Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Pain Symptom Manage. 2012 Jul;44(1):84-94. doi: 10.1016/j.jpainsymman.2011.08.009.
Exercise reduces cancer-related disablement and adverse symptoms, yet patients' attitudes toward exercise remain largely unexamined.
This qualitative study sought to characterize the beliefs of patients with late-stage disease regarding exercise, its relationship to their symptoms, and their clinicians' roles in providing related counseling.
Semistructured interviews with 20 adults (half male and half aged 65 years or older) with Stage IIIB or IV nonsmall cell lung cancer were qualitatively analyzed. Participants were questioned about their levels of activity, the influence of their symptoms on their activities, perceived barriers and facilitators for exercise, and exercise-related instructions received from their professional caregivers.
Participants overwhelmingly cited usual daily activities as their source of "exercise." Symptoms, particularly treatment-related, discouraged participation, with fear of harm being a significant concern only among younger women. Exercise was recognized as important for physical and mental well-being but seldom as a means to mitigate symptoms. Weather, recalled levels of premorbid fitness, and exercise participation modulated current exercise behaviors. Although respondents preferred to receive guidance from their oncologist, none reported receiving more than general encouragement to "stay active." A lack of direction was typically accepted as a sanction of their current activity levels. Participants appeared less receptive to guidance from ancillary health professionals.
Effective use of exercise and activity modification to ameliorate cancer-related symptoms appears to require a linkage to a patient's usual and past activities, proactive negotiation of potential barriers, education regarding symptoms and exercise, and the positive support of their oncologist.
运动可以减少癌症相关的残疾和不良反应，但患者对运动的态度仍在很大程度上未被研究。
本定性研究旨在描述晚期疾病患者对运动的信念，以及运动与他们的症状之间的关系，以及他们的临床医生在提供相关咨询方面的作用。
对 20 名患有 IIIB 期或 IV 期非小细胞肺癌的成年人（一半为男性，一半为 65 岁或以上）进行半结构式访谈，并进行定性分析。受访者被问及他们的活动水平、症状对其活动的影响、对运动的感知障碍和促进因素，以及从专业护理人员那里获得的与运动相关的建议。
参与者压倒性地将日常活动作为“运动”的来源。症状，特别是与治疗相关的症状，阻碍了他们的参与，只有年轻女性才会担心受伤。运动被认为对身心健康很重要，但很少被认为是缓解症状的手段。天气、回忆起的发病前健康水平和运动参与度调节了当前的运动行为。尽管受访者希望从肿瘤学家那里获得指导，但没有人报告收到过更多的一般性鼓励，即“保持活跃”。缺乏指导通常被认为是对他们当前活动水平的一种制裁。参与者似乎不太愿意接受辅助健康专业人员的指导。
有效利用运动和活动改变来缓解癌症相关的症状，似乎需要与患者的日常和过去的活动建立联系，积极协商潜在的障碍，对症状和运动进行教育，并得到肿瘤学家的积极支持。
