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      PERSPECTIVEs on supervised exercise programs in people with metastatic breast cancer- a qualitative study in four European countries

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          Abstract

          Purpose

          Supervised exercise is a potentially promising supportive care intervention for people with metastatic breast cancer (MBC), but research on the patients’ perspective is limited. The aim of the current focus group study was to gain an in-depth understanding of MBC patients’ perceived barriers, facilitators, and preferences for supervised exercise programs.

          Methods

          Eleven online focus groups with, in total, 44 MBC patients were conducted in four European countries (Germany, Poland, Spain, Sweden). Main topics of the semi-structured discussions covered attitudes towards participation in supervised exercise programs, perceived facilitators, experienced barriers, and exercise preferences. Interviews were transcribed verbatim, translated into English, and coded based on a preliminary coding framework, supplemented by themes emerging during the sessions. The codes were subsequently examined for interrelations and re-organized into overarching clusters.

          Results

          Participants had positive attitudes towards exercise, but experienced physical limitations and insecurities that inhibited their participation. They expressed a strong desire for exercise tailored to their needs, and supervision by an exercise professional. Participants also highlighted the social nature of group training as an important facilitator. They had no clear preference for exercise type, but rather favored a mixture of different activities. Flexible training modules were considered helpful to increase exercise program adherence.

          Conclusions

          MBC patients were generally interested in supervised exercise programs. They preferred group exercise that facilitates social interaction, but also expressed a need for individualized exercise programs. This suggests the relevance to develop flexible exercise programs that are adjusted to the individual’s needs, abilities, and preferences.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00520-023-07739-x.

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          Most cited references42

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Organizational Behavior and Human Decision Processes, 50(2), 179-211
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              The qualitative content analysis process.

              This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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                Author and article information

                Contributors
                m.stuiver@nki.nl
                Journal
                Support Care Cancer
                Support Care Cancer
                Supportive Care in Cancer
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0941-4355
                1433-7339
                19 April 2023
                19 April 2023
                2023
                : 31
                : 5
                : 281
                Affiliations
                [1 ]GRID grid.7497.d, ISNI 0000 0004 0492 0584, Division of Physical Activity, Prevention and Cancer, , German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, ; Heidelberg, Germany
                [2 ]GRID grid.430814.a, ISNI 0000 0001 0674 1393, Center for Quality of Life, , Netherlands Cancer Institute, ; Amsterdam, The Netherlands
                [3 ]GRID grid.430814.a, ISNI 0000 0001 0674 1393, Division of Psychosocial Research and Epidemiology, , Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, ; Amsterdam, the Netherlands
                [4 ]GRID grid.24381.3c, ISNI 0000 0000 9241 5705, Division of Nursing, Department of Neurobiology, Care Sciences, and Society, , Karolinska Institute and Karolinska Comprehensive Cancer Center, Karolinska University Hospital, ; Stockholm, Sweden
                [5 ]GRID grid.497559.3, ISNI 0000 0000 9472 5109, Oncology Departments, , Complejo Hospitalario de Navarra, ; Pamplona, Spain
                [6 ]GRID grid.410607.4, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), , University Medical Center of the Johannes Gutenberg University Mainz, ; Mainz, Germany
                [7 ]GRID grid.11451.30, ISNI 0000 0001 0531 3426, Department of Oncology and Radiotherapy, , Medical University of Gdańsk, ; Gdańsk, Poland
                [8 ]GRID grid.5477.1, ISNI 0000000120346234, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, , Utrecht University, ; Utrecht, The Netherlands
                Author information
                http://orcid.org/0000-0002-3034-9313
                http://orcid.org/0000-0003-2574-4850
                http://orcid.org/0000-0001-8317-7829
                http://orcid.org/0000-0002-4415-2570
                http://orcid.org/0000-0003-4476-0020
                http://orcid.org/0000-0002-0887-6504
                http://orcid.org/0000-0003-0643-3790
                http://orcid.org/0000-0001-5215-5651
                Article
                7739
                10.1007/s00520-023-07739-x
                10115708
                37074497
                8119fd54-4a30-4613-8713-7989bd2c55ef
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 1 December 2022
                : 6 April 2023
                Funding
                Funded by: European Union’s Horizon 2020 research and innovation program
                Award ID: 825677
                Award ID: 825677
                Award ID: 825677
                Award ID: 825677
                Award ID: 825677
                Award Recipient :
                Categories
                Research
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2023

                Oncology & Radiotherapy
                metastatic breast cancer,exercise,barriers,preferences,focus groups,qualitative research

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