Physical problems, functional limitations, and preferences for physical therapist-guided exercise programs among Dutch patients with metastatic breast cancer: a mixed methods study

• Published in: Supportive care in cancer Vol. 27; no. 8; pp. 3061 - 3070
• Main Authors: ten Tusscher, M. R., Groen, W. G., Geleijn, E., Sonke, G. S., Konings, I. R., Van der Vorst, M. J., van Zweeden, A., Aaronson, N. K., Stuiver, Martijn M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2019; Springer; Springer Nature B.V
• Subjects: Breast cancer; Cancer; Cancer patients; Care and treatment; Content analysis; Exercise; Focus groups; Health behavior; Medicine; Medicine & Public Health; Metastasis; Methods; Mixed methods research; Nursing; Nursing Research; Oncology; Oncology, Experimental; Original Article; Pain Medicine; Physical fitness; Physical therapists; Physical therapy; Preferences; Qualitative research; Quantitative analysis; Rehabilitation Medicine; Surveys; Therapeutics, Physiological; Netherlands; Metastatic breast cancer; Exercise; Functional limitations; Physical therapy; Quality of life
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-018-4619-x

Purpose In this study we aimed (1) to identify the most prevalent physical symptoms and functional limitations that limit physical activity of patients with palliative treatment for metastatic breast cancer (MBC) and (2) to identify their preferences for exercise-based physical therapy programs, as a first step towards the development of physical therapist (PT)-guided exercise programs for patients with MBC. Methods We performed a mixed-method study that comprised a cross-sectional survey and two focus group sessions among patients with MBC. Survey results were analyzed using descriptive statistics. The focus groups were audio-taped, transcribed verbatim, and analyzed independently by two researchers, using directed content analysis. Results A total of 114 women (response rate 61%) completed the survey (mean age 63.5, SD 10.2). Eighty-six percent of the women reported at least some level of physical problems limiting their ability to be physically active, of whom 46% reported substantial problems. The most prevalent problems were fatigue, painful joints, painful muscles, and shortness of breath. Uptake of exercise appeared to be limited. Exercise preferences varied strongly. Fifty-three percent indicated a preference for some form of PT-supervision, and 34% for a prolonged period of time (> 8 weeks). Focus group results clarified that patients’ preferences for supervision, by PTs with special qualifications in oncology, were related to feelings of insecurity about their ability to self-manage physical functioning. Conclusions Patients with MBC experience a broad range of physical health problems that limit their ability to be physically active. While preferences vary strongly, patients with MBC would value the availability of high quality, PT-guided, tailored exercise programs.