Scott Hunter, Brown Nashira I, Schleicher Erica A, Oster Robert A, McAuley Edward, Courneya Kerry S, Anton Philip, Ehlers Diane K, Phillips Siobhan M, Rogers Laura Q
Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
J Clin Med. 2023 Oct 14;12(20):6531. doi: 10.3390/jcm12206531.
Despite exercise benefits for cancer survivor health, most breast cancer survivors do not meet exercise recommendations. Few studies have examined associations between psychosocial symptoms and exercise barriers in this population. To improve physician exercise counseling by identifying survivors with high barriers in a clinical setting, associations between breast cancer symptoms (fatigue, mood, sleep quality) and exercise barriers were investigated. Physically inactive survivors ( = 320; average age 55 ± 8 years, 81% White, 77% cancer stage I or II) completed a baseline survey for a randomized physical activity trial and secondary analyses were performed. Potential covariates, exercise barriers interference score, Fatigue Symptom Inventory, Hospital Anxiety and Depression Scale (HADS), and Pittsburgh Sleep Quality Index were assessed. Based on multiple linear regression analyses, only HADS Global (B = 0.463, < 0.001) and number of comorbidities (B = 0.992, = 0.01) were independently associated with total exercise barriers interference score, explaining 8.8% of the variance (R = 0.088, F(2,317) = 15.286, < 0.001). The most frequent barriers to exercise for survivors above the HADS clinically important cut point included procrastination, routine, and self-discipline. These results indicate greater anxiety levels, depression levels, and comorbidities may be independently associated with specific exercise barriers. Health professionals should consider mood and comorbidities when evaluating survivors for exercise barriers, and tailoring exercise counseling.
尽管运动对癌症幸存者的健康有益，但大多数乳腺癌幸存者并未达到运动建议标准。很少有研究探讨这一人群心理社会症状与运动障碍之间的关联。为了通过在临床环境中识别出运动障碍高的幸存者来改善医生的运动咨询，我们调查了乳腺癌症状（疲劳、情绪、睡眠质量）与运动障碍之间的关联。身体不活动的幸存者（n = 320；平均年龄55±8岁，81%为白人，77%为癌症I期或II期）完成了一项随机体育活动试验的基线调查，并进行了二次分析。评估了潜在的协变量、运动障碍干扰评分、疲劳症状量表、医院焦虑抑郁量表（HADS）和匹兹堡睡眠质量指数。基于多元线性回归分析，只有HADS总分（B = 0.463，P < 0.001）和合并症数量（B = 0.992，P = 0.01）与总的运动障碍干扰评分独立相关，解释了8.8%的方差（R² = 0.088，F(2,317) = 15.286，P < 0.001）。在HADS临床重要切点以上的幸存者中，最常见的运动障碍包括拖延、日常事务和自律。这些结果表明，更高的焦虑水平、抑郁水平和合并症可能与特定的运动障碍独立相关。健康专业人员在评估幸存者的运动障碍并进行针对性的运动咨询时，应考虑情绪和合并症情况。
