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  • br Corresponding author Department of Oncology Copenhagen Un

    2020-08-18


    ∗ Corresponding author. Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark. E-mail addresses: [email protected] (M.K. Mikkelsen), [email protected] (D.L. Nielsen), [email protected] (A. Vinther), [email protected] (C.M. Lund), [email protected] (M. Jarden).
    Table 1
    Interview guide.
    Research areas Interview questions
    PA status (introduction) • Tell me about your current level of PA.
    Attitudes towards PA and exercise during oncological
    • What type of PA/exercise do you engage in?
    • What does PA mean to you?
    treatment • What does it Rosiglitazone mean to you and for your daily life to be physically active?
    • • What does it mean to you and for your daily life to be physically inactive?
    What are your thoughts about being physically active and exercising during treatment with chemotherapy/
    • immunotherapy?
    Has the cancer diagnosis and/or oncological treatment affected your daily level of PA?
    Barriers towards PA • What (if anything) makes it difficult for you to stay physically active and/or to exercise in your current situation?
    Motivators, facilitators and preferences for PA • What motivates you to stay physically active/to exercise?
    • What could motivate you to become more physically active/start exercising?
    • What could help you to stay motivated for PA/exercise?
    • What kind of PA/exercise would you prefer?
    • Would you prefer to engage in PA/exercise alone or in groups (if any preferences)?
    • Who would you prefer to engage in PA/exercise with (if any preferences)?
    • If you were to imagine engaging in PA and/or participating in an exercise program in your current situation, how
    should the program be composed and organized?
    Abbreviation: PA (physical activity).
    2007; Townsley et al., 2005). Older patients with cancer are also un-derrepresented in exercise-based intervention studies (Kilari et al., 2016). Especially, there is a serious lack of evidence regarding the feasibility and effect of exercise-based interventions in older patients with advanced cancer (Kilari et al., 2016).
    Patients tend to decrease their level of physical activity (PA) after a cancer diagnosis (Fassier et al., 2016). In a systematic review com-prising 15 studies, Ormel et al. (2018) investigated predictors of ex-ercise adherence during and after cancer treatment, and found that close location of training facilities, extensive exercise history, high motivation, and fewer physical limitations were the most prominent predictors of adherence (Ormel et al., 2018). Due to challenges with maintenance of PA among patients with cancer, monocots is essential to explore the patients’ perceptions of PA and to use this information to develop feasible exercise programs. Prior studies focusing on patients with cancer during treatment have identified factors such as symptoms and side effects, physical limitations, comorbidities, psychological problems (i.e. distress, depression and anxiety), and environmental factors (e.g. bad weather and lack of transportation) as barriers to exercise (Blaney et al., 2010; Fisher et al., 2016; Granger et al., 2017; Mas et al., 2015). In contrast, support from friends and family and tailored programs have been identified as facilitating factors (Blaney et al., 2010; Fisher et al., 2016; Granger et al., 2017; Mas et al., 2015). However, only one qua-litative study has investigated the perceptions of exercise in older pa-tients with cancer. In this study, Rosiglitazone Whitehead et al. (Whitehead and Lavelle, 2009) explored PA patterns and attitudes towards exercise among 29 female breast cancer survivors ≥59 years (range 59–86, mean 67) through individual or focus group interviews and found that the levels of PA declined during treatment and did not return to pre-diagnosis level. Cancer-related symptoms and side effects, comorbid-ities, lack of motivation, and fear of harmful effects were identified among several barriers to exercise. Perceived motivators included health benefits, controlling medical conditions, returning to normal life, better self-image and weight loss. All participants in the study were one to five years post-diagnosis and received hormone therapy (Whitehead and Lavelle, 2009). Hence, there is a lack of knowledge regarding the perceptions of PA among older patients with advanced cancer during oncological treatment. To fill in this gap in the literature and to develop future intervention studies, the aim of this study was to explore atti-tudes towards and experiences with PA and exercise among older pa-tients with advanced cancer during palliative oncological treatment.