Quality of Life: A Nurse-Led Physical Activity Coaching Program to Improve the Quality of Life of Patients With Cancer During the COVID-19 Pandemic

2021 ◽  
Vol 25 (5) ◽  
pp. 571-577
Author(s):  
Judi Forner ◽  
Andrea Doughty ◽  
Matthew Dalstrom ◽  
Brandie Messer ◽  
Shannon Lizer
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Patients With Cancer

scholarly journals An Activity Tracker–Guided Physical Activity Program for Patients Undergoing Radiotherapy: Protocol for a Prospective Phase III Trial (OnkoFit I and II Trials) (Preprint)

2021 ◽  
Author(s):  
Franziska Hauth ◽  
Barbara Gehler ◽  
Andreas Michael Nieß ◽  
Katharina Fischer ◽  
Andreas Toepell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Functional Assessment ◽  
Exercise Program ◽  
Daily Step ◽  
Patients With Cancer ◽  
Activity Tracker ◽  
Cancer Related Fatigue ◽  
Daily Step Count

BACKGROUND The positive impact that physical activity has on patients with cancer has been shown in several studies over recent years. However, supervised physical activity programs have several limitations, including costs and availability. Therefore, our study proposes a novel approach for the implementation of a patient-executed, activity tracker–guided exercise program to bridge this gap. OBJECTIVE Our trial aims to investigate the impact that an activity tracker–guided, patient-executed exercise program for patients undergoing radiotherapy has on cancer-related fatigue, health-related quality of life, and preoperative health status. METHODS Patients receiving postoperative radiotherapy for breast cancer (OnkoFit I trial) or neoadjuvant, definitive, or postoperative treatment for other types of solid tumors (OnkoFit II trial) will be randomized (1:1:1) into 3-arm studies. Target accrual is 201 patients in each trial (50 patients per year). After providing informed consent, patients will be randomized into a standard care arm (arm A) or 1 of 2 interventional arms (arms B and C). Patients in arms B and C will wear an activity tracker and record their daily step count in a diary. Patients in arm C will receive personalized weekly targets for their physical activity. No further instructions will be given to patients in arm B. The target daily step goals for patients in arm C will be adjusted weekly and will be increased by 10% of the average daily step count of the past week until they reach a maximum of 6000 steps per day. Patients in arm A will not be provided with an activity tracker. The primary end point of the OnkoFit I trial is cancer-related fatigue at 3 months after the completion of radiotherapy. This will be measured by the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire. For the OnkoFit II trial, the primary end point is the overall quality of life, which will be assessed with the Functional Assessment of Cancer Therapy-General sum score at 6 months after treatment to allow for recovery after possible surgery. In parallel, blood samples from before, during, and after treatment will be collected in order to assess inflammatory markers. RESULTS Recruitment for both trials started on August 1, 2020, and to date, 49 and 12 patients have been included in the OnkoFit I and OnkoFit II trials, respectively. Both trials were approved by the institutional review board prior to their initiation. CONCLUSIONS The OnkoFit trials test an innovative, personalized approach for the implementation of an activity tracker–guided training program for patients with cancer during radiotherapy. The program requires only a limited amount of resources. CLINICALTRIAL ClinicalTrials.gov NCT04506476; https://clinicaltrials.gov/ct2/show/NCT04506476. ClinicalTrials.gov NCT04517019; https://clinicaltrials.gov/ct2/show/NCT04517019. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/28524

scholarly journals An Activity Tracker–Guided Physical Activity Program for Patients Undergoing Radiotherapy: Protocol for a Prospective Phase III Trial (OnkoFit I and II Trials)

10.2196/28524 ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. e28524
Author(s):  
Franziska Hauth ◽  
Barbara Gehler ◽  
Andreas Michael Nieß ◽  
Katharina Fischer ◽  
Andreas Toepell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Functional Assessment ◽  
Exercise Program ◽  
Daily Step ◽  
Patients With Cancer ◽  
Activity Tracker ◽  
Cancer Related Fatigue ◽  
Daily Step Count

Background The positive impact that physical activity has on patients with cancer has been shown in several studies over recent years. However, supervised physical activity programs have several limitations, including costs and availability. Therefore, our study proposes a novel approach for the implementation of a patient-executed, activity tracker–guided exercise program to bridge this gap. Objective Our trial aims to investigate the impact that an activity tracker–guided, patient-executed exercise program for patients undergoing radiotherapy has on cancer-related fatigue, health-related quality of life, and preoperative health status. Methods Patients receiving postoperative radiotherapy for breast cancer (OnkoFit I trial) or neoadjuvant, definitive, or postoperative treatment for other types of solid tumors (OnkoFit II trial) will be randomized (1:1:1) into 3-arm studies. Target accrual is 201 patients in each trial (50 patients per year). After providing informed consent, patients will be randomized into a standard care arm (arm A) or 1 of 2 interventional arms (arms B and C). Patients in arms B and C will wear an activity tracker and record their daily step count in a diary. Patients in arm C will receive personalized weekly targets for their physical activity. No further instructions will be given to patients in arm B. The target daily step goals for patients in arm C will be adjusted weekly and will be increased by 10% of the average daily step count of the past week until they reach a maximum of 6000 steps per day. Patients in arm A will not be provided with an activity tracker. The primary end point of the OnkoFit I trial is cancer-related fatigue at 3 months after the completion of radiotherapy. This will be measured by the Functional Assessment of Chronic Illness Therapy-Fatigue questionnaire. For the OnkoFit II trial, the primary end point is the overall quality of life, which will be assessed with the Functional Assessment of Cancer Therapy-General sum score at 6 months after treatment to allow for recovery after possible surgery. In parallel, blood samples from before, during, and after treatment will be collected in order to assess inflammatory markers. Results Recruitment for both trials started on August 1, 2020, and to date, 49 and 12 patients have been included in the OnkoFit I and OnkoFit II trials, respectively. Both trials were approved by the institutional review board prior to their initiation. Conclusions The OnkoFit trials test an innovative, personalized approach for the implementation of an activity tracker–guided training program for patients with cancer during radiotherapy. The program requires only a limited amount of resources. Trial Registration ClinicalTrials.gov NCT04506476; https://clinicaltrials.gov/ct2/show/NCT04506476. ClinicalTrials.gov NCT04517019; https://clinicaltrials.gov/ct2/show/NCT04517019. International Registered Report Identifier (IRRID) DERR1-10.2196/28524

scholarly journals Digital Self-Management Support Tools in the Care Plan of Patients With Cancer: Review of Randomized Controlled Trials

10.2196/20861 ◽  
2021 ◽  
Vol 23 (6) ◽  
pp. e20861
Author(s):  
Danielle JM Adriaans ◽  
Angelique TM Dierick-van Daele ◽  
Marc Johannes Hubertus Maria van Bakel ◽  
Grard AP Nieuwenhuijzen ◽  
Joep AW Teijink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Randomized Controlled Trials ◽  
Self Management ◽  
Controlled Trials ◽  
Management Support ◽  
Patients With Cancer ◽  
Randomized Controlled ◽  
Support Tools

Background Digital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care. Objective The aim of this review is to analyze published randomized clinical trials to assess the effectiveness of DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer. Methods Five databases were searched from January 2013 to January 2020. English or Dutch language randomized controlled trials comparing DSMSTs with no intervention, usual care, alternative interventions, or a combination and including patients aged ≥18 years with pathologically proven cancer in the active treatment or survivorship phases were included. The results were summarized qualitatively. Results A total of 19 publications describing 3 types of DSMSTs were included. Although the content, duration, and frequency of interventions varied considerably across studies, the commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in 6 (out of 10) studies, on anxiety in 1 (out of 5) study and depression in 2 (out of 8) studies, on symptom distress in 5 (out of 7) studies, on physical activity in 4 (out of 6) studies, on dietary behavior in 1 (out of 4) study, and on fatigue in 2 (out of 5) studies. Moreover, significant negative effects were observed on anxiety in 1 (out of 5) study and depression in 1 (out of 8) study. Most interventions were web-based interventions; 2 studies used mobile apps, and 1 study used a game as a DSMST. The overall quality of the studies was found to be good, with 13 out of 19 studies classified as high quality. Conclusions This review suggests that DSMSTs have a beneficial effect on the quality of life. For effects on other patient outcomes (eg, anxiety and depression, symptom distress, physical activity, dietary behavior, and fatigue), the evidence is inconsistent and limited or no effect is suggested. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effects of specific interventions at different stages of disease progression.

The effectiveness of nutritional-sensitive approach to restore physical activity in cachexic female palliative patients: A randomized controlled trial.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 258-258
Author(s):  
Neha Kapoor
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Placebo Group ◽  
Health Status ◽  
Global Health ◽  
Intervention Group ◽  
Global Health Status ◽  
Patients With Cancer ◽  
Palliative Patients

258 Background: Loss of lean body mass, body fat along with inflammation characterizes cachexia in patients with cancer. Nutrition intervention with counseling may ameliorate undernutrition and metabolic alterations. The aim of this study was to improve nutritional status and quality of life by providing nutrients dense natural food (IAtta) along with counseling. Methods: Female patients with cancerwith symptoms of cachexia were randomly distributed into placebo (n = 75) and intervention group (n = 75). Patients were recruited from the palliative clinic, Oncology department in AIIMS, New Delhi, India. In addition to nutritional counseling, patients were instructed to consume 100g nutritional supplement on daily basis with their normal dietary intake and for six months period. The intervention group received 100g of IAtta while placebo group received 100g of whole wheat flour. Body weight – BW; mid upper arm circumference - MUAC, physical activity level - PAL, quality of life – QoL domains and total body water (TBW) were assessed at baseline, three months and after six months. Study variables were analyzed using repeated-measures ANOVA and the Friedman test (P-value < 0.05; 95% confidence interval). Results: After 6 months,patients in group IAtta had significant improvement in PAL and QoL domain (global health status, p < 0.001 and fatigue, p = 0.001). Despite the decrease in BW from 43.3 ± 7.0 to 41.6 ± 5.7 Kg (p = 0.014), TBW and MUAC (p = 0.068) were maintained. Conversely, the QoL in placebo group did not improve (global health status, p = 0.74) neither their PAL. Moreover, significant increase in TBW (due to water retention) and BW (from 42.6±7.1 to 43.5±7.4 Kg, p = 0.001). Conclusions: Nutrition-sensitive approach (IAtta meal), along with nutrition counseling, improve quality of life and physical activity in female cachexia palliative patients with cancer. Clinical trial information: NCT02561143. [Table: see text]

scholarly journals Digital Self-Management Support Tools in the Care Plan of Patients With Cancer: Review of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Danielle JM Adriaans ◽  
Angelique TM Dierick-van Daele ◽  
Marc Johannes Hubertus Maria van Bakel ◽  
Grard AP Nieuwenhuijzen ◽  
Joep AW Teijink ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Randomized Controlled Trials ◽  
Self Management ◽  
Controlled Trials ◽  
Management Support ◽  
Patients With Cancer ◽  
Randomized Controlled ◽  
Support Tools

BACKGROUND Digital self-management support tools (DSMSTs)—electronic devices or monitoring systems to monitor or improve health status—have become increasingly important in cancer care. OBJECTIVE The aim of this review is to analyze published randomized clinical trials to assess the effectiveness of DSMSTs on physical and psychosocial symptoms or other supportive care needs in adult patients with cancer. METHODS Five databases were searched from January 2013 to January 2020. English or Dutch language randomized controlled trials comparing DSMSTs with no intervention, usual care, alternative interventions, or a combination and including patients aged ≥18 years with pathologically proven cancer in the active treatment or survivorship phases were included. The results were summarized qualitatively. RESULTS A total of 19 publications describing 3 types of DSMSTs were included. Although the content, duration, and frequency of interventions varied considerably across studies, the commonly used elements included an assessment component, tailored symptom self-management support, an information section, a communication section, and a diary. Significant positive effects were observed on quality of life in 6 (out of 10) studies, on anxiety in 1 (out of 5) study and depression in 2 (out of 8) studies, on symptom distress in 5 (out of 7) studies, on physical activity in 4 (out of 6) studies, on dietary behavior in 1 (out of 4) study, and on fatigue in 2 (out of 5) studies. Moreover, significant negative effects were observed on anxiety in 1 (out of 5) study and depression in 1 (out of 8) study. Most interventions were web-based interventions; 2 studies used mobile apps, and 1 study used a game as a DSMST. The overall quality of the studies was found to be good, with 13 out of 19 studies classified as <i>high quality</i>. CONCLUSIONS This review suggests that DSMSTs have a beneficial effect on the quality of life. For effects on other patient outcomes (eg, anxiety and depression, symptom distress, physical activity, dietary behavior, and fatigue), the evidence is inconsistent and limited or no effect is suggested. Future research should focus on specific tumor types, study different types of interventions separately, and assess the effects of specific interventions at different stages of disease progression.

scholarly journals Impact of the Method of Delivering Electronic Health Behavior Change Interventions in Survivors of Cancer on Engagement, Health Behaviors, and Health Outcomes: Systematic Review and Meta-Analysis (Preprint)

2019 ◽  
Author(s):  
Kate Furness ◽  
Mitchell N Sarkies ◽  
Catherine E Huggins ◽  
Daniel Croagh ◽  
Terry P Haines
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Patients With Cancer ◽  
Behavior Change Interventions

BACKGROUND Increased accessibility to the internet and mobile devices has seen a rapid expansion in electronic health (eHealth) behavior change interventions delivered to patients with cancer and survivors using synchronous, asynchronous, and combined delivery methods. Characterizing effective delivery methods of eHealth interventions is required to enable improved design and implementation of evidence-based health behavior change interventions. OBJECTIVE This study aims to systematically review the literature and synthesize evidence on the success of eHealth behavior change interventions in patients with cancer and survivors delivered by synchronous, asynchronous, or combined methods compared with a control group. Engagement with the intervention, behavior change, and health outcomes, including quality of life, fatigue, depression, and anxiety, were examined. METHODS A search of Scopus, Ovid MEDLINE, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature Plus, PsycINFO, Cochrane CENTRAL, and PubMed was conducted for studies published between March 2007 and March 2019. We looked for randomized controlled trials (RCTs) examining interventions delivered to adult cancer survivors via eHealth methods with a measure of health behavior change. Random-effects meta-analysis was performed to examine whether the method of eHealth delivery impacted the level of engagement, behavior change, and health outcomes. RESULTS A total of 24 RCTs were included predominantly examining dietary and physical activity behavior change interventions. There were 11 studies that used a synchronous approach and 11 studies that used an asynchronous approach, whereas 2 studies used a combined delivery method. Use of eHealth interventions improved exercise behavior (standardized mean difference [SMD] 0.34, 95% CI 0.21-0.48), diet behavior (SMD 0.44, 95% CI 0.18-0.70), fatigue (SMD 0.21, 95% CI −0.08 to 0.50; SMD change 0.22, 95% CI 0.09-0.35), anxiety (SMD 1.21, 95% CI: 0.36-2.07; SMD change 0.15, 95% CI −0.09 to 0.40), depression (SMD 0.15, 95% CI 0.00-0.30), and quality of life (SMD 0.12, 95% CI −0.10 to 0.34; SMD change 0.14, 95% CI 0.04-0.24). The mode of delivery did not influence the amount of dietary and physical activity behavior change observed. CONCLUSIONS Physical activity and dietary behavior change eHealth interventions delivered to patients with cancer or survivors have a small to moderate impact on behavior change and a small to very small benefit to quality of life, fatigue, depression, and anxiety. There is insufficient evidence to determine whether asynchronous or synchronous delivery modes yield superior results. Three-arm RCTs comparing delivery modes with a control with robust engagement reporting are required to determine the most successful delivery method for promoting behavior change and ultimately favorable health outcomes.

scholarly journals Are patient-reported outcomes of physical function a valid substitute for objective measurements?

2018 ◽  
Vol 25 (5) ◽  
Author(s):  
J. A.J. Douma ◽  
H. M.W. Verheul ◽  
L. M. Buffart
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Stem Cell ◽  
Physical Function ◽  
Patient Reported Outcomes ◽  
Exercise Intervention ◽  
Objective Measures ◽  
Patients With Cancer ◽  
Patient Reported

BackgroundPhysical function is important for defining treatment strategies in patients with cancer and can be estimated using patient-reported outcomes (pros). Although pros are subjective, physical activity and fitness can be tested objectively with adequate, but more labour-intensive methods that are rarely used in daily clinical practice. To determine whether pros for physical function (pro-pf) accurately predict physical function, we studied their interrelationships with objective measures of physical activity and fitness in patients with cancer who had completed cancer treatment, including adjuvant or neoadjuvant chemotherapy or autologous stem-cell transplantation.MethodsBaseline data from the react (Resistance and Endurance Exercise After Chemotherapy) and exist(Exercise Intervention After Stem-Cell Transplantation) studies were evaluated. In those studies, the effects of an exercise intervention on physical fitness, fatigue, and health-related quality of life in patients with cancer shortly after completion of chemotherapy or stem-cell transplantation were studied. Interrelationships between pro-pf (physical function subscale of the European Organisation for Research and Treatment of Cancer 30-question core Quality of Life Questionnaire), physical activity (accelerometer), and cardiorespiratory fitness (peak oxygen uptake) were assessed using univariable and multivariable multilevel linear mixed-model analyses.ResultsAfter adjustment for age, sex, and body mass index, the pro-pf was significantly associated with physical activity (β = 1.75; 95% confidence interval: 1.08 to 2.42) and cardiorespiratory fitness (β = 0.10; 95% confidence interval: 0.06 to 0.13). Standardized coefficients were 0.28 and 0.26 respectively, indicating a weak association.ConclusionsThe pro-pf is only weakly associated with objective physical activity and fitness evaluation in patients after curative treatment for cancer. The pro-pf cannot, therefore, be used in clinical practice as a substitute for objective measures of physical function.

scholarly journals Physiotherapy and Physical Activity as Factors Improving the Psychological State of Patients With Cancer

2021 ◽  
Vol 12 ◽  
Author(s):  
Ewelina Zyzniewska-Banaszak ◽  
Jolanta Kucharska-Mazur ◽  
Aleksandra Mazur
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Substance Use ◽  
Emotional State ◽  
Well Being ◽  
Psychological State ◽  
Oncological Treatment ◽  
Patients With Cancer ◽  
Fatigue Syndrome

Physiotherapy in oncology is a process closely related to cancer treatment methods. Rehabilitation is based on physical activity in various forms involving the musculoskeletal system but also affects the emotional state. Physical activity influences physical and psychological well-being of people undergoing oncological treatment, in the course of which the most common psychiatric disorders are depression, substance use disorder, sleep disorders, fatigue syndrome, resulting in worsening of the quality of life. Difficulties in implementing physical exercise in cancer patients pose a challenge to treatment teams.

scholarly journals Impact of the Method of Delivering Electronic Health Behavior Change Interventions in Survivors of Cancer on Engagement, Health Behaviors, and Health Outcomes: Systematic Review and Meta-Analysis

10.2196/16112 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e16112
Author(s):  
Kate Furness ◽  
Mitchell N Sarkies ◽  
Catherine E Huggins ◽  
Daniel Croagh ◽  
Terry P Haines
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Behavior ◽  
Behavior Change ◽  
Health Outcomes ◽  
Meta Analysis ◽  
Health Behavior Change ◽  
Patients With Cancer ◽  
Behavior Change Interventions

Background Increased accessibility to the internet and mobile devices has seen a rapid expansion in electronic health (eHealth) behavior change interventions delivered to patients with cancer and survivors using synchronous, asynchronous, and combined delivery methods. Characterizing effective delivery methods of eHealth interventions is required to enable improved design and implementation of evidence-based health behavior change interventions. Objective This study aims to systematically review the literature and synthesize evidence on the success of eHealth behavior change interventions in patients with cancer and survivors delivered by synchronous, asynchronous, or combined methods compared with a control group. Engagement with the intervention, behavior change, and health outcomes, including quality of life, fatigue, depression, and anxiety, were examined. Methods A search of Scopus, Ovid MEDLINE, Excerpta Medica dataBASE, Cumulative Index to Nursing and Allied Health Literature Plus, PsycINFO, Cochrane CENTRAL, and PubMed was conducted for studies published between March 2007 and March 2019. We looked for randomized controlled trials (RCTs) examining interventions delivered to adult cancer survivors via eHealth methods with a measure of health behavior change. Random-effects meta-analysis was performed to examine whether the method of eHealth delivery impacted the level of engagement, behavior change, and health outcomes. Results A total of 24 RCTs were included predominantly examining dietary and physical activity behavior change interventions. There were 11 studies that used a synchronous approach and 11 studies that used an asynchronous approach, whereas 2 studies used a combined delivery method. Use of eHealth interventions improved exercise behavior (standardized mean difference [SMD] 0.34, 95% CI 0.21-0.48), diet behavior (SMD 0.44, 95% CI 0.18-0.70), fatigue (SMD 0.21, 95% CI −0.08 to 0.50; SMD change 0.22, 95% CI 0.09-0.35), anxiety (SMD 1.21, 95% CI: 0.36-2.07; SMD change 0.15, 95% CI −0.09 to 0.40), depression (SMD 0.15, 95% CI 0.00-0.30), and quality of life (SMD 0.12, 95% CI −0.10 to 0.34; SMD change 0.14, 95% CI 0.04-0.24). The mode of delivery did not influence the amount of dietary and physical activity behavior change observed. Conclusions Physical activity and dietary behavior change eHealth interventions delivered to patients with cancer or survivors have a small to moderate impact on behavior change and a small to very small benefit to quality of life, fatigue, depression, and anxiety. There is insufficient evidence to determine whether asynchronous or synchronous delivery modes yield superior results. Three-arm RCTs comparing delivery modes with a control with robust engagement reporting are required to determine the most successful delivery method for promoting behavior change and ultimately favorable health outcomes.

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