Trinh Linda, Plotnikoff Ronald C, Rhodes Ryan E, North Scott, Courneya Kerry S
Author Affiliations: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada (Drs Trinh and Courneya); Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia (Dr Plotnikoff); Faculty of Education, University of Victoria, Canada (Dr Rhodes); and Department of Medicine, Cross Cancer Institute, Edmonton, Canada (Dr North).
Cancer Nurs. 2014 Sep-Oct;37(5):E8-22. doi: 10.1097/NCC.0b013e3182a40fb6.
Supervised physical activity (PA) improves short-term health outcomes in cancer survivors, but longer-term adherence is rarely achieved.
The aim of this study was to evaluate the feasibility and preliminary efficacy of adding behavioral counseling to supervised PA in kidney cancer survivors (KCSs).
Thirty-two KCSs were randomized to a 4-week supervised PA program plus standard exercise counseling (SPA + EC group; n = 16) or a 4-week supervised PA plus behavioral counseling based on the Theory of Planned Behavior (SPA + BC group; n = 16). The primary outcome was self-reported PA at 12 weeks. Secondary outcomes were quality of life, anthropometric measures, cardiorespiratory fitness, and physical function.
Follow-up rates for outcomes at 12 weeks were 88% and 94% for fitness testing and questionnaires, respectively. Adherence to the interventions was 94% in both groups with a 6% attrition rate. Analyses of covariance revealed that PA minutes at 12 weeks favored the SPA + BC group by +34 minutes (95% confidence interval, -62 to 129), which was a small effect size (d = 0.21) not reaching statistical significance (P = .47). Moreover, the SPA + BC group increased their 6-minute walk by 48 m more than the SPA + EC group (95% confidence interval, 1-95; d = +0.64; P = .046). There were no significant changes in quality of life measures.
This pilot study provides preliminary evidence that adding behavioral counseling to supervised PA in KCSs is feasible and may improve PA and fitness in the short-term. Larger and longer-term trials are needed.
Oncology nurses may consider adopting behavioral counseling strategies in addition to supervised PA to motivate KCSs to maintain PA.
有监督的体育活动（PA）可改善癌症幸存者的短期健康状况，但长期坚持却很少能实现。
本研究的目的是评估在肾癌幸存者（KCS）中，在有监督的PA基础上增加行为咨询的可行性和初步疗效。
32名KCS被随机分为一个为期4周的有监督PA计划加标准运动咨询组（SPA + EC组；n = 16）或一个为期4周的有监督PA加基于计划行为理论的行为咨询组（SPA + BC组；n = 16）。主要结局是12周时自我报告的PA。次要结局包括生活质量、人体测量指标、心肺适能和身体功能。
12周时结局的随访率，健身测试为88%，问卷调查为94%。两组对干预措施的依从率均为94%，损耗率为6%。协方差分析显示，12周时的PA分钟数，SPA + BC组比SPA + EC组多34分钟（95%置信区间，-62至129），效应量较小（d = 0.21），未达到统计学显著性（P = 0.47）。此外，SPA + BC组比SPA + EC组6分钟步行距离多增加48米（95%置信区间，1 - 95；d = +0.64；P = 0.046）。生活质量指标无显著变化。
这项初步研究提供了初步证据，表明在KCS的有监督PA基础上增加行为咨询是可行的，并且可能在短期内改善PA和适能。需要进行更大规模和更长时间的试验。
肿瘤护理人员除了有监督的PA外，可能还应考虑采用行为咨询策略，以激励KCS维持PA。
