Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK.
School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Psychooncology. 2018 Feb;27(2):458-464. doi: 10.1002/pon.4512. Epub 2017 Sep 6.
Patients with advanced cancer frequently suffer a decline in activities associated with involuntary loss of weight and muscle mass (cachexia). This can profoundly affect function and quality of life. Although exercise participation can maintain physical and psychological function in patients with cancer, uptake is low in cachectic patients who are underrepresented in exercise studies. To understand how such patients' experiences are associated with exercise participation, we investigated exercise history, self-confidence, and exercise motivations in patients with established cancer cachexia, and relationships between relevant variables.
Lung and gastrointestinal cancer outpatients with established cancer cachexia (n = 196) completed a questionnaire exploring exercise history and key constructs of the Theory of Planned Behaviour relating to perceived control, psychological adjustment, and motivational attitudes.
Patients reported low physical activity levels, and few undertook regular structured exercise. Exercise self-efficacy was very low with concerns it could worsen symptoms and cause harm. Patients showed poor perceived control and a strong need for approval but received little advice from health care professionals. Preferences were for low intensity activities, on their own, in the home setting. Regression analysis revealed no significant factors related to the independent variables.
Frequently employed higher intensity, group exercise models do not address the motivational and behavioural concerns of cachectic cancer patients in this study. Developing exercise interventions which match perceived abilities and skills is required to address challenges of self-efficacy and perceived control identified. Greater engagement of health professionals with this group is required to explore potential benefits of exercise.
晚期癌症患者常因非自愿性体重和肌肉量（恶病质）下降而活动能力下降。这会严重影响功能和生活质量。尽管运动参与可以维持癌症患者的身体和心理功能，但在运动研究中代表性不足的恶病质患者中，参与率较低。为了了解这些患者的经历如何与运动参与相关，我们调查了已确诊恶病质的癌症患者的运动史、自信心和运动动机，以及相关变量之间的关系。
196 名患有已确诊恶病质的肺癌和胃肠道癌门诊患者完成了一份问卷，该问卷探讨了运动史以及与感知控制、心理调整和动机态度相关的计划行为理论的关键结构。
患者报告的身体活动水平较低，很少有规律地进行结构化运动。运动自我效能感非常低，担心运动会加重症状并造成伤害。患者表现出较差的感知控制和强烈的寻求认可的需求，但很少得到医疗保健专业人员的建议。他们更喜欢低强度的活动，独自在家中进行。回归分析显示，没有与自变量相关的显著因素。
在本研究中，经常采用的更高强度的小组运动模式并不能解决恶病质癌症患者的动机和行为问题。需要开发与感知能力和技能相匹配的运动干预措施，以解决自我效能感和感知控制方面的挑战。需要更多的卫生专业人员与该群体接触，以探讨运动的潜在益处。
