Increasing the frequency of physical activity very brief advice by nurses to cancer patients. A mixed methods feasibility study of a training intervention

BACKGROUND A cancer diagnosis and cancer treatment can cause high levels of distress, which is often not sufficiently addressed in standard medical care. Therefore, a variety of supportive non-pharmacological treatments have been suggested to reduce cancer patients’ distress. However, not all patients use those interventions because of limited access or being unaware. To overcome these barriers, mHealth might be a promising way to deliver respective supportive treatments. OBJECTIVE The aim of this study was to evaluate effects and the implementation of a mindfulness and relaxation app intervention for cancer patients as well as patients’ adherence to such an intervention. METHODS In this observational feasibility study with a mixed-methods approach, cancer patients were recruited online and through hospitals in Switzerland. All enrolled patients received access to a mindfulness and relaxation app. Patients completed self-reported outcomes (general health, health-related quality of life, anxiety, depression, distress, mindfulness, and fear of progression) at baseline, week 4, 10, and 20. The frequency of app exercise usage was gathered directly through the app in order to assess the adherence of patients. In addition, we conducted interviews with 5 health professionals for their thoughts on the implementation of the app intervention into standard medical care. We analyzed patients’ self-reported outcomes with linear mixed models (LMM) and qualitative data with content analysis. RESULTS A total of 100 cancer patients (74 female) with a mean age of 53.2 (SD 11.6) participated in the study, of which 25 patients used the app regularly until week 20. LMM analyses revealed an improvement in anxiety (P=.04), distress (P<.001), fatigue (P=.01), sleep disturbance (P=.02), quality of life (P=.03), and mindfulness (P<.001) over the course of 20 weeks. Further LMM analyses revealed a larger improvement of distress (P<.001), a moderate improvement of anxiety (P=.001), and depression (P=.03) in patients with high symptom levels at baseline in the respective domains. The interviews revealed that the health professionals perceived the app as a helpful addition to standard care. They also made suggestions for improvements, which could facilitate the implementation and adherence to such an app. CONCLUSIONS This study indicates that a mindfulness and relaxation app for cancer patients can be a feasible and effective way to deliver a self-care intervention, especially for highly distressed patients. Future studies should investigate if the appeal of the app can be increased with more content and the effectiveness of such an intervention needs to be tested in a randomized controlled trial. CLINICALTRIAL

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Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072515 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2515 ◽

Cited By ~ 1

Author(s):

Katherine N. Irvine ◽

Melissa R. Marselle ◽

Alan Melrose ◽

Sara L. Warber

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Feasibility Study ◽

Large Scale ◽

Holistic Health ◽

Physical Activity Guidelines ◽

Health And Wellbeing ◽

Activity Trackers ◽

Outdoor Walking ◽

Programme Delivery

Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) incorporating activity trackers and use of a holistic health and wellbeing measure, the Self-sasessment of Change (SAC) scale. A mixed methods design explored participant recruitment and retention, programme delivery, and measures of physical activity and health and wellbeing. Walker data included: pre-post questionnaires, daily step counts, and interviews. Programme delivery information included: weekly checklists, staff reflections, stakeholder meeting minutes, and a report. Thirteen adults (age 63–81, 76% female) joined and completed the activity tracker GOHW. Activity trackers motivated walkers to join and be more active but complicated programme delivery. Activity trackers allowed the quantification of physical activity and the SAC health and wellbeing measure was easy to use. By week 12, all participants met national physical activity guidelines. Clinically relevant changes on the SAC scale included: sleeping well, experiencing vibrant senses, and feeling energised, focused, joyful, calm and whole. Results illustrate the feasibility of using activity trackers to motivate engagement in and provide a measure of physical activity from GOHWs. The SAC scale offers a promising measure for nature–health research. A conceptual model is provided for the development of future large-scale studies of NBIs, such as group outdoor health walks.

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