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“The healthy me appears”: Palliative cancer patients' experiences of participation in a physical group exercise program

Published online by Cambridge University Press:  26 November 2009

Hanne Paltiel*
Affiliation:
Physiotherapy Department, St. Olavs University Hospital, Trondheim, Norway
Edel Solvoll
Affiliation:
Sør-Trøndelag University College, Trondheim, Norway
Jon Håvard Loge
Affiliation:
Department of Clinical Cancer Research, Rikshospitalet University Hospital, Oslo, Norway Pain and Palliation Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Trondheim, Norway
Stein Kaasa
Affiliation:
Pain and Palliation Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Trondheim, Norway Palliative Medicine Unit, St. Olav's University Hospital, Trondheim, Norway
Line Oldervoll
Affiliation:
Pain and Palliation Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Trondheim, Norway
*
Address correspondence and reprint requests to: Hanne Paltiel, Physiotherapy Department, St. Olav's University Hospital, 7006 Trondheim, Norway. E-mail: hanne.paltiel@stolav.no

Abstract

Objective:

Tentative results from a pilot study showed that patients with advanced cancer were willing and able to take part in a group exercise intervention. Limited knowledge exists, though, about the meaning and significance of such programs. The purpose of the present study was to understand the meaning of such an intervention for the individual participant and thereby to provide knowledge for shaping future clinical practice.

Methods:

Thirty-four palliative cancer patients with a life expectancy of less than 1 year completed a 6-week group exercise program. Five randomly selected individuals were interviewed 7 months after completion. Results from a self-report evaluation questionnaire identified relevant themes that formed the basis of an interview guide. These were addressed in a semistructured interview. Verbatim transcripts were analyzed with a phenomenological–hermeneutical approach.

Results:

Two main themes emerged from the interviews: (1) perceptions of the group and (2) a secure and caring setting for the group. Themes identified regarding perception of the group were a sense of belonging and commitment. Themes identified regarding a secure and caring setting for the group were a life-empowering group as a setting for enhancing coping, the qualifications of those who led the group, and a public gym as an unsuitable setting.

Significance of results:

Our study indicates that an individually adjusted group exercise program, with competent leaders, can provide a setting to enhance psychological well-being in cancer patients with life expectancy below 1 year. Small sample size, however, limits the possibility to generalize the findings.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Adamsen, L., Midtgaard, J., Rorth, M., et al. (2003). Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy. Support Care in Cancer, 11, 707716.CrossRefGoogle ScholarPubMed
Adamsen, L., Quist, M., Midtgaard, J., et al. (2006). The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Support Care in Cancer, 4, 116127.CrossRefGoogle Scholar
Adamsen, L., Rasmussen, J.M. & Pedersen, L.S. (2001). ‘Brothers in arms': How men with cancer experience a sense of comradeship through group intervention which combines physical activity with information relay. Journal of Clinical Nursing, 10, 528537.Google Scholar
Axelsson, B. & Sjoden, P.O. (1998). Quality of life of cancer patients and their spouses in palliative home care. Palliative Medicine, 12, 2939.CrossRefGoogle ScholarPubMed
Blanchard, C.M., Courneya, K.S., Rodgers, W.M., et al. (2002). Determinants of exercise intention and behavior in survivors of breast and prostate cancer: An application of the theory of planned behavior. Cancer Nursing, 25, 8895.Google Scholar
Breitbart, W., Chochinov, H. & Passik, S. (2004). Psychiatric symptoms in palliative medicine. In Oxford Textbook of Palliative Medicine, Doyle, D. et al. (eds.), pp. 746771. New York: Oxford University Press.Google Scholar
Charmaz, K. (1999). Stories of suffering: Subjective tales and research narratives. Qualitative Health Research, 9, 362382.CrossRefGoogle Scholar
Cheville, A. (2001). Rehabilitation of patients with advanced cancer. Cancer, 92, 10391048.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Clayton, J.M., Butow, P.N., Arnold, R.M., et al. (2005). Fostering coping and nurturing hope when discussing the future with terminally ill cancer patients and their caregivers. Cancer, 103, 19651975.CrossRefGoogle ScholarPubMed
Coates, A., Abraham, S., Kaye, S.B., et al. (1983). On the receiving end—Patient perception of the side-effects of cancer chemotherapy. European Journal of Cancer & Clinical Oncology, 19, 203208.Google Scholar
Courneya, K.S. (2001). Exercise interventions during cancer treatment: Biopsychosocial outcomes. Exercise and Sport Science Reviews, 29, 6064.Google ScholarPubMed
Courneya, K.S. (2003). Exercise in cancer survivors: An overview of research. Medicine and Science in Sports and Exercise, 35, 18461852.CrossRefGoogle ScholarPubMed
Courneya, K.S., Segal, R.J., Reid, R.D., et al. (2004). Three independent factors predicted adherence in a randomized controlled trial of resistance exercise training among prostate cancer survivors. Journal of Clinical Epidemiology, 57, 571579.CrossRefGoogle Scholar
Crevenna, R., Schmidinger, M., Keilani, M., et al. (2003). Aerobic exercise as additive palliative treatment for a patient with advanced hepatocellular cancer. Wiener Medizinische Wochenschrift, 153, 237240.CrossRefGoogle ScholarPubMed
Emslie, C., Whyte, F., Campbell, A., et al. (2007). ‘I wouldn't have been interested in just sitting round a table talking about cancer': Exploring the experiences of women with breast cancer in a group exercise trial. Health Education Research, 22, 827838.Google Scholar
Folkman, S. & Greer, S. (2000). Promoting psychological well-being in the face of serious illness: When theory, research and practice inform each other. Psycho-oncology, 9, 1119.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
Forsyth, D.R. (2006). Group Dynamics. Belmont, CA: Thomson Wadsworth.Google Scholar
Hansen, E.C. (2006). Successful Qualitative Health Research. Berkshire, England: Open University Press.Google Scholar
Hunt-Shanks, T.T., Blanchard, C.M., Baker, F., et al. (2006). Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: Examination of exercise intention. Integrative Cancer Therapies, 5, 109116.Google Scholar
Jones, L.W. & Courneya, K.S. (2002). Exercise counseling and programming preferences of cancer survivors. Cancer Practice, 10, 208215.Google Scholar
Koropchak, C.M., Pollak, K.I., Arnold, R.M., et al. (2006). Studying communication in oncologist-patient encounters: The SCOPE Trial. Palliative Medicine, 20, 813819.Google Scholar
Kvale, S. (1996). Interviews: An Introduction to Qualitative Research Interviewing. Thousand Oaks, CA: Sage Publications Inc.Google Scholar
Lofland, J. & Lofland, L. (1994). Analyzing Social Settings. Belmont, CA: Wadsworth.Google Scholar
Maguire, P. & Pitceathly, C. (2004). Learning counseling. In Oxford Textbook of Palliative Medicine, Doyle, D. et al. (eds.), pp. 11761182. New York: Oxford University Press.Google Scholar
Merluzzi, T.V., Nairn, R.C., Hegde, K., et al. (2001). Self-efficacy for coping with cancer: Revision of the Cancer Behaviour Inventory (version 2.0). Psycho-oncology, 10, 206217.CrossRefGoogle ScholarPubMed
Midtgaard, J., Rorth, M., Stelter, R., et al. (2006). The group matters: An explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment. European Journal of Cancer Care, 15, 2533.Google Scholar
Midtgaard, J., Stelter, R., Rorth, M., et al. (2007). Regaining a sense of agency and shared self-reliance: The experience of advanced disease cancer patients participating in a multidimensional exercise intervention while undergoing chemotherapy—Analysis of patient diaries. Scandinavian Journal of Psychology, 48, 181190.Google Scholar
Oldervoll, L.M., Loge, J.H., Paltiel, H., et al. (2005). Are palliative cancer patients willing and able to participate in a physical exercise program? Palliative and Supportive Care, 3, 281287.CrossRefGoogle Scholar
Oldervoll, L.M., Loge, J.H., Paltiel, H., et al. (2006). The effect of a physical exercise program in palliative care: A phase II study. Journal of Pain and Symptom Management, 31, 421430.CrossRefGoogle ScholarPubMed
Porock, D., Kristjanson, L.J., Tinnelly, K., et al. (2000). An exercise intervention for advanced cancer patients experiencing fatigue: A pilot study. Journal of Palliative Care, 16, 3036.CrossRefGoogle ScholarPubMed
Sutherland, H.J., Lockwood, G.A. & Boyd, N.F. (1990). Ratings of the importance of quality of life variables: Therapeutic implications for patients with metastatic breast cancer. Journal of Clinical Epidemiology, 43, 661666.CrossRefGoogle ScholarPubMed
Turner, J., Hayes, S. & Reul-Hirche, H. (2004). Improving the physical status and quality of life of women treated for breast cancer: A pilot study of a structured exercise intervention. Journal of Surgical Oncology, 86, 141146.Google Scholar
Weiner, J.S., Arnold, R.M., Curtis, J.R., et al. (2006). Manualized communication interventions to enhance palliative care research and training: Rigorous, testable approaches. Journal of Palliative Medicine, 9, 371381.Google Scholar
Weiner, J.S. & Efferen, L.S. (2005). Recognition and communication: Essential elements to improving end-of-life care. Chest, 127, 18861888.CrossRefGoogle ScholarPubMed
White, C.A. (2000). Body image dimensions and cancer: A heuristic cognitive behavioral model. Psycho-oncology, 9, 183192.3.0.CO;2-L>CrossRefGoogle Scholar
Yalom, I. (2005). The Theory and Practice of Group Psychotherapy. New York: Basic Books.Google Scholar