QOL Perceptions Important When Designing Exercise Interventions for Patients With Cancer

Although more than one definition can be found, quality of life (QOL) is often defined as a state of well-being in which an individual can perform daily activities, combined with satisfaction with the levels of functioning and control of the disease and/or its symptoms (Hacker, 2009). Key to this definition is patients’ perception of their own QOL versus healthcare providers’ impression of it. When making assessments from a satisfaction perspective, patients’ cognitive appraisal of their condition applies; for example, patients may recognize that their health isn’t ideal but still feel satisfaction with life. By this token, changes in functional status may not necessarily correspond to a change in life satisfaction for some patients. Therefore, when assessing a patient for a potential exercise intervention, it is important to recognize that both health status and life satisfaction must be considered. Because many studies identify QOL as a primary end point, it is important to ensure that assessment is accurate and reflects appropriate goals.

Equally complex is the relationship between a patient’s actual symptoms and their perceptions of them, and in turn their effect on life satisfaction. Patients may be told to expect a period of fatigue following surgery and radiation, for example, but may not be prepared for the degree to which the symptoms occur. If told that an exercise program may improve these symptoms, and symptoms do improve, life satisfaction may improve. Conversely, if symptoms do not improve as expected, life satisfaction declines. Adding to this complexity, research supports that perceptions of enhanced QOL lag behind the actual changes realized in health status (Hacker & Ferrans, 2003).

For more information, listen to a podcast of “Exercise and Quality of Life: Strengthening the Connections.” The Godin Leisure-Time Exercise Questionnaire and the Euro-Qol EQ-5D Questionnaire may be useful in the development and evaluation of exercise prescriptions.


Hacker, E. (2009). Exercise and quality of life: Strengthening the connections. Clinical Journal of Oncology Nursing, 13, 31–39. doi: 10.1188/09.CJON.31-39

Hacker, E.D., & Ferrans, C.E. (2003). Quality of life immediately after peripheral blood stem cell transplantation. Cancer Nursing, 26, 312–322. doi: 10.1097/00002820-200308000-00010