Dataset Information

Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors?

ABSTRACT:

Background

Self-management is recommended for patients with chronic conditions, but its use with cancer survivors is underexplored. Optimal strategies for achieving lifestyle changes in cancer survivors are not known.

Objective

We aimed to determine feasibility, acceptability and preliminary efficacy of self-management-based nutrition and physical activity interventions for cancer survivors.

Design, setting and participants

Adult survivors (n = 25) during (Group 1 , n = 11) or post (Group 2, n = 14)-curative chemotherapy for solid tumours, most (n = 20, 80%) with breast cancer, were recruited prospectively from a single clinical centre.

Intervention

The Flinders Living Well Self-Management Program, a generic self-management care planning programme, was utilized to establish patient-led nutrition and exercise goals within a tailored 12-week intervention. Fortnightly progress reviews occurred with assessments at baseline, 6 and 12 weeks.

Results

Most participants (84%) found the intervention acceptable/very acceptable. Both groups showed a trend towards significant improvement in the self-management capability 'knowledge about changing risk factors' (P = 0.047); Group 2 showed a trend towards significantly improved 'psychological impacts' (P = 0.007). Goal ratings improved for both groups (P = 0.001). Quality of life improved for both groups for emotional functioning (P = 0.03). Physical functioning improved for Group 2 (P = 0.05); however, most symptom domains worsened for Group 1, as expected given their treatment stage.

Discussion and conclusions

Self-management interventions are feasible for this population. In particular, building self-management capacity during the active phase of patients' cancer treatment provides health and psychosocial benefits. Larger randomized controlled trials are required to further determine efficacy. Further translational research is also needed to determine acceptability,feasibility, enablers and barriers for clinicians embedding this approach into routine cancer survivorship care.

SUBMITTER: Lawn S

PROVIDER: S-EPMC5810724 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Publications

Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors?

Lawn Sharon S Zrim Stephanie S Leggett Stephanie S Miller Michelle M Woodman Richard R Jones Lynnette L Kichenadasse Ganessan G Sukumaran Shawgi S Karapetis Chris C Koczwara Bogda B

Health expectations : an international journal of public participation in health care and health policy 20141228 6

<h4>Background</h4>Self-management is recommended for patients with chronic conditions, but its use with cancer survivors is underexplored. Optimal strategies for achieving lifestyle changes in cancer survivors are not known.<h4>Objective</h4>We aimed to determine feasibility, acceptability and preliminary efficacy of self-management-based nutrition and physical activity interventions for cancer survivors.<h4>Design, setting and participants</h4>Adult survivors (n = 25) during (Group 1 , n = 11) ...[more]

PMID: 25545411

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Project description:PurposeOngoing symptoms and impairments in quality of life (QOL) among breast cancer survivors remain a significant problem. We tested the feasibility and acceptability of a manualized Ayurvedic nutrition and lifestyle intervention for breast cancer survivors.MethodsEligible participants had Stage I-III breast cancer, underwent treatment within the past year that included chemotherapy, and were without active disease. The 4-month individualized Ayurvedic intervention included counseling on nutrition, lifestyle, yoga, and marma (like acupressure) during 8 one-on-one visits with an Ayurvedic practitioner. Feasibility and acceptability were the primary outcomes. QOL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ C30]) and symptoms-sleep disturbance (General Sleep Disturbance Scale [GSDS]), fatigue (Lee Fatigue Scale [LFS]), depressive symptoms (Center for Epidemiological Studies-Depression Scale [CES-D]), anxiety (Spielberger State-Trait Anxiety Inventory [STAI-S, STAI-T]), and stress (Perceived Stress Scale [PSS])-were measured prior to, at midpoint, and at the end of the 4-month intervention. Effect sizes (Cohen's d) were calculated along with paired t tests comparing baseline to end of month 4 time points. Mixed effects models were used for repeated measures analyses.ResultsParticipants (n?=?32) had a mean age of 48?years (SD?=?10). Retention at the end of the intervention was 84%. Among those who completed the intervention (n?=?27), adherence was high (99.5% of visits with practitioners attended). Large improvements were seen in QLQ-C30 emotional functioning (d?=?0.84, P?<?0.001), QLQ-C30 cognitive functioning (d?=?0.86, P?<?0.001), GSDS (d?=?-1.23, P?<?0.001), and CES-D (d?=?-1.21, P?<?0.001). Moderate improvements were seen in QLQ-C30 global health (d?=?0.65, p?=?0.003), LFS (d?=?-0.68, P?=?0.002), and PSS (d?=?-0.75, P?<?0.001). No adverse events were observed due to the intervention.ConclusionThis 4-month Ayurvedic whole-systems multimodal nutrition and lifestyle intervention was feasible and acceptable for breast cancer survivors. Promise of clinical benefit was seen in terms of improvements in symptoms and QOL that warrants further investigation.

Project description:The contribution of this research lies in its dual approach to the question of physical activity (PA) among adolescents, combining objective measurement of PA by teenagers and a comparison of psychological satisfaction through physical activities involving differing degrees of autonomy (i.e., organized or unstructured). Using the conceptual framework of Self-Determination Theory, the analysis also examines the relationship between levels of PA among adolescents and physical self-concept and satisfaction of basic psychological needs during exercise. The study surveyed 129 first-year higher secondary education students from schools in the city of A Coruña. Satisfaction of basic psychological needs during organized and unstructured physical activities was measured using the Basic Psychological Needs in Exercise Scale. PA levels were assessed based on step count per day for a week as measured by an accelerometer. The results show that the daily step average recorded by students (7,400) is below the minimum recommended levels of PA for this age group, that students are more active on weekdays than at the weekend, and that there is no significant difference in PA levels between male and female subjects (T = 0.23, p < 0.05, d = 0.04). Findings from the comparative analysis of the three basic psychological needs show greater satisfaction of the need for autonomy during unstructured activities (T = 6.15, p < 0.001, d = 0.68), and greater satisfaction of the need for competence during organized activities (T = -2.50, p < 0.05, d = 0.27). No variation in terms of sex was found in relation to satisfaction of the need for autonomy or relatedness from unstructured activities; however, girls showed notably lower satisfaction than boys in relation to the need for competence (T = -2.62, p < 0.01, d = 0.49). Self-esteem was found to play an important mediating role and observed to be strongly related to sex (T = -5.16, p < 0.001, d = 0.90). Organized PA was found to provide greater need satisfaction among boys than girls across all categories. The study showed no relationship between psychological variables and objectively measured PA (Pillai's trace: F = 0.86, p > 0.05, ?2 = 0.08, observed power = 0.66). Basic psychological needs show significant positive interrelation between them and a significant positive relationship between them and physical self-concept, as expected based on previous literature.

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Project description:BackgroundPhysical activity is a modifiable risk factor for health and wellbeing, all-cause mortality and healthy aging. However, for middle- to older-age females less is known about the benefits of sports participation on these outcomes. Further, the acceptability and feasibility of setting-up, implementing and maintaining sports-based programmes for an aging population is an understudied area of inquiry. The current study used the RE-AIM framework to investigate a nationwide Walking Netball (WN) programme.MethodsThe evaluation used a mixed-methods approach incorporating a multiple-baseline study, quasi-experimental study, programme monitoring data and qualitative studies to evaluate the programme in the Women's Institutes (WI) in England. Data were analysed using multilevel growth modelling, mixed-design ANOVAs, multilevel regression, t-testing, and thematic analysis. Data were triangulated to address each dimension of the RE-AIM framework.FindingsThe programme reached 1.4% (n = 3148) of the WI population across 82.0% of WI regions in England and attracted inactive members at risk of ill-health. WN contributed to adaptations in physical function, mental health and wellbeing, social isolation, quality of life and increased physical activity. The adoption of the programme was successful with 87.7% WN groups' maintaining participation beyond the 20-session initial delivery phase. Adoption was effective because of its set-up, peer-mentorship and long-term delivery; these factors likewise shaped implementation. Adapting and tailoring WN to the varying characteristics of participants within the WI and the facilities available, along with training delivery staff and providing resources are key programme components. The Walking Netball programme can be maintained through promotion within the local community, sustainable funding, inter-WI competitions, festivals and networks, multiple-hosts and continued host development.ConclusionsWN was found to be an acceptable, feasible and effective intervention to increase physical activity and improve health in middle- to older- aged women. Future programmes may consider adapted styles of set-up and delivery. These include adapting to people, places and spaces through personalised support and providing a range of resources. Future designs may seek to understand how participation can contribute to healthy aging through longitudinal research beyond 12-months.Study registrationThe evaluation protocol was published in Open Science Framework in December 2018 prior to follow-up data collection being collected ( https://www.osf.io/dcekz ). Date of registration: 17 December 2018.

Project description:BackgroundWithin-household transmission of Covid-19 is responsible for a significant number of infections. Efforts to protect at risk communities are needed. This study explored the acceptability of offering accommodation to support self-isolation among at risk populations, to prevent transmission of Covid-19 within vulnerable households.MethodsMixed methods design structured in two phases. Phase 1: Survey of 545 individuals who had provided consent to be contacted about ongoing research projects into infection control. Phase 2: Semi-structured interviews with 19 participants from ethnic minority and low income communities.ResultsMany survey and interview participants viewed the provision of accommodation as important and necessary in certain contexts. Of the 110 survey respondents, 85 (77%) said that they were not able to isolate at home. Among this group, 24 (28%) said they would accept accommodation and 23 (27%) said that they would probably accept. Of those unable to isolate at home, and at high risk if they caught the virus (N = 36) or living with someone at high risk (N 18), 19 (35%) said that they would accept, and 12 (22%) said they would probably accept accommodation. Factors influencing uptake of accommodation included perceived 1) household vulnerability 2) virus exposure and 3) lack of isolation at home options. Barriers to accepting the accommodation offer included 1) able to isolate at home 2) wanting to be with family 3) caring responsibilities 4) mental wellbeing concerns 5) concerns about moving when ill and 6) infection control concerns. Participants raised issues that should be addressed before accommodation is offered, including questions regarding who should use temporary accommodation and when, and how infection control in temporary accommodation would be managed.ConclusionThe provision of accommodation to prevent within household transmission of Covid-19 is viewed as acceptable, feasible and necessary by some people who are concerned about infection transmission in the home and are unable to self-isolate or socially distance at home. Different households will have different requirements, e.g., those with caring responsibilities, and to overcome these challenges additional support may be needed for the provision of accommodation to be feasible to those who could benefit most.

Project description:OBJECTIVES:(1) Assess whether cardiac rehabilitation (CR) is a feasible and acceptable model of rehabilitation for postsurgical colorectal cancer (CRC) survivors, (2) evaluate trial procedures. This article reports the results of the first objective. DESIGN AND SETTING:A pragmatic pilot randomised controlled trial with embedded qualitative study was conducted in 3 UK hospitals with CR facilities. Descriptive statistics were used to summarise trial parameters indicative of intervention feasibility and acceptability. Interviews and focus groups were conducted and data analysed thematically. PARTICIPANTS:People with CRC were considered for inclusion in the trial if they were ? 18 years old, diagnosed with primary CRC and in the recovery period postsurgery (they could still be receiving adjuvant therapy). 31% (n=41) of all eligible CRC survivors consented to participate in the trial. 22 of these CRC survivors, and 8 people with cardiovascular disease (CVD), 5 CRC nurses and 6 CR clinicians participated in the qualitative study. INTERVENTION:Referral of postsurgical CRC survivors to weekly CR exercise classes and information sessions. Classes included CRC survivors and people with CVD. CR nurses and physiotherapists were given training about cancer and exercise. RESULTS:Barriers to CR were protracted recoveries from surgery, ongoing treatments and poor mobility. No adverse events were reported during the trial, suggesting that CR is safe. 62% of participants completed the intervention as per protocol and had high levels of attendance. 20 health professionals attended the cancer and exercise training course, rating it as excellent. Participants perceived that CR increased CRC survivors' confidence and motivation to exercise, and offered peer support. CR professionals were concerned about CR capacity to accommodate cancer survivors and their ability to provide psychosocial support to this group of patients. CONCLUSIONS:CR is feasible and acceptable for postsurgical CRC survivors. A large-scale effectiveness trial of the intervention should be conducted. TRIAL REGISTRATION NUMBER:ISRCTN63510637.

Dataset Information

Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors?

Background

Objective

Design, setting and participants

Intervention

Results

Discussion and conclusions

Publications

Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors?

Similar Datasets

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