‘A good stepping stone to normality’: a qualitative study of cancer survivors’ experiences of an exercise-based rehabilitation program

Amy M. Dennett1,2 & Casey L. Peiris1 & Nicholas F. Taylor1,2 & Melissa S. Reed1 & Nora Shields1,3. Supportive Care in Cancer. 2018

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‘A good stepping stone to normality’: a qualitative study of cancer survivors’ experiences of an exercise-based rehabilitation program

Amy M. Dennett1,2 & Casey L. Peiris1 & Nicholas F. Taylor1,2 & Melissa S. Reed1 & Nora Shields1,3. Supportive Care in Cancer. 2018

Purpose Exercise-based rehabilitation is not routinely offered to patients. We explored the experience of cancer survivors completing an exercise-based cancer rehabilitation program with and without motivational interviewing.

Method A qualitative study using semi-structured interviews and thematic analysis was completed with a purposive sample of 26 cancer survivors (n=17 female, n=18 post-treatment) participating in cancer rehabilitation at a tertiary hospital. Interviews were recorded and transcribed verbatim. Coding was completed by two reviewers independently and confirmed by a third reviewer.

Results The main theme that emerged was exercise-based rehabilitation facilitated a return to normality after diagnosis which included positive changes in physical activity behaviour. Sub-themes were that rehabilitation is person-centred, challenges expectations, empowering and facilitated by expert staff. Common themes emerged whether participants received additional motivational interviewing or not. However, participants who received motivational interviewing were more likely to report feeling accountable for their physical activity levels. Transition to ongoing independent physical activity remained a challenge for some people who did not feel empowered or socially supported.

Conclusion Exercise-based cancer rehabilitation is important in facilitating ‘return to normal’ including increased participation in physical activity. To challenge expectations and to empower cancer survivors, rehabilitation programs should be person-centred and led by expert staff.

Main findings

  • The program comprised 1 h of exercise and 1 h of interactive education, including facilitated group discussion and activities on topics such as exercise, nutrition, relaxation and fatigue. The program ran twice-weekly for 7 weeks and was delivered by a multidisciplinary team comprising a physiotherapist, nurse, occupational therapist and dietitian.
  • A small sample size of twenty-six participants (17 women) were approached to be interviewed and all agreed to participate.
  • Main theme: rehabilitation helps participants regain normal.
  • Sub-themes:
    • Rehabilitation is patient-centred, and includes essential elements
    • Rehabilitation challenges expectations
    • Rehabilitation is empowering
    • Rehabilitation is facilitated by sensitive, interested, expert staff