Owens, B., Jackson, M., & Berndt, A. (2009). Pilot study of a structured aerobic exercise program for Hispanic women during treatment for early-stage breast cancer. Medsurg Nursing, 18, 23–29.

Study Purpose

To evaluate the feasibility of a structured aerobic exercise intervention during treatment in a predominately Hispanic population of women.

Intervention Characteristics/Basic Study Process

A convenience sample of women who met the criteria at the time of their outpatient appointments were included. Patients were weighed and measured and completed tests regarding side effect burden and fatigue. Patients were given a sports outlet gift card for walking shoes and a six-month membership to the community health club. They were instructed to make an appointment with a physical therapist and a community health club for exercise. The research intervention was exercise three times a week for one hour with a goal to continue for six months. Exercises involved 10 minutes of warm-ups, 30 minutes of resistance training to improve muscle tone, 20 minutes of brisk walking to improve heart strength, and 10 minutes of cool-down. Assessments occurred at three and six months.

Sample Characteristics

  • Thirteen participants (all female) were included, although five did not go to a health club; only eight were available for a one-on-one interview.
  • Age ranged from 40 to 63 years.
  • Patients had first-time diagnoses of stage II breast cancer.
  • Patients had undergone surgery and were either receiving chemotherapy or had completed chemotherapy in the past six months.
  • Eight participants were on leave from work following surgery and during chemotherapy/radiation treatment.
  • Of the participants, 73% experienced chemotherapy-induced menopause.
  • All patients were Hispanic.

Setting

  • Single site
  • Cancer Center Therapy & Research Center, San Antonio, Texas

Study Design

The study used a mixed qualitative and quantitative, repeated measure, quasiexperimental design.

Measurement Instruments/Methods

  • Side Effect Burden Scale
  • Revised Piper Fatigue Scale (PFS)
  • Five-minute walk test
  • Strength and range of motion testing
  • Penn Shoulder Score
  • Hip and waist measurements
  • Percent body fat and body mass index
  • Pearson correlation coefficients (used in analysis)

Results

Fatigue was significantly correlated with age (p = 0.05), fasting blood glucose (p = 0.05), and weight gain (p = 0.01). Mean weight gain was 15 lb. No changes were seen in fatigue. Qualitative analysis identified physical limitations, family responsibilities, lack of transportation, return to work, and lack of habit development as factors that influenced adherence to the exercise program. Sources of support for adherence included family, peers, employer, and health care providers. Several patients indicated that they preferred to exercise in an area that had only women. Self-report of exercise adherence was 66% at the first follow-up and 7% at the study conclusion.

Conclusions

Social, physical, and psychosocial factors influenced the women’s exercise adoptions. The provision of a gift card and recommendations did not have an effect on fatigue in these individuals.

Limitations

  • The study had a small sample size, with less than 30 participants.
  • Observational data relied on recall.
  • This was a Hispanic population, so specific qualitative findings may not be applicable to other cultural groups.

Nursing Implications

A structured exercise program appears to facilitate recovery from cancer. These Hispanic women had difficulty setting aside time to exercise. Support from health care providers was identified as a facilitator of adherence to exercise, suggesting that encouragement to exercise may be helpful. Concrete barriers, such as lack of transportation and dealing with family responsibilities, need to be addressed if patients are to be able to participate in exercise programs. Interventions need to fit lifestyle needs and preferences of the individual.