Group versus individual exercise interventions for women with breast cancer: a meta-analysis

Abstract

Background. Both during and after treatment, cancer survivors experience declines in physical and psychosocial quality of life (QoL). Prior research indicates that exercise interventions alleviate problems in physical functioning and some aspects of psychological functioning. For survivors seeking social support, exercise programmes that are conducted in group settings may foster optimal QoL improvement (by addressing additional issues related to isolation and social support) over individually based exercise programmes. Methods. We reviewed literature on group cohesion in exercise studies, and conducted a meta-analysis to test the hypothesis that group as compared to individual exercise interventions for breast cancer survivors would show greater improvement in QoL. Results. As currently implemented, group exercise interventions showed no advantage. However, they typically did not provide any evidence that they capitalised upon potentially beneficial group processes. Conclusions. Future exercise intervention studies could investigate the effect on QoL of deliberately using group dynamics processes, such as team-building experiences and group goal setting to foster group cohesion.     

Expression and reception of treatment information in breast cancer support groups: How health self-efficacy moderates effects on emotional well-being

ObjectivesTo examine the effects of exchanging treatment information within computer-mediated breast cancer support groups on emotional well-being, and to explore whether this relationship is moderated by health self-efficacy.MethodsSample: 177 breast cancer patients using an electronic Health (eHealth) program with discussion group. Measure: expression and reception of treatment information; emotional well-being scale (0, 4 months). Analyses: hierarchical regression.ResultsEffects of expression and reception of treatment information on emotional well-being were significantly greater for those who have higher health self-efficacy.ConclusionsResults conditionally support prior research finding positive effects of treatment information exchanges among breast cancer patients. Such exchanges had a positive impact on emotional well-being for those with higher health self-efficacy, but they had a negative influence for those with lower health self-efficacy.Practice implicationsGiven that the association between emotional well-being and exchanging treatment information was moderated by health self-efficacy, clinicians should explain the role of health self-efficacy before encouraging patients to use eHealth systems for treatment exchanges.     

One-on-one peer support and quality of life for breast cancer patients

The Canadian Cancer Society's Reach to Recovery program provides one-on-one support for breast cancer patients that is delivered by breast cancer survivors. Professionally-led social support programs have generally been found to influence positively the quality of life of cancer patients. However, there is a lack of evidence on the benefits of one-on-one peer support programs. An evaluation of the Reach to Recovery program was completed in 1995 to determine if cancer patients who received the program were satisfied with the program and to determine if participation in Reach to Recovery affected the quality of life of program participants compared to patients who did not receive the program. We found that Reach to Recovery program participants were generally satisfied with the program they received and that the program has incremental benefits to the quality of life of patients with breast cancer. Peer-led, volunteer breast cancer support programs can be effective in enhancing the quality of life of breast cancer patients.     

心理干预对乳腺癌患者应对方式及社会支持的影响

目的探讨综合性心理干预对化疗期间乳腺癌患者应对方式及社会支持的影响方法将83例化疗期乳腺癌患者随机分为实验组和对照组,实验组除接受常规化疗及护理外,还进行为期8周的综合性心理干预,对照组仅接受常规化疗及护理,以乳腺癌患者防御方式（DSQ）,社会支持（SSRS）为指标,评价心理干预对乳腺癌患者防御方式及社会支持的影响。结果心理干预后,对两组进行比较显示,实验组比对照组更多地采取积极防御方式,较少地采取消极的防御方式（P〈0.05）。心理干预后,实验组在社会支持总分、主观支持得分、支持利用度等方面较心理干预前均有明显提高（P〈0.05）,而对照组前后无明显变化（P〉0.05）。结论综合性的心理干预能够使乳腺癌患者的积极应对方式增加,对社会支持的利用度增加,从而降低负性情绪的影响,提高其生存质量。     

The effects of an integrated health education and exercise program in community-dwelling older adults with hypertension: A randomized controlled trial

Objective

The aim of this study was to examine the effectiveness of HAHA (Healthy Aging and Happy Aging) program, which is an integrated health education and exercise program for community-dwelling older adults with hypertension. Methods: Older adults with hypertension from one senior center were randomly allocated to experimental (n = 18) or control group (n = 22). Experimental group received health education, individual counseling and tailored exercise program for 12 weeks. Results: The mean ages were 71 years (experimental group) and 69 (control group). After the intervention, systolic blood pressure of experimental group was significantly decreased than that of control group. Scores of exercise self-efficacy, general health, vitality, social functioning, and mental health in SF-36 were statistically higher than those of control group. Conclusion: The HAHA program was effective in control of systolic blood pressure and improving self-efficacy for exercise and health-related quality of life.     

Effects of an Aerobic and Resistance Exercise Intervention on Health‐Related Quality of Life in Women with Obesity

The efficacy of a combined aerobic and resistance exercise intervention was examined in improving health‐related quality of life in women with obesity. An experimental design was used with a 1‐year follow‐up. After randomization into a control and an exercise group, women with obesity (n = 72) participated in a structured exercise program for 12 weeks. Health‐related quality of life variables were measured using the Short Form‐36v2 Health Survey instrument. Exercise effects were revealed for physical functioning, vitality, bodily pain, mental health, and role emotional, but not social functioning, general health, role physical, and reported health transition. Exercise intervention effects lasted between nine and 12 months. A 12‐week aerobic and resistance exercise program may improve health‐related quality of life in women with obesity.     

Psychological Factors and Characteristics of Recurrent Breast Cancer Patients with or without Psychosocial Group Therapy Intervention

To clarify psychological factors of patients with recurrent breast cancer, we examined their interest in group intervention and studied the characteristics of participants and non-participants in an intervention program. Using several self-administered assessment scales to evaluate the quality of life (QOL) of cancer patients and the symptoms specific to breast cancer patients, we compared sociomedical variables and QOL scores between participants and non-participants. Inter-group differences were significant in the scores for constipation, body image and future perspectives, suggesting the QOL to be higher among participants than non-participants. Interest in group intervention was identified as a major reason for participation in this type of program. Not only physical but also psychologicalfactors were shown to be the reasons for deciding not to participate in group intervention. It is now desirable that efforts be made to stimulate greater understanding of group intervention as a means of psychosocial support for patients with recurrent breast cancer and that social environments be arranged so that these patients are supported by an approach tailored to individual cases, involving both group and individual intervention.     

Evaluation of an Intervention to Increase Self-Efficacy for Independent Exercise in Cardiac Rehabilitation

Adherence to independent exercise is an essential outcome of cardiac rehabilitation (CR), yet limited theory-based interventions to improve adherence exist. This study tested the effects of an intervention based on Bandura's conceptualization of self-efficacy. The self-efficacy coaching intervention (SCI), a supplement to standard care, was designed to increase self-efficacy for independent exercise and independent exercise behavior in CR. We examined whether the SCI vs. attention control (AC) resulted in improved exercise self-efficacy (ESE), barriers self-efficacy (BARSE), and minutes of independent exercise for CR participants (n = 65). While between-group differences did not reach significance (p > .10) for any of the outcome measures, significant within-group changes were noted in BARSE scores and independent exercise (p < .001) for the SCI group. Change in independent exercise for the AC group was also significant (p =. 006). Further study is needed to explore whether short-term changes translate into maintenance of independent exercise participation after program completion.     

Benefits of a Psychosocial Intervention on Positive Affect and Posttraumatic Growth for Chinese American Breast Cancer Survivors: A Pilot Study

Abstract

Breast cancer survivors report persistent psychological and physical symptoms, which affect their quality of life and may challenge the recovery process. Due to social, cultural, and linguistic barriers, culturally sensitive care is largely unavailable for Chinese Americans, and their psychological needs are not often addressed. We aimed to investigate whether the Joy Luck Academy (JLA), a psychosocial intervention providing both information and peer support, was associated with positive adjustment among Chinese American breast cancer survivors. Thirty-nine Chinese American breast cancer survivors participated in a pilot psychosocial intervention. The educational materials and lectures were delivered in the participants’ native language of Chinese. All of the educators and mentors shared the same linguistic and cultural background with the participants. The program utilized a community-based participatory research (CBPR) approach to further enhance the cultural sensitivity of the intervention. Participants’ post-traumatic growth and positive affect were assessed before and after the intervention. The JLA showed an improvement in positive affect, and they had a greater appreciation for life. The intervention was found to be feasible, well-accepted, and beneficial for this population. Chinese American breast cancer survivors reported improved psychological health after attending the intervention. These findings encourage the development and implementation of psychosocial interventions for Chinese breast cancer survivors. Similar programs could be integrated into other ethnic or cultural communities.     

护理干预对乳腺癌患者社会支持的影响

目的 探讨护理干预对乳腺癌术后放疗患者社会支持的影响情况.方法 将88例放疗期乳腺癌术后患者随机分为实验组和对照组,实验组除了病房护士进行常规的护理外,还接受研究者对患者及主要支持者提供的集体化和个体化护理干预.通过使用肖水源编制的社会支持评定量表对88例乳腺癌术后放疗患者进行调查分析,经过资料整理计算积分并使用t检验进行比较.结果 护理干预后,实验组在社会支持总分、主观支持、支持利用度较护理干预前均有明显提高（t=17.025,t=7.036,t =8.145;P ＜0.05）,而对照组前后无明显变化（t=1.453,t=1.684,t=1.773;P ＞0.05）.结论 护理干预可以有效地改善乳腺癌患者的社会支持状况.护理人员应采取有效措施帮助患者优化社会支持网络,做好健康教育,以提高乳腺癌患者的生活质量.     

An 8-week exercise study to improve cancer treatment related fatigue and QOL among African American breast cancer patients undergoing radiation treatment: A pilot randomized clinical trial

BackgroundCancer treatment related fatigue (CTRF) is one of the most debilitating side effects of adjuvant radiation therapy (RT). Several studies have found that physical activity (PA) may be an effective intervention to decrease fatigue and enhance QOL in cancer survivors. The primary objective of the PEDLAR study is to test the feasibility of an easily administered 8-week structured moderate-intensity PA intervention, delivered concurrently with RT, in reducing CTRF and improving health-related QOL among African-American breast cancer patients. This study is also designed to provide pilot data on the acceptability and adherence of PA interventions in African-American women with breast cancer.MethodsIt is a prospective, 2-arm, 8-week feasibility trial. Participants are randomized to either a structured, moderate-intensity aerobic training exercise regimen concurrent with radiotherapy or a control group.ResultsParticipants in intervention group reported high satisfaction with exercise and adherence was >75% for exercise sessions.ConclusionsAfrican-American breast cancer patients in a moderate-intensity 75 min/wk aerobic exercise intervention had marginally lower fatigue at 8-wk follow-up compared to baseline. The control group participants had marginally higher fatigue at 8-wk follow-up compared to baseline. Participants in the intervention group reported slightly better quality of life at 8-wk follow-up compared to baseline (P = 0.06).     

The effect of salutogenic treatment principles on coping with mental health problems A randomised controlled trial

ObjectiveThe importance of psychosocial counselling after a diagnosis of cancer has been acknowledged and many intervention studies have been carried out, with the aim to find out which types of intervention are most effective in enhancing quality of life in cancer patients. A factor which could be part of effective counselling could be the time of offering psychosocial counselling. The aim of this study was to research the effect of time of enrolment in a psychosocial group intervention on psychosocial adjustment.MethodsIn the present study, 67 women with early stage breast cancer were randomised in a psychosocial group intervention program starting within 4 months after surgery or in the same intervention program starting at least 3 months later.ResultsThe main conclusion of this study is that women who started with their intervention early were less distressed at 6 months follow-up than women who were in the delayed condition. Medical and demographic variables were predictive for some psychosocial adjustment indicators, but were not associated with time of enrolment. Regardless of time of enrolment, women improved in distress, body image and recreational activities, but showed a decrease in social interaction.ConclusionThough results are limited, based on these results we suggest that psychosocial counselling should be offered as soon after diagnosis or surgery for breast cancer.Practice implicationsWomen diagnosed with primary breast cancer should be able to start with psychological counselling soon after being diagnosed, to prevent them from becoming distressed at long term.     

Social Cognitive Correlates of Leisure Time Physical Activity Among Latinos

Despite the well-documented benefits of leisure time physical activity, Latinos are reported to be highest among all ethnic groups in leisure time inactivity. The present study examined the relationship between leisure time physical activity and exercise self-efficacy, exercise barriers self-efficacy, exercise social support, and perceived importance of physical activity. Data were obtained from 153 Latinos (n = 86 female, n = 67 male). Comparisons were made between Latinos with high and low levels of leisure time physical activity and between men and women. Results revealed that Latinos high in leisure time physical activity had significantly greater exercise and barriers self-efficacy, received more social support from friends to exercise, and placed greater importance on physical activity outcomes than did Latinos low in leisure time physical activity. No significant differences were revealed for social support from family, nor between men and women on the psychosocial variables. Physical activity interventions targeting sources of self-efficacy, increasing social support, and emphasizing the importance of regular physical activity should be helpful in increasing leisure time physical activity of Latinos. Future research should examine the influence of environmental and cultural variables on the leisure time physical activity of Latinos and how they interact with psychosocial factors.     

Effects of couple based coping intervention on self-efficacy and quality of life in patients with resected lung cancer

ObjectiveWe aimed to assess the couple based coping intervention (CBCI) for self-efficacy and quality of life in patients with resected lung cancer, compared with individual coping intervention (ICI).MethodsFrom October to December 2015, 132 consecutive patients with resected lung cancer who were married/lived in a stable relationship were randomly assigned to the ICI group and the CBCI group.ResultsThe CBCI group had higher GSES compared with the ICI group at 2 month after operation, and at 6 month after operation (P < 0.05). The CBCI group had higher VT, SF, RE, and MH score of SF-36 compared with the ICI group at 2 month after operation, and at 6 month after operation (P < 0.05), but no significant differences were found in RP, PF, BP, and GH score of SF-36 compared between two groups (P > 0.05) in these 2 time points.ConclusionCouple based coping intervention is more effective than individual coping intervention for improving the self-efficacy and the quality of life in patients with resected lung cancer.Practice implicationsPractitioners might like to consider using couple based coping intervention strategy to improve self-efficacy and quality of life in patients with resected lung cancer.     

Enhancement of daily physical activity increases physical fitness of outclinic COPD patients: Results of an exercise counseling program

Objective

To investigate whether a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity in outclinic Chronic Obstructive Pulmonary Disease (COPD) patients who do not participate in a rehabilitation program in a controlled way.

Methods

35 outclinic COPD patients (21 males, mean age 62 years, GOLD I–III, mean FEV₁% predicted 64.7) were randomized for a 12-week individual pedometer-based exercise counseling program promoting daily physical activities or usual care. Daily physical activity (DigiWalker SW-200), physical fitness, health-related quality of life, self-efficacy, fatigue, depression and motivation to be physically active were assessed before and after the intervention.

Results

After the intervention, COPD patients in the exercise counseling group showed a significant increase in their mean number of steps/day (from 7087 to 7872), whereas the usual care group showed a decrease (from 7539 to 6172). Significant differences favoring the exercise counseling group were demonstrated in arm strength, leg strength, health-related quality of life and intrinsic motivation to be physically active.

Conclusion

Our study shows that a 12-week pedometer-based exercise counseling strategy is feasible and effectively enhances daily physical activity, physical fitness, health-related quality of life and intrinsic motivation in outclinic COPD patients who do not participate in a rehabilitation program.

Practice implications

The feasibility of our exercise counseling strategy is good and patients were motivated to participate.     

Effect of peer support on adults with diabetes-related peripheral neuropathy

ObjectiveTo explore the effect of peer support on exercise self-efficacy, physical activity level, and neuropathic symptoms in patients with diabetes-related peripheral neuropathy (DPN).MethodsA total of 60 adults with DPN were assigned to groups. Patients in the control group received routine education (RE), while patients in the intervention group received peer support (PS) combined with routine diabetes education. Data were collected at baseline and after intervention (12 weeks).ResultsAt 12 weeks, better outcomes were found in the PS group compared to the RE group for the following aspects: exercise self-efficacy, steps, total physical activity, fasting blood glucose and 2-hour postprandial blood glucose. Decreases in scores on Toronto Clinical Scoring System occurred between baseline and post-intervention in both groups.ConclusionPeer support is an effective way to improve exercise self-efficacy, number of steps, and general physical activity and to reduce blood glucose for patients with DPN. But the effects of peer support on neuropathic symptoms is are obvious. Further research is needed.Practice implicationsAs a low-cost, effective education approach, peer support strategies should be integrated into our healthcare system to meet the minimum needs of patients with DPN.     

模型讲解与视频宣教对四肢骨折患者自我效能及 康复锻炼依从性的影响

目的 探讨模型讲解与视频宣教对四肢骨折自我效能及康复锻炼依从性的影响。方法 选取2017年1月~12月我院收治的四肢骨折患者110例,根据随机数字表法分为观察组和对照组,每组55例。对照组给予常规性护理指导,观察组给予模型讲解与视频宣教护理指导,比较两组干预情况及干预前后自我效能、Barthel指数及生活质量评分。结果 观察组疾病知识知晓率、康复锻炼依从率、预后良好率、患者满意率均高于对照组,并发症发生率低于对照组,差异有统计学意义（P＜0.05）。干预前两组干自我效能、Barthel指数及生活质量评分比较,差异无统计学意义（P＞0.05）;干预后,观察组自我效能评分、Barthel指数、生活质量评分均高于对照组,差异有统计学意义（P＜0.05）。结论 模型讲解与视频宣教能有效提高四肢骨折患者自我效能及锻炼依从性,促进患者预后,提高患者生活质量。     

The effectiveness of the information-motivation-behavioral skills model-based intervention on preventive behaviors against respiratory infection among community-dwelling older adults

ObjectiveTo evaluate the effectiveness of an information–motivation–behavioral skills (IMB) model-based multi-component intervention on engagement and the quality of preventive behaviors against respiratory infections among community-dwelling older adults.MethodsThis study was a controlled pretest–posttest study in which 91 community-dwelling older adults aged above 65 years were included. The intervention group (n = 42) received the six-week intervention theoretically based on the IMB model that comprised weekly group education and 5–10 min of tele-counseling per week.ResultsThe results showed that, after the intervention, the improvement in the level of knowledge, self-efficacy, self-reported engagement, and the quality of respiratory infection preventive behaviors was significantly greater in the intervention group compared to the control group. There was no significant difference between the two groups for the perceived threat of respiratory infection.ConclusionThe IMB model-based intervention improved the engagement and quality of preventive behaviors by increasing the level of knowledge and self-efficacy in community-dwelling older adults.Practice implicationsThe IMB model-based multi-component intervention can be an effective approach to improve preventive behaviors and will contribute to the preparation of communities for outbreaks of respiratory infections.     

Effectiveness of motivational interviewing among patients with COPD: A systematic review with meta-analysis and trial sequential analysis of randomized controlled trials

ObjectiveTo evaluate the effectiveness of motivational interviewing (MI) for COPD in behavioral changes and health outcomes, and also verify the reliability of results in conjunction with trial sequential analysis and the Grading of Recommendations Assessment, Development, and Evaluation tool.MethodsStudies that implemented MI interventions for COPD patients were systematically searched by eight databases from inception to December 2021. Study screening, quality assessment, data extraction, and meta-analysis were conducted according to Cochrane standards.ResultsTwenty-one studies involving 2344 patients were included. The results of meta-analyses indicated that MI made significant improvement in self-efficacy, lung function, quality of life, emotion, and COPD-related admission, but not in self-management and exercise capacity. Subgroup analyses found that the intervention duration was inversely associated with effect size for both self-efficacy and negative emotion severity. The trial sequential analysis showed MI improved patients' lung function and reduced COPD-related hospitalization with certainty, but the findings for exercise capacity need to be confirmed by further research.ConclusionsThis systematic review suggested the positive effects of MI on self-efficacy, lung function, quality of life, emotion and COPD-related hospitalization. To make a firm conclusion, more well-designed clinical trials with bigger sample sizes required.Practice implicationsClinical and community nurses can use MI for COPD to increase healthy behaviors.Trial registrationCRD42021278674.