NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
BMC Public Health. 2022 Aug 20;22(1):1587. doi: 10.1186/s12889-022-13980-6.
Weight gain is common after breast cancer. The aim of this study was to identify and describe the barriers to and enablers of successful weight management for women with breast cancer.
This was a combined inductive and deductive framework analysis of free text responses to an anonymous cross-sectional survey on weight after breast cancer. Women were recruited mainly through the Breast Cancer Network Australia Review and Survey Group. We applied deductive thematic analysis to free text responses to questions on barriers, enablers, research priorities, and one open-ended question at the end of the survey using the Capability, Opportunity, Motivation and Behaviour (COM-B) model as a framework. Subthemes that arose from the inductive analysis were mapped onto the COM-B model framework. Findings were used to identify behaviour change intervention functions.
One hundred thirty-three women provided free text responses. Most women were of Caucasian origin and had been diagnosed with non-metastatic breast cancer, with a mean age of 59.1 years. Women's physical capability to adopt and sustain healthy lifestyle habits was significantly affected by treatment effects and physical illness, and some lacked psychological capability to self-regulate the face of stress and other triggers. Limited time and finances, and the social impact of undergoing cancer treatment affected the ability to control their diet. Frustration and futility around weight management were prominent. However, some women were confident in their abilities to self-regulate and self-monitor lifestyle behaviours, described support from friends and health professionals as enablers, and welcomed the physical and psychological benefits of being active in the context of embracing transformation and self-care after cancer.
Women need specific advice and support from peers, friends and families and health professionals. There is a substantial gap in provision of supportive care to enable women to adopt and sustain healthy lifestyles. Environmental restructuring (including financial support), incentivization (creating an expectation of looking and feeling better), persuasion and coercion (aiming to prevent recurrence), and equipping women with specific knowledge and skills, would also facilitate optimal lifestyle behaviours and weight management.
乳腺癌治疗后体重增加较为常见。本研究旨在确定并描述乳腺癌女性成功进行体重管理的障碍和促进因素。
这是一项针对乳腺癌后体重的匿名横断面调查的自由文本回复的综合归纳和演绎框架分析。女性主要通过澳大利亚乳腺癌网络审查和调查小组招募。我们应用了演绎主题分析，使用能力、机会、动机和行为（COM-B）模型作为框架，对调查结束时的问题（障碍、促进因素、研究重点和一个开放式问题）的自由文本回复进行分析。从归纳分析中产生的子主题被映射到 COM-B 模型框架上。研究结果用于确定行为改变干预功能。
133 名女性提供了自由文本回复。大多数女性为白种人，被诊断为非转移性乳腺癌，平均年龄为 59.1 岁。治疗效果和身体疾病严重影响了女性采用和维持健康生活习惯的身体能力，一些人缺乏自我调节压力和其他触发因素的心理能力。有限的时间和财力，以及癌症治疗的社会影响，影响了对饮食的控制。对体重管理的沮丧和徒劳是突出的。然而，一些女性对自己自我调节和自我监测生活方式行为的能力充满信心，将朋友和健康专业人员的支持描述为促进因素，并在接受癌症治疗的背景下，欢迎积极参与身体和心理上的好处，以拥抱自我关怀和自我转变。
女性需要来自同伴、朋友和家人以及健康专业人员的具体建议和支持。在提供支持性护理以帮助女性采用和维持健康生活方式方面存在巨大差距。环境重构（包括财政支持）、激励（创造看起来和感觉更好的期望）、劝说和强制（旨在预防复发），以及为女性提供特定的知识和技能，也将促进最佳的生活方式行为和体重管理。
