Mao Jiayu, Zhang Yi, Qiu Xiaoke, Wang Can, Yang Xueli, Li Qiuping
Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province, China.
Semin Oncol Nurs. 2025 Apr;41(2):151811. doi: 10.1016/j.soncn.2025.151811. Epub 2025 Feb 1.
Physical activity (PA) is essential in cancer rehabilitation. Worryingly, PA compliance among colorectal cancer (CRC) survivors is relatively poor, and the barriers and facilitators of PA participation in this population are poorly understood. This review aimed to identify the barriers and facilitators of PA participation among CRC survivors and apply the Capability-Opportunity-Motivation-Behavior (COM-B) model to analyze and categorize these factors.
A mixed-method systematic review was conducted using six electronic databases (Embase, Medline, PubMed, Scopus, Web of Science, and Chinese National Knowledge Infrastructure) to conduct literature search. The searches were conducted from the inception of databases till May 2024, and eligible studies were limited to English or Chinese. The mixed methods appraisal tool (MMAT) was utilized to perform quality assessment, and the convergent integrated approach and descriptive analysis were used for data synthesis and analysis.
This review included 32 studies (seven qualitative, 24 quantitative, and one mixed-method), and no studies were eliminated due to quality. According to the COM-B model, cancer-related symptoms, time constraints, and lack of motivation or interest were the main barriers to PA participation among CRC survivors. The main facilitators of PA participation for CRC survivors included improvement in cancer-related symptoms, enough social support from family and friends, and perceived benefits of PA.
This review comprehensively identified the unique barriers and facilitators to PA participation among CRC survivors based on the COM-B model. Future research should consider these barriers and facilitators and develop effective PA interventions to increase PA compliance among CRC survivors.
身体活动（PA）在癌症康复中至关重要。令人担忧的是，结直肠癌（CRC）幸存者的PA依从性相对较差，而且对于该人群参与PA的障碍和促进因素了解甚少。本综述旨在确定CRC幸存者参与PA的障碍和促进因素，并应用能力-机会-动机-行为（COM-B）模型对这些因素进行分析和分类。
采用混合方法进行系统综述，使用六个电子数据库（Embase、Medline、PubMed、Scopus、Web of Science和中国国家知识基础设施）进行文献检索。检索从数据库建立之初至2024年5月，纳入的研究限于英文或中文。使用混合方法评估工具（MMAT）进行质量评估，并采用收敛性综合方法和描述性分析进行数据综合与分析。
本综述纳入32项研究（7项定性研究、24项定量研究和1项混合方法研究），没有研究因质量问题被排除。根据COM-B模型，癌症相关症状、时间限制以及缺乏动力或兴趣是CRC幸存者参与PA的主要障碍。CRC幸存者参与PA的主要促进因素包括癌症相关症状的改善、来自家人和朋友的充分社会支持以及对PA益处的认知。
本综述基于COM-B模型全面确定了CRC幸存者参与PA的独特障碍和促进因素。未来的研究应考虑这些障碍和促进因素，并制定有效的PA干预措施，以提高CRC幸存者的PA依从性。
