Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Department of Hematology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Cancer Med. 2024 Jun;13(12):e7361. doi: 10.1002/cam4.7361.
BACKGROUND: Healthy behaviors are paramount in preventing long-term adverse health outcomes in childhood, adolescent, and young adult (CAYA) cancer survivors. We systematically reviewed and synthesized existing literature on barriers, facilitators, and other factors associated with health behaviors in this population. METHODS: MEDLINE and PsycInfo were searched for qualitative and quantitative studies including survivors aged 16-50 years at study, a cancer diagnosis ≤25 years and ≥2 years post diagnosis. Health behaviors included physical activity, smoking, diet, alcohol consumption, sun exposure, and a combination of these behaviors (defined as health behaviors in general). RESULTS: Barriers, facilitators, and other factors reported in ≥2 two studies were considered relevant. Out of 4529 studies, 27 were included (n = 31,905 participants). Physical activity was the most frequently examined behavior (n = 12 studies), followed by smoking (n = 7), diet (n = 7), alcohol (n = 4), sun exposure (n = 4), and health behavior in general (n = 4). Relevant barriers to physical activity were fatigue, lack of motivation, time constraints, and current smoking. Relevant facilitators were perceived health benefits and motivation. Influence of the social environment and poor mental health were associated with more smoking, while increased energy was associated with less smoking. No relevant barriers and facilitators were identified for diet, alcohol consumption, and sun exposure. Barriers to healthy behavior in general were unmet information needs and time constraints whereas lifestyle advice, information, and discussions with a healthcare professional facilitated healthy behavior in general. Concerning other factors, women were more likely to be physically inactive, but less likely to drink alcohol and more likely to comply with sun protection recommendations than men. Higher education was associated with more physical activity, and lower education with more smoking. CONCLUSION: This knowledge can be used as a starting point to develop health behavior interventions, inform lifestyle coaches, and increase awareness among healthcare providers regarding which survivors are most at risk of unhealthy behaviors.
背景:健康行为对于预防儿童、青少年和青年期癌症幸存者(CAYA)的长期不良健康后果至关重要。我们系统地回顾和综合了现有文献,探讨了与该人群健康行为相关的障碍、促进因素和其他因素。
方法:在 MEDLINE 和 PsycInfo 中搜索了定性和定量研究,包括研究时年龄在 16-50 岁、癌症诊断≤25 岁且≥2 年的幸存者。健康行为包括体力活动、吸烟、饮食、饮酒、晒太阳和这些行为的组合(定义为一般健康行为)。
结果:报告了≥2 项研究的障碍、促进因素和其他因素被认为是相关的。在 4529 项研究中,有 27 项研究符合纳入标准(n=31905 名参与者)。体力活动是最常被研究的行为(n=12 项研究),其次是吸烟(n=7)、饮食(n=7)、饮酒(n=4)、晒太阳(n=4)和一般健康行为(n=4)。体力活动的相关障碍包括疲劳、缺乏动力、时间限制和当前吸烟。相关促进因素包括感知健康益处和动力。社会环境的影响和较差的心理健康与更多的吸烟有关,而增加能量与较少的吸烟有关。饮食、饮酒和晒太阳方面没有发现相关的障碍和促进因素。一般健康行为的障碍是未满足的信息需求和时间限制,而健康生活方式的建议、信息和与医疗保健专业人员的讨论促进了一般健康行为。关于其他因素,女性更可能不进行体力活动,但更可能不饮酒,更可能遵守防晒建议,而男性则更可能进行体力活动、饮酒和不遵守防晒建议。较高的教育程度与更多的体力活动有关,而较低的教育程度与更多的吸烟有关。
结论:这些知识可以作为开发健康行为干预措施的起点,为生活方式教练提供信息,并提高医疗保健提供者对哪些幸存者最容易出现不健康行为的认识。
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