Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584, CG, Utrecht, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, STR 6.131, 3508, GA, Utrecht, The Netherlands.
Support Care Cancer. 2023 May 6;31(6):320. doi: 10.1007/s00520-023-07769-5.
Participation in a post-treatment exercise program improves cardiorespiratory fitness and aspects of quality of life for esophageal cancer survivors. For optimal effects, high adherence to the exercise intervention is important. We assessed which facilitators and barriers to exercise adherence are perceived by esophageal cancer survivors, who participate in a post-treatment exercise program.
The current qualitative study was performed within the randomized controlled PERFECT trial, in which we investigated effects of a 12-week supervised exercise program with moderate-to-high intensity and daily physical activity advice. Semi-structured interviews were conducted with patients randomized to the exercise group. A thematic content approach was used to derive perceived facilitators and barriers.
Thematic saturation was reached after inclusion of sixteen patients. Median session attendance was 97.9% (IQR 91.7-100%), and relative dose intensity (compliance) to all exercises was ≥90.0%. Adherence to the activity advice was 50.0% (16.7-60.4%). Facilitators and barriers were captured in seven themes. The most important facilitators were patients' own intention to engage in exercise and supervision by a physiotherapist. Barriers were mainly experienced in completion of the activity advice, and included logistic factors and physical complaints.
Esophageal cancer survivors are well capable to attend a moderate-to-high intensity post-treatment exercise program, and to fulfill the exercises according to protocol. This is facilitated by patients' own intention to engage in exercise and supervision of the physiotherapist, and only minimally affected by barriers as logistic factors and physical complaints.
When implementing postoperative exercise programs in clinical care, it can be useful to be aware of perceived facilitators and barriers of cancer survivors in order to achieve optimal exercise adherence and maximize beneficial exercise effects.
Dutch Trial Register NTR 5045.
参加治疗后运动方案可提高食管癌幸存者的心肺适能和生活质量。为了达到最佳效果，需要高度坚持运动干预。我们评估了参加治疗后运动方案的食管癌幸存者认为哪些因素可促进或阻碍他们坚持运动。
本研究为随机对照 PERFECT 试验的一部分，在该试验中，我们调查了 12 周高强度监督运动方案和日常体力活动建议对食管癌患者的影响。对随机分配到运动组的患者进行了半结构化访谈。采用主题内容分析方法得出感知到的促进因素和阻碍因素。
纳入 16 例患者后达到主题饱和。中位数疗程出席率为 97.9%（IQR 91.7-100%），所有运动的相对剂量强度（依从性）≥90.0%。活动建议的依从率为 50.0%（16.7-60.4%）。促进因素和阻碍因素包括 7 个主题。最重要的促进因素是患者自身进行运动的意愿和物理治疗师的监督。障碍主要在完成活动建议时出现，包括后勤因素和身体抱怨。
食管癌幸存者能够很好地参加中高强度治疗后运动方案，并根据方案完成运动。这得益于患者自身进行运动的意愿和物理治疗师的监督，仅受到后勤因素和身体抱怨等障碍的轻微影响。
在临床护理中实施术后运动方案时，了解癌症幸存者感知到的促进因素和阻碍因素可能有助于实现最佳运动依从性并最大限度地发挥有益的运动效果。
荷兰临床试验注册中心 NTR 5045。
