Exercise behaviors in breast cancer survivors in Taiwan.

BACKGROUND: Although exercise is a recommended rehabilitation intervention for many breast cancer survivors, exercise activity after cancer treatment is rarely reported in this patient group in Taiwan. OBJECTIVE: The objectives of this study were to analyze trends in exercise activity in breast cancer survivors in Taiwan. INTERVENTIONS/METHODS: This prospective, longitudinal study with repeated-measures design used standardized instruments to measure trends in exercise activity but performed no treatments or interventions. RESULTS: Of the 196 breast cancer survivors who participated in this study, 39% regularly engaged in light-to-moderate intensity exercise for approximately 15 minutes per day throughout the 6-month period of the study. Of these, 40% indicated that their exercise stage had increased, and only 13% indicated that their exercise stage had decreased. The most common exercise activities were walking, hiking, calisthenics, folk dancing, chi kung and tai chi. Although most women reported that exercise made them feel better both physically and emotionally, most said that they exercised mainly for health maintenance reasons. CONCLUSIONS: Frequency, duration, and intensity of exercise significantly increased during the 6-month study but did not reach the recommended levels. Most women believed that physical activity enhanced their recovery from cancer treatment. IMPLICATIONS FOR PRACTICE: When planning patient education interventions for breast cancer survivors, healthcare professionals should consider not only the role of exercise in breast cancer recovery, but also trends in exercise behavior among breast cancer survivors. The findings of this study contribute to the literature on exercise trends in breast cancer survivors.

Timing and sustainability of an exercise intervention in women with breast cancer during and after cancer treatment.

PURPOSE/OBJECTIVES: To compare changes in frequency, duration, and intensity of exercise behaviors over time in women with breast cancer between those who started their exercise intervention at the beginning of chemotherapy (EE) and those who started at the completion of chemotherapy (CE). DESIGN: A secondary data analysis of a randomized, controlled trial for exercise intervention. SETTING: Five cancer centers in the San Francisco Bay Area in California. SAMPLE: 66 outpatient women with breast cancer who were receiving chemotherapy. METHODS: Piecewise linear mixed models analysis was used to study changes in exercise behaviors over time in the EE group during and after treatment. In addition, linear mixed models analysis was used to examine changes between the EE and CE groups after treatment. Participants were in the trial for various length of time (EE group: 19-86 weeks; CE group: 6-43 weeks). MAIN RESEARCH VARIABLES: Exercise frequency, intensity, and duration. FINDINGS: In the EE group, weekly exercise duration increased significantly during treatment (p = 0.02). In addition, weekly exercise intensity increased significantly during treatment (p = 0.02) and decreased significantly after treatment (p = 0.003). After treatment, initial weekly exercise duration was significantly lower in the CE group than in the EE group (p = 0.01). No significant differences existed in frequency and intensity over time between the EE and CE groups. CONCLUSIONS: Women with breast cancer can sustain exercise behaviors when they start an exercise intervention in the beginning of chemotherapy treatment. IMPLICATIONS FOR NURSING: Strategies to support patients in maintaining their exercise habit may be needed during the post-treatment period.

Identification of latent classes in patients who are receiving biotherapy based on symptom experience and its effect on functional status and quality of life.

PURPOSE/OBJECTIVES: to identify subgroups of patients receiving biotherapy with pain, fatigue, sleep disturbance, and depression and to determine functional status and quality of life differences between subgroups. DESIGN: a descriptive, prospective, cohort study design. SETTING: internet-based survey. SAMPLE: 187 patients with cancer receiving biotherapy. METHODS: pain intensity, Piper Fatigue Scale, General Sleep Disturbance Scale, Center for Epidemiological Studies-Depression, Karnofsky Performance Scale, and the Multidimensional Quality of Life Scale-Cancer were used at two time points one month apart (T1 and T2). Latent profile analysis identified subgroups. MAIN RESEARCH VARIABLES: biotherapy, symptoms, functional status, and quality of life. FINDINGS: At T1 (N = 187), five patient subgroups were identified, ranging from subgroup 1 (mild fatigue and sleep disturbance) to subgroup 5 (severe on all four symptoms). At T2 (N = 114), three patient subgroups were identified, ranging from subgroup 1 (mild pain, fatigue, and sleep disturbance without depression) to subgroup 3 (mild pain, moderate fatigue, and sleep disturbance with severe depression). At each time point, the patient subgroup with the most severe symptoms showed significantly lower functional status and quality of life. CONCLUSIONS: as with other cancer treatments, biotherapy can be divided into similar patient subgroups with four prevalent symptoms. Subgroups of patients differ in functional status and quality of life as a result of symptom severity. IMPLICATIONS FOR NURSING: clinicians should assess and identify patients with severe levels of the four prevalent symptoms and offer appropriate interventions. Future study is needed to investigate the factors that contribute to symptom severity and to examine the occurrence of symptom clusters that may place patients at increased risk for poorer outcomes.