Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Institute of Sport Science, University of Bern, Switzerland.
Swiss Med Wkly. 2022 May 12(19-20). doi: 10.4414/smw.2022.w30155. eCollection 2022 May 9.
Exercise is an effective therapy for breast cancer patients to reduce fatigue and to improve health-related quality of life and physical function. Yet breast cancer patients often do not meet the recommended physical activity guidelines. To better understand why recommendations are not met and to improve long-term physical activity maintenance, this study aimed at identifying facilitators and barriers of breast cancer survivors to supervised, centre-based exercise within a cardio-oncological rehabilitation programme and to unsupervised, home-based exercise both during and after the completion of the programme, as well as strategies used to manage these barriers.
Breast cancer patients who had previously completed a structured centre-based exercise programme at a Swiss tertiary centre were recruited by mailed invitation letter. Semi-structured telephone interviews were conducted with consenting patients and subsequent thematic analysis was performed to identify common themes.
Of the 37 eligible breast cancer patients, 19 patients (51%, mean age 48.9 ± 9.7 years) responded to our invitation. Baseline characteristics did not differ from the total eligible population. General facilitators for exercise were anticipated and experienced benefits on physical and mental health and enjoyment of exercise. Facilitators specific for supervised centre-based exercise were social support, accountability and the provision of structured exercise by the programme. Centre-based exercise barriers included physical, psychological and environmental barriers, whereby psychological barriers were reported predominantly in the context of home-based exercise. Strategies to manage these barriers were diverse and included the adaptation of training circumstances, behaviour change strategies and strategies to deal with side effects.
This first study on facilitators of and barriers to exercise in breast cancer patients in Switzerland identified more barriers, particularly psychological barriers, for unsupervised home-based exercise than for supervised centre-based exercise. These findings support the importance of providing structured supervised exercise programmes for breast cancer patients and suggest that a special focus should be directed at the transition from supervised to self-organized exercise in order to enhance and maintain long-term exercise participation.
运动是乳腺癌患者减少疲劳、改善健康相关生活质量和身体功能的有效治疗方法。然而，乳腺癌患者往往不符合推荐的体育活动指南。为了更好地了解为什么无法达到建议标准，并改善长期的体育活动维持，本研究旨在确定乳腺癌幸存者在心脏肿瘤康复计划中接受监督的中心基础运动以及在完成计划期间和之后进行的非监督的家庭运动的促进因素和障碍，以及用于管理这些障碍的策略。
通过邮寄邀请函招募曾在瑞士一家三级中心完成过结构化中心基础运动计划的乳腺癌患者。对同意参加的患者进行半结构化电话访谈，并进行主题分析以确定常见主题。
在 37 名符合条件的乳腺癌患者中，有 19 名患者（51%，平均年龄 48.9 ± 9.7 岁）响应了我们的邀请。基线特征与总合格人群无差异。运动的一般促进因素包括对身心健康和运动享受的预期和体验益处。监督中心基础运动的具体促进因素包括社会支持、问责制和计划提供结构化运动。中心基础运动障碍包括身体、心理和环境障碍，其中心理障碍主要在家庭基础运动中报告。管理这些障碍的策略多种多样，包括调整训练环境、行为改变策略和处理副作用的策略。
这项关于瑞士乳腺癌患者运动促进因素和障碍的首次研究发现，与监督中心基础运动相比，非监督家庭基础运动存在更多障碍，特别是心理障碍。这些发现支持为乳腺癌患者提供结构化监督运动计划的重要性，并表明应特别关注从监督到自我组织运动的过渡，以增强和维持长期运动参与。
