Physical Activities and Distress among Participants of a Cancer Wellness Centre:A Community-Based Pilot Study
26 Apr 2014-International Journal of Physical Medicine and Rehabilitation (OMICS International)-Vol. 2, Iss: 3, pp 1-8
TL;DR: The results suggest that distress may be reduced by participation in physical activities such as gym, yoga and/or Qi Gong among cancer survivors at a cancer wellness centre.
Abstract: Background: Severe distress in patients has been negatively correlated with treatment compliance and treatment outcomes. Cancer survivors who have been diagnosed and undergone treatment may be subject to increased distress, anxiety and depression. Little research has been conducted using physical activities as a means of mediating distress among cancer survivors in a community setting. Objective: This study explored the relationship between physical activities and distress among participants of a cancer wellness centre in Montreal, Quebec. Methods: Using a longitudinal design and data from participants (N=44), a distress assessment was administered at Time 1, and three months later at Time 2. The Distress Thermometer (DT), and the Hospital Anxiety and Depression Scale (HADS) were used to assess an individual’s psychological distress. Physical activities were measured using the Metabolic Equivalent of Tasks (METs) from the Compendium of Physical Activities classification system. Results: T-tests and regression analysis indicated that at Time 1 participation in physical activities had a significant inverse relationship with distress, in that as participation increased, distress decreased. At Time 2, three months later participation in physical activities was also associated with decreased distress especially as measured by the HADS. Participation in physical activities almost reached significance with the DT as well. Conclusions: The results suggest that distress may be reduced by participation in physical activities such as gym, yoga and/or Qi Gong among cancer survivors at a cancer wellness centre. Clinical implications include promoting the benefits of physical activities and exercise among cancer survivors as they relate to distress and other major health outcomes during the treatment and post-treatment phase. Implications for future research include the need to corroborate results using a larger sample assessing other supportive activities as they also relate to the outcome of distress.
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01 Jan 2011
TL;DR: In this article, a walking intervention for women undergoing chemotherapy for ovarian cancer was evaluated and participants reported significant improvements in physical functioning, physical symptoms, physical well-being and ovarian cancerspecific quality of life.
Abstract: Background: Exercise interventions during adjuvant cancer therapy have been shown to increase functional capacity, relieve fatigue and distress and may assist rates of chemotherapy completion. These studies have been limited to breast, gastric and mixed cancer groups and it is not yet known if a similar intervention is even feasible among women with ovarian cancer. We aimed to assess safety, feasibility and potential effect of a walking intervention in women undergoing chemotherapy for ovarian cancer.
Methods: Women newly diagnosed with ovarian cancer were recruited to participate in an individualised walking intervention throughout chemotherapy and were assessed pre-and post-intervention. Feasibility measures included session adherence, compliance with exercise physiologist prescribed walking targets and self-reported program acceptability. Changes in objective physical functioning (6 minute walk test), self-reported distress (Hospital Anxiety and Depression Scale), symptoms (Memorial Symptom Assessment Scale - Physical) and quality of life (Functional Assessment of Cancer Therapy - Ovarian) were calculated, and chemotherapy completion and adverse intervention effects recorded.
Results: Seventeen women were enrolled (63% recruitment rate). Mean age was 60 years (SD = 8 years), 88% were diagnosed with FIGO stage III or IV disease, 14 women underwent adjuvant and three neo-adjuvant chemotherapy. On average, women adhered to > 80% of their intervention sessions and complied with 76% of their walking targets, with the majority walking four days a week at moderate intensity for 30 minutes per session. Meaningful improvements were found in physical functioning, physical symptoms, physical well-being and ovarian cancerspecific quality of life. Most women (76%) completed ≥85% of their planned chemotherapy dose. There were no withdrawals or serious adverse events and all women reported the program as being helpful.
Conclusions: These positive preliminary results suggest that this walking intervention for women receiving chemotherapy for ovarian cancer is safe, feasible and acceptable and could be used in development of future work. Trial registration: ACTRN12609000252213
41 citations
TL;DR: Analysis of data from a convenience sample revealed that spiritual well-being was positively correlated with self-perceived health, negatively associated with depression, and significantly mediated the relationship between depression and self-Perceived health.
13 citations
Journal Article•
TL;DR: In this paper, the feasibility of delivering an exercise and counseling intervention to 43 breast cancer survivors, to determine if counseling can add value to an exercise intervention for improving quality of life (QOL) in terms of physical and psychological function.
Abstract: Background: Improved survivorship has led to increased recognition of the need to manage the side effects of cancer and its treatment. Exercise and psychological interventions benefit survivors; however, it is unknown if additional benefits can be gained by combining these two modalities. Objective: Our purpose was to examine the feasibility of delivering an exercise and counseling intervention to 43 breast cancer survivors, to determine if counseling can add value to an exercise intervention for improving quality of life (QOL) in terms of physical and psychological function. Methods: We compared exercise only (Ex), counseling only (C), exercise and counseling (ExC), and usual care (UsC) over an 8 week intervention. Results: In all, 93% of participants completed the interventions, with no adverse effects documented. There were significant improvements in VO2max as well as upper body and lower body strength in the ExC and Ex groups compared to the C and UsC groups (P < .05). Significant improvements on the Beck Depression Inventory were observed in the ExC and Ex groups, compared with UsC (P < .04), with significant reduction in fatigue for the ExC group, compared with UsC, and no significant differences in QOL change between groups, although the ExC group had significant clinical improvement. Limitations: Limitations included small subject number and study of only breast cancer survivors. Conclusions: These preliminary results suggest that a combined exercise and psychological counseling program is both feasible and acceptable for breast cancer survivors and may improve QOL more than would a single-entity intervention.
7 citations
01 Jan 2016
TL;DR: It becomes important for oncology clinicians and family members to further encourage participation in physical activities among cancer survivors as a means of buffering and lessening the fear of cancer recurrence and thus contributing to better quality of life.
Abstract: With medical and psychosocial advances in treatment, cancer survivorship has increased, yet fear of cancer recurrence is a main concern negatively affecting the quality of life among cancer survivors. This pilot study examined the relationship between physical activity, locus of control (LOC), and fear of cancer recurrence among participants in a community cancer support program. Self-reported interviews were used to examine if physical activity and LOC have a modifying effect on the negative impact of fear of recurrence among a group of cancer survivors (N = 32). The variables were measured using the fear of cancer recurrence inventory (FCRI), metabolic equivalency tasks (METs), and Rotter’s locus of control questionnaire. The results indicated that higher education levels and higher internal LOC lead to better coping, and thus having a modifying impact on the fear of recurrence. For those undergoing surgery less physical impairment was observed, thereby effecting and lessening the fear of recurrence. Implications for clinical practice and further research are discussed. It becomes important for oncology clinicians and family members to further encourage participation in physical activities among cancer survivors as a means of buffering and lessening the fear of cancer recurrence and thus contributing to better quality of life.
5 citations
Cites background from "Physical Activities and Distress am..."
...The results of this study associating LOC and fear of recurrence provide further support for additional interventions to address personal coping skills, which can have a mitigating effect on fear of recurrence (Leimanis and Fitzpatrick 2014; Wheaton 1985)....
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...5 km/h), and are dependent on an individual’s resting metabolic rate (RMR), which in itself depends on lean body mass, as opposed to total weight (Ainsworth et al. 1993; Leimanis and Fitzpatrick 2014)....
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...Physical activity is a form of social support with a great potential of lessening the constant dread and fear of cancer recurrence via participation in physical activity programs and facilities directed toward cancer-related community interventions (Leimanis and Fitzpatrick 2014; Wheaton 1985)....
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01 Jan 2016
TL;DR: In this article, the relationship between therapeutic interventions and their relationship to quality of life among children, adolescents and older Latinos with cancer is explored, and useful information and strategies are suggested for culturally competent practice to address the psychological and physical health needs of Latino cancer survivors.
Abstract: The quality of life and one’s emotional and physical health assumes greater importance for vulnerable and ethnic populations diagnosed with cancer. This chapter explores the relationship between therapeutic interventions and their relationship to quality of life among children, adolescents and older Latinos with cancer. Theories of ethnicity and aging and cultural perspectives designed to address and provide further insight into the barriers and challenges faced by the Latino cancer survivors are discussed. The second emphasis provides insight into therapeutic interventions such as leisure and physical activity, educational interventions for families and their children, church-related interventions, and specific types of support groups in the community. Useful information and strategies are suggested for culturally competent practice to address the psychological and physical health needs of Latino cancer survivors. Implications for health care professionals and future research are discussed.
2 citations
References
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Journal Article•
TL;DR: These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health.
Abstract: "Physical activity," "exercise," and "physical fitness" are terms that describe different concepts. However, they are often confused with one another, and the terms are sometimes used interchangeably. This paper proposes definitions to distinguish them. Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure. The energy expenditure can be measured in kilocalories. Physical activity in daily life can be categorized into occupational, sports, conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Physical fitness is a set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health.
7,608 citations
"Physical Activities and Distress am..." refers background in this paper
...Physical activity is defined as any body movement that exerts one’s muscles and requires more energy than resting, and can be categorized as occupational, leisure, various sports, household [20], and or physical exercise, which is a more structured subset of physical activity [21]....
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TL;DR: Evidence of strong covariation of depression and medical noncompliance suggests the importance of recognizing depression as a risk factor for poor outcomes among patients who might not be adhering to medical advice.
Abstract: Background: Depression and anxiety are common in medical patients and are associated with diminished health status and increased health care utilization. This article presents a quantitative review and synthesis of studies correlating medical patients’ treatment noncompliance with their anxiety and depression.
3,882 citations
"Physical Activities and Distress am..." refers background in this paper
...Severe distress in patients has been negatively correlated with treatment compliance [12-14] and treatment outcomes such as survival time [15,16]....
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TL;DR: In this article, a coding scheme for classifying physical activity by rate of energy expenditure, i.e., by intensity, was presented for classification of physical activity using five digits that classify activity by purpose (i.e. sports, occupation, sel
Abstract: A coding scheme is presented for classifying physical activity by rate of energy expenditure, i.e., by intensity. Energy cost was established by a review of published and unpublished data. This coding scheme employs five digits that classify activity by purpose (i.e., sports, occupation, sel
3,679 citations
TL;DR: The goal of this project was to determine the prevalence of psychological distress among a large sample of cancer patients and variations in distress among 14 cancer diagnoses.
Abstract: Purpose:
The goal of this project was to determine the prevalence of psychological distress among a large sample of cancer patients (n=4496). In addition, variations in distress among 14 cancer diagnoses were examined.
Patients and methods:
The sample was extracted from a database that consists of 9000 patients who completed the Brief Symptom Inventory as a component of comprehensive cancer care. Relevant data points for each case included age, diagnosis, gender, insurance status, marital status, race and zip code. Simple frequencies, percentages, measures of central tendency and variability were calculated. In addition, a univariate and multiple regression analysis was used to examine the relationships of these relevant variables to psychological distress.
Results:
The overall prevalence rate of distress for this sample was 35.1%. The rate varied form 43.4% for lung cancer to 29.6% for gynecological cancers. While some rates were significantly different, diagnoses with a poorer prognosis and greater patient burden produced similar rates of distress. Pancreatic cancer patients produced the highest mean scores for symptoms such as anxiety and depression, while Hodgkin's patients exhibited the highest mean scores for hostility
Conclusions:
These results offer vital support for the need to identify high-risk patients through psychosocial screening in order to provide early intervention. To simply perceive cancer patients as a homogeneous group is an erroneous assumption. Failure to detect and treat elevated levels of distress jeopardizes the outcomes of cancer therapies, decreases patients' quality of life, and increases health care costs. Copyright © 2001 John Wiley & Sons, Ltd.
2,378 citations
"Physical Activities and Distress am..." refers background in this paper
...Cancer survivors who have been diagnosed and undergone treatment (chemotherapy, radiation) are known to experience an increase in their distress levels [1,2]....
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TL;DR: The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a 'case-identifier' for psychiatric disorder or depression.
Abstract: Background. Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its ecacy in determining the presence of depression in dierent patient groups has been questioned. Methods. Psychometric properties of the HADS were assessed in six dierent groups of Dutch subjects (N fl 6165): (1) a random sample of younger adults (age 18‐65 years) (N fl 199); (2) a random sample of elderly subjects of 57 to 65 years of age (N fl 1901); (3) a random sample of elderly subjects of 66 years or older (N fl 3293); (4) a sample of consecutive general practice patients (N fl 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms (N fl 169); and (6) a sample of consecutive psychiatric out-patients (N fl 491). Results. Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test‐retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. Conclusions. The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a ‘case-identifier’ for psychiatric disorder or depression.
1,955 citations
"Physical Activities and Distress am..." refers background in this paper
...The Hospital Anxiety and Depression Scale (HADS) is a widely used 14-item measure that assesses symptom severity of anxiety and depression, has been used in cancer patient populations [54], with its validity and reliability well established....
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