Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China.
Department of Oncology Surgery, the Children's Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China.
Support Care Cancer. 2022 Nov;30(11):9221-9232. doi: 10.1007/s00520-022-07324-8. Epub 2022 Sep 3.
Regular physical activity (PA) is essential for childhood cancer survivors (CCS), yet most CCS have difficulty participating in it. The level of PA participation among CCS in China is lower than those of western countries, leading to a worse long-term survival of CCS in China. Here, the study aims to explore the associated factors on the PA performance among CCS.
From September to December 2020, the study used purposive sampling to recruit 35 families (88.9%) as sampling units among two hospitals in Hangzhou City, China. The data collection conducted two designs on semi-structured interviews with different roles under family structure - children (n = 35) and parents (n = 35) - respectively. The design of predetermined questions relied on the health belief model (HBM) as a thematic framework. The qualitative analysis applied codebook thematic analysis and used the deductive approach to finalize the main findings.
The study only presented preliminary conclusions from interviews with CCS, which resulted in four themes (changes in PA performance; perceptions on participating PA; cognitions of PA; impacts from others) with eight sub-themes. In particular, CCS replied diversity changes in PA, but most of them mentioned the inactive PA after diagnosis, especially the decline of moderate-to-vigorous PA (MVPA). As for the "perceptions of PA," almost all CCS had substantial perceived benefits about PA, specifically on their physical well-being. All children also expressed perceived barriers to PA, including the side effects of disease and treatment, fatigue, academic burden, changes in psychological status, and lack of companions. On the cognitions of PA, the CCS had limited realizations of regular PA and low self-efficacy on MVPA. Furthermore, CCS expressed their need for support from their parents, school teachers, and healthcare providers. But in reality, they recieved less support on PA from these important people.
The changes in PA after illness among CCS are apparent and unavoidable because of the interaction impacts from internal factors (e.g., personal characters, cognization, perceptions of PA) and external factors (e.g., disease effects, interpersonal supports). The findings explained the main elements under HBM but also provided explored views as the evidence on developing theories and guiding motivations and practices on PA among CCS.
In this exploratory study of 35 CCS, we identified the current situation of PA among CCS in China and explored the associated factors. As the first qualitative study on the CCS in mainland China, the study considered particular effects on social culture and living environment.
有规律的身体活动（PA）对癌症幸存者至关重要，但大多数癌症幸存者都难以参与其中。中国癌症幸存者的 PA 参与水平低于西方国家，导致中国癌症幸存者的长期生存状况更差。本研究旨在探讨癌症幸存者 PA 表现的相关因素。
2020 年 9 月至 12 月，采用目的抽样法，从杭州市 2 家医院招募 35 个家庭（88.9%）作为抽样单位。数据收集采用半结构式访谈设计，分别以儿童（n=35）和父母（n=35）为访谈对象。预设问题的设计以健康信念模型（HBM）为主题框架。定性分析采用编码主题分析，并采用演绎法得出主要结论。
本研究仅呈现了对癌症幸存者访谈的初步结论，得出了 4 个主题（PA 表现的变化；参与 PA 的认知；对 PA 的认知；他人的影响）和 8 个子主题。特别是，癌症幸存者回答了 PA 表现的多样性变化，但他们大多数提到了诊断后的非活跃 PA，尤其是中等至剧烈 PA（MVPA）的减少。至于“对 PA 的认知”，几乎所有的癌症幸存者都对 PA 有实质性的好处认知，特别是对他们的身体健康。所有儿童还表示对 PA 有障碍认知，包括疾病和治疗的副作用、疲劳、学业负担、心理状态的改变和缺乏同伴。在对 PA 的认知方面，癌症幸存者对定期 PA 的认识有限，对 MVPA 的自我效能感较低。此外，癌症幸存者表示他们需要来自父母、学校老师和医疗保健提供者的支持。但实际上，他们从这些重要的人那里获得的 PA 支持较少。
癌症幸存者患病后的 PA 变化是明显的，也是不可避免的，因为内部因素（如个人性格、认知、对 PA 的认知）和外部因素（如疾病影响、人际支持）的相互作用影响。研究结果解释了 HBM 的主要要素，同时也提供了探索性的观点，为癌症幸存者的 PA 理论发展、指导动机和实践提供了证据。
在对 35 名癌症幸存者的探索性研究中，我们确定了中国癌症幸存者 PA 的现状，并探讨了相关因素。作为中国大陆第一项关于癌症幸存者的定性研究，该研究考虑了社会文化和生活环境的特殊影响。
