Demonstration and manifestation of self-determination and illness resistance--a qualitative study of long-term maintenance of physical activity in posttreatment cancer survivors.
ABSTRACT The aim of this study was to describe posttreatment cancer survivors' lived experience of long-term maintenance of physical activity (PA).
A qualitative, salutogenetic-oriented study was conducted based on four audiotaped, semistructured focus group interviews. Interviewee selection was carried out through purposeful sampling. Twenty-three cancer survivors (17 women and 6 men; median age 50 years, range 29-70) who were physically inactive prior to their diagnosis but who had been exercising regularly for a minimum of 18 months posttreatment participated in the study. The participants were recruited from The Copenhagen PACT Study that evaluated the effect of a one-year rehabilitation program (supervised exercise [weekly], expert lectures [trimonthly], in-group coaching [bimonthly] and individual coaching [3 × 1 h]). Data were analyzed by use of systematic condensation analysis inspired by Giorgi's descriptive phenomenological methodology (see Sketch of a psychological phenomenological method, in: Giorgi A (ed.), Phenomenology and Psychological Research, Duquesne University Press, Pittsburgh, 1985).
The analysis revealed five categories, which were summarized into an overall sentence describing the essence of long-term PA maintenance in cancer survivors: demonstration and manifestation of self-determination and illness resistance. In sum, the participants described regular PA as a prerequisite for feeling and staying well and preserving and pursuing own potentials whereby PA maintenance becomes a goal in itself.
This study indicates that cancer survivors' continued motivation for PA may be dependent on the fulfillment of a personal and conscious experience of being in the process of creating and living a comprehensible and meaningful life. Future theory-based interventions to encourage PA maintenance in cancer survivors could potentially benefit by integration of humanistic and existential psychology in addition to social cognitive theory and theory of planned behavior.
- SourceAvailable from: ncbi.nlm.nih.gov[show abstract] [hide abstract]
ABSTRACT: Evidence of the benefits of exercise for those treated for cancer has led to exercise interventions for this population. Some have questioned whether cancer patients offered a home-based intervention adhere to the exercise prescribed. We examined exercise adherence in a randomized controlled trial of a 12-week, home-based exercise trial for breast cancer patients. Three adherence outcomes were examined: minutes of exercise participation/week, number of steps taken during planned exercise/week, and whether the participant met her weekly exercise goal. Predictors of adherence (e.g. demographic and medical variables, Transtheoretical Model variables, history of exercise) were examined. Findings indicate that participants significantly increased their minutes of exercise and steps taken during planned exercise from Week 1 to 12. The percentage of participants achieving exercise goals was highest in the first few weeks. Exercise self-efficacy significantly predicted each adherence outcome. Baseline PA predicted mean exercise session steps over the 12 weeks. Adherence to a home-based exercise intervention for breast cancer patients changes over time and may be related to baseline levels of exercise self-efficacy.Psycho-Oncology 03/2009; 18(4):369-76. · 3.51 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: The healing and preventive powers of people's health resources and self-assessed knowledge have so far been grossly underestimated in medicine. In this article, we call attention to ethical and epistemological dilemmas related to knowledge, values, communication, and autonomy embedded in the prevailing risk-oriented epidemiology, and suggest a patient-centred salutogenetic approach to promote a better balance between resources and risks in medicine. Identification and intervention upon risk factors can provide hypotheses about origins of disease and predict and sometimes prevent disease at a group level. However, there are several pitfalls related to this perspective concerning causal factors, group level based possibilities, adequate end points for intervention, informed consent, and medicalization, especially in the individualized context of the clinical encounter. By introducing a salutogenic perspective, we urge to shift the attention toward resources, agency and strength, which may counteract risk of disease and empower the patient. Talk can mediate oppression as well as empowerment. A communicative key question approach, and self-assessed health resources identified through this strategy, are briefly presented as examples of empowerment through dialogue.Medicine Health Care and Philosophy 02/2000; 3(3):257-64. · 0.91 Impact Factor
- [show abstract] [hide abstract]
ABSTRACT: Qualitative research methods could help us to improve our understanding of medicine. Rather than thinking of qualitative and quantitative strategies as incompatible, they should be seen as complementary. Although procedures for textual interpretation differ from those of statistical analysis, because of the different type of data used and questions to be answered, the underlying principles are much the same. In this article I propose relevance, validity, and reflexivity as overall standards for qualitative inquiry. I will discuss the specific challenges in relation to reflexivity, transferability, and shared assumptions of interpretation, which are met by medical researchers who do this type of research, and I will propose guidelines for qualitative inquiry.The Lancet 09/2001; 358(9280):483-8. · 39.06 Impact Factor