = .30, p > .05), normative beliefs (β = -.27, p > .05), and perceived behavioral control (β = .23, p > .10). Finally, the independent predictors of exercise contamination in the control condition were past exercise (β = .70, p > .001), sex (β = .20, p > .05), and intention (β = .17, p > .10). We conclude that the correlates of exercise adherence and contamination differ in kind as well as in degree. Explanations for these findings and practical implications for conducting exercise RCTs in this population are offered.

Physical exercise and immune system function in cancer survivors: a comprehensive review and future directions.

Abstract: BACKGROUND There are a limited number of interventions for cancer survivors following completion of primary therapy that might reduce the risk of cancer recurrence and/or secondary malignancies and increase survival times. It has been proposed that physical exercise may be beneficial by enhancing the anticancer immune system response. The purpose of the current article is to: 1) briefly describe the immune system response to tumors, 2) discuss the impact of anticancer therapy on immune system function in cancer survivors, 3) provide a systematic and comprehensive review of the extant literature examining physical exercise and immune system function in cancer survivors, and 4) offer a critical analysis of this literature and outline directions for future research. METHODS A comprehensive literature search up to March 2001 identified empirical articles that examined the effects of physical exercise training on immune system function in cancer survivors from CD-ROM database searches and manual searches. RESULTS To the authors' knowledge, six empirical studies published between 1994 and 2000 have examined physical exercise and immune system function in cancer survivors. Overall, four out of six studies reported statistically significant improvements in a number of cancer-related immune system components as a result of exercise. However, there are several limitations that must be considered when interpreting the findings of these studies. These limitations involve the samples, designs, physical exercise interventions, physical fitness assessments, and immunologic assessments. CONCLUSIONS Additional research is needed to determine if physical exercise in cancer survivors may reduce the risk of cancer recurrence and secondary malignancies and increase survival times. Cancer 2002;94:539–51. © 2002 American Cancer Society.

Does Personality Moderate the Theory of Planned Behavior in the Exercise Domain

Abstract: This study investigated the moderating influence of the five-factor model of personality (FFM) on the theory of planned behavior (TPB) in the exercise domain. Although an analysis of all possible moderation effects was conducted, it was hypothesized that high extraversion (E) and conscientiousness (C) individuals would demonstrate significantly stronger relationships between intentions and exercise behavior than those low in E and C. Conversely, it was expected that high neuroticism (N) individuals would show a significantly weaker relationship between intention and exercise behavior than those low in N. A total of 300 undergraduate students completed measures of the FFM, TPB, and a 2-week follow-up of exercise behavior. Two-group structural equation models of the TPB were created using a median split for each personality trait. Overall, 5 significant (p < .05) moderating effects were found. Specifically, N was found to moderate the effect of subjective norm on intention. E also moderated the effects of s...

Exercise for breast cancer survivors: research evidence and clinical guidelines.

Abstract: Exercise can have significant benefits for breast cancer survivors during and after treatment. The general aerobic prescription is for moderate-intensity activity (50% to 75% heart rate reserve), 3 to 5 days per week, 20 to 60 minutes per session. Resistance training should also be incorporated into the programs. Psychological health is optimized by exercise that is enjoyable, develops new skills, incorporates social interaction, and takes place in a mind- and spirit-stimulating environment. Conditions that warrant prescription modification include fatigue and nausea, cytopenias, lymphedema, and bone metastasis. Postcancer exercise is facilitated by instilling a positive attitude toward exercise, confidence in overcoming barriers, and a supportive social environment.

Determinants of exercise intention and behavior in survivors of breast and prostate cancer: an application of the theory of planned behavior.

Abstract: The purpose of this study was to evaluate the theory of planned behavior as a framework for understanding exercise intention and behavior in survivors of breast and prostate cancer. Participants were 83 survivors of breast and 46 survivors of prostate cancer who were diagnosed within the previous 4 years and had completed treatment. Each participant completed a mailed self-administered questionnaire that assessed exercise during the previous week, demographic and medical variables, and the theory of planned behavior. For survivors of breast cancer, regression analyses indicated that attitude, subjective norm, and perceived behavioral control explained 45% of the variance in exercise intention with attitude, subjective norm, and perceived behavioral control each uniquely contributing to intention. Furthermore, exercise intention explained 30% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. For survivors of prostate cancer, attitudes, subjective norm, and perceived behavioral control explained 36% of the variance in exercise intention, but only perceived behavioral control made a significant unique contribution. Furthermore, intention explained 36% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. Results suggest that nurses may use the theory of planned behavior as a model for understanding the determinants of exercise intentions and behavior in survivors of breast and prostate cancer.

Case-control study of anthropometric measures and prostate cancer risk.

Abstract: A population-based case-control study of 988 stage T2 or greater prostate cancer cases and 1063 controls was conducted in Alberta from November 1997 to December 2000 to examine the influence of anthropometric risk factors on the risk of prostate cancer using several different measures. An in-person interview was conducted, and all anthropometric measurements were taken using standardized methods. Respondents also recalled their body weight at each decade from age 20 to the referent year. Several anthropometric variables were derived, and unconditional logistic regression analyses were performed. The multivariable odds ratios, when comparing the highest to the lowest quartile were: for body mass index, OR = 1.12 (95% CI 0.85-1.47); for waist-hip ratio, OR = 1.07 (0.83-1.38); for height, OR = 0.78 (0.60-1.02); for weight, OR = 0.91 (0.70-1.18); for weight gain since age 20, OR = 0.91 (0.70-1.19); and for difference between minimum and maximum adult weight, OR = 0.89 (0.69-1.16). Our study provides evidence for no association between any measures of anthropometry including several derived measures of changes in weight over lifetime and prostate cancer risk.

Exercise Discussions During Cancer Treatment Consultations

Abstract: purpose: Physical exercise has been shown to help cancer survivors cope with treatment side effects. The purpose of this study was to examine the role of the oncologist in promoting exercise in cancer survivors. description of study: Cancer survivors who had recently completed treatment (N = 311) were mailed a self-administered questionnaire that assessed the following: whether exercise was discussed during any of their treatment consultations; whether they preferred that exercise be discussed during this time; their perceived oncologist approval for exercise; and the amount of exercise they performed during treatment. results: Descriptive statistics showed that 28.4% of cancer survivors reported that their oncologist initiated a discussion of exercise during their treatment consultation, that 13.9% said that they initiated a discussion, and that 57.8% said that exercise was not discussed. Survivors younger than 60 years of age were more likely to initiate a discussion of exercise than were older survivors. Survivors whose oncologist initiated a discussion of exercise also reported a stronger normative belief for exercise, performing more frequent exercise during treatment, and performing more total minutes of exercise during treatment. Most (82.2%) survivors preferred that the oncologist initiate the discussion of exercise. clinical implications: These findings indicate that most cancer survivors responding to this survey preferred that their oncologist initiate a discussion of exercise. Such a discussion appears to increase survivor exercise levels during treatment. If confirmed in a prospective, randomized, controlled trial, the implication is that an oncologist-initiated discussion of exercise during treatment consultations may be a cost-effective strategy for promoting exercise in cancer survivors.

Self-efficacy and mood in cardiac rehabilitation: should gender be considered?

Abstract: The authors proposed to (a) determine the influence of phase II cardiac rehabilitation (CR) on task and barrier efficacy and mood in men and women, (b) determine the influence of task and barrier efficacy on postphase II CR exercise adherence, and (c) examine the bidirectional relationship between self-efficacy and mood Fifty-seven men and 24 women completed task and barrier efficacy scales and the anxiety, depression, and vigor subscales 3 to 5 weeks before phase II CR, immediately before and after phase II CR, and 6 to 10 weeks after phase II CR They found that the women had significantly larger increases in task and barrier efficacy from pre- to postphase II CR than the men did, whereas both men and women had a significant decline at follow-up Men and women had a similar decrease in anxiety and an increase in vigor during phase II CR However, vigor significantly declined at follow-up All changes in mood were significantly related to changes in task and barrier efficacy

Does barrier efficacy mediate the gender-exercise adherence relationship during phase II cardiac rehabilitation?

Abstract: Objective: To determine whether barrier efficacy (i.e., confidence in one's ability to perform an elemental task under challenging conditions) mediated the gender- exercise adherence relationship in Phase II cardiac rehabilitation. Study Design and Participants: A questionnaire concerning 9 exercise barriers was administered to 98 Phase II cardiac rehabilitation patients (50 male and 48 female). Results: Men had significantly higher exercise adherence rates, F(1, 96) 5 7.22, p 5 .01, effect size 5 .53, and barrier efficacy, F(1, 95) 5 17.50, p , .001, effect size 5 .79. Partial correlations demonstrated that barrier efficacy mediated the gender- exercise adherence relationship during Phase II rehabilitation. Specifically, men had significantly higher barrier efficacy overall and efficacy for overcoming (a) fear of having a cardiac event, (b) back pain, (c) medication side effects, (d) lack of time, (e) angina, and (f) the expense to exercise, which in turn was associated with higher exercise adherence during Phase II cardiac rehabilitation compared with women. Conclusion: Interventions should focus on building women's self- efficacy for overcoming specific exercise barriers during Phase II cardiac rehabil- itation.

Moderators of the Exercise/Feeling‐State Relationship: The Influence of Self‐Efficacy, Baseline, and In‐Task Feeling States at Moderate‐ and High‐Intensity Exercise

Abstract: The present study examined the moderating influence of self-efficacy, baseline feeling states, and in-task feeling states on exercise-related feeling-state changes at moderate- and high-intensity exercise. Physically active females (N= 60) participated in 1 of 5 conditions: (a) attention control for 30 min, (b) exercise at 50% heart rate reserve (HRR) for 15 min, (c) exercise at 50% HRR for 30 min, (d) exercise at 85% HRR for 15 min, and (e) exercise at 85% HRR for 30 min. The Exercise-Induced Feeling Inventory (EFI; Gauvin & Rejeski, 1993) was completed pre-, during, and post-exercise, while self-efficacy was completed pre-exercise. Multilevel modeling (Bryk & Raudenbaush, 1992) revealed that pre-exercise self-efficacy and in-task tranquility moderated the change in tranquility for high-intensity exercise. Furthermore, baseline feeling states moderated the change in all 4 feeling states. It is recommended that baseline and in-task feeling states and self-efficacy be considered when examining high-intensity exercise.