Ungar Nadine, Wiskemann Joachim, Sieverding Monika
Institute of Psychology, Heidelberg University Heidelberg, Germany.
Division of Medical Oncology, National Center for Tumor Diseases Heidelberg and University Clinic Heidelberg Heidelberg, Germany.
Front Psychol. 2016 Jun 21;7:898. doi: 10.3389/fpsyg.2016.00898. eCollection 2016.
Physical activity (PA) can support cancer patients during medical treatment by reducing side-effects and increasing quality of life. However, PA levels mostly decline after diagnosis. Which factors can explain if patients are able to remain or even increase their PA level? Self-efficacy is an important cognitive factor that has been linked to cancer patients' PA across many studies. In contrast, affective factors such as PA enjoyment have rarely been examined. We compare the influence of self-efficacy and PA enjoyment on cancer patients' PA levels after completion of an exercise or stress-management intervention.
Outpatient cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34%, 15%)] were enrolled in the MOTIVACTION study, a 4-week intervention (1 h counseling followed by weekly phone calls), with pre-test (T1), post-test (T2), and a 10-week follow-up (T3). Participants were randomized to either an exercise intervention (emphasizing self-regulatory strategies for behavior change) or to a stress management intervention (coping and relaxation techniques). Sixty-seven patients remained in the study and completed the SQUASH assessment of PA, a measure of maintenance self-efficacy (7 items, Cronbach's α = 0.88) and PA enjoyment (2 items, Cronbach's α = 0.89). Regression analyses were calculated with PA level (at T2 and T3) as dependent variable and relative weight analyses were conducted. The study was registered at clinicalTrials.gov (unique identifier:NCT01576107; URL: https://clinicaltrials.gov/ct2/show/NCT01576107?term=motivaction&rank=1).
Baseline self-efficacy and change in PA enjoyment significantly predicted cancer patients' PA level at T2 adjusting for baseline PA and type of intervention. Relative weight (RW) analysis revealed that PA enjoyment (baseline and change together) explained 34.3% of the dependent variable, self-efficacy (baseline and change) explained 38.4%. At follow-up, self-efficacy was still a significant predictor of PA (RW = 74.6%), whereas PA enjoyment was no longer a relevant factor (RW = 5.2%).
The affective factor PA enjoyment was equally important as self-efficacy for predicting cancer patient' PA level directly after completion of the intervention. Reasons for the reduced relevance at follow-up and a broader range of affective factors should be analyzed in future studies on cancer patients' PA level.
身体活动（PA）可通过减轻副作用和提高生活质量来支持癌症患者接受医学治疗。然而，PA水平在诊断后大多会下降。哪些因素可以解释患者是否能够维持甚至提高其PA水平？自我效能感是一个重要的认知因素，在许多研究中都与癌症患者的PA相关。相比之下，诸如PA乐趣等情感因素很少被研究。我们比较了自我效能感和PA乐趣对癌症患者在完成运动或压力管理干预后的PA水平的影响。
门诊癌症患者[N = 72；54%为女性；M = 56岁，标准差 = 12.34；大多数为乳腺癌或结肠癌患者（34%，15%）]参加了MOTIVACTION研究，这是一项为期4周的干预（1小时咨询，随后每周电话随访），包括预测试（T1）、后测试（T2）和10周随访（T3）。参与者被随机分配到运动干预组（强调行为改变的自我调节策略）或压力管理干预组（应对和放松技巧）。67名患者留在研究中并完成了PA的SQUASH评估、维持自我效能感测量（7项，克朗巴哈α系数 = 0.88）和PA乐趣测量（2项，克朗巴哈α系数 = 0.89）。以PA水平（在T2和T3时）为因变量进行回归分析，并进行相对权重分析。该研究已在ClinicalTrials.gov注册（唯一标识符：NCT01576107；网址：https://clinicaltrials.gov/ct2/show/NCT01576107?term=motivaction&rank=1）。
在调整基线PA和干预类型后，基线自我效能感和PA乐趣的变化显著预测了癌症患者在T2时的PA水平。相对权重（RW）分析显示，PA乐趣（基线和变化合计）解释了因变量的34.3%，自我效能感（基线和变化）解释了38.4%。在随访时，自我效能感仍然是PA的显著预测因素（RW = 74.6%），而PA乐趣不再是一个相关因素（RW = 5.2%）。
情感因素PA乐趣在干预完成后直接预测癌症患者的PA水平方面与自我效能感同样重要。在未来关于癌症患者PA水平的研究中，应分析随访时相关性降低的原因以及更广泛的情感因素。
