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      Perceções e Comportamentos dos Médicos Oncologistas relativos à Promoção de Atividade Física Translated title: Oncologist’s Behaviours and Perceptions of Physical Activity Promotion

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          Abstract

          Objetivo

          Descrever e explorar determinantes da promoção de Atividade Física (AF) por parte dos oncologistas, analisar a perceção de capacidade, oportunidade e motivação dos médicos quanto à promoção de AF, e analisar as preocupações relacionadas com a prática de exercício físico dos doentes oncológicos.

          Método

          Um total de 76 oncologistas preencheram um questionário constituído por demografia, questões sobre a promoção da AF ligadas às perceções de capacidade, oportunidade, motivação, comportamento, e necessidades. Foram realizadas análises de correlação de Pearson e Spearman, regressão linear múltipla, teste-t paramétrico e não paramétrico.

          Resultados

          Foram detetadas perceções de capacidade e oportunidade baixas e uma motivação elevada. A grande maioria promove atividade física, mas não promove exercício físico estruturado, contudo, reconhecem a sua importância. A capacidade é a variável mais preponderante no comportamento, mas as restantes variáveis estão associadas ao mesmo. É reportada uma necessidade de melhoria de condições para a promoção de AF.

          Conclusão

          Os resultados devem ser analisados com cautela devido à amostra reduzida, no entanto, sugerem que os médicos valorizam a prática de AF dos seus doentes mas não se sentem capazes para promovê-la, o que legitima a presença de fisiologistas do exercício nos serviços de saúde. A presença do fisiologista do exercício pode ser um fator desencadeador da promoção de AF e exercício físico.

          Translated abstract

          Aim

          Describe and explore the determinants of PA (physical activity) promotion by oncologists, analyse the perception of the capacity, opportunity and motivation of oncologists in the promotion of PA, analyse the concerns related to the practice of PA in cancer patients.

          Method

          A total of 76 oncologists completed a questionnaire to assess demographics, perception of capacity, opportunity, motivation, behaviour, felt needs, and other characterisation questions. Statistical analyses were conducted using Pearson and Spearman correlations, Linear Multiple Regression, Parametric and non-parametric T-test.

          Results

          Results found indicate low levels of capacity and opportunity to promote PA despite the high level of motivation to do so. Most oncologists promote PA but do not promote structured exercise. However, they recognise its importance. Capacity is the most relevant variable, but all variables have meaningful contributions to explain the behaviour. It is stated the need for better conditions for PA promotion.

          Conclusion

          Results should be analysed carefully due to the small sample size. Oncologists value the practice of PA by patients but they don’t feel capable to discuss and prescribe it to their patients, which legitimises the exercise physiologists presence in healthcare services. Therefore, the presence of exercise physiologists can be a facilitator of exercise and PA promotion.

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          Most cited references41

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            The behaviour change wheel: A new method for characterising and designing behaviour change interventions

            Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.
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              Validation of the theoretical domains framework for use in behaviour change and implementation research

              Background An integrative theoretical framework, developed for cross-disciplinary implementation and other behaviour change research, has been applied across a wide range of clinical situations. This study tests the validity of this framework. Methods Validity was investigated by behavioural experts sorting 112 unique theoretical constructs using closed and open sort tasks. The extent of replication was tested by Discriminant Content Validation and Fuzzy Cluster Analysis. Results There was good support for a refinement of the framework comprising 14 domains of theoretical constructs (average silhouette value 0.29): ‘Knowledge’, ‘Skills’, ‘Social/Professional Role and Identity’, ‘Beliefs about Capabilities’, ‘Optimism’, ‘Beliefs about Consequences’, ‘Reinforcement’, ‘Intentions’, ‘Goals’, ‘Memory, Attention and Decision Processes’, ‘Environmental Context and Resources’, ‘Social Influences’, ‘Emotions’, and ‘Behavioural Regulation’. Conclusions The refined Theoretical Domains Framework has a strengthened empirical base and provides a method for theoretically assessing implementation problems, as well as professional and other health-related behaviours as a basis for intervention development.
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                Author and article information

                Journal
                PCH
                Psychol Community Health
                Psychology, Community & Health
                Psychol. Community Health
                PsychOpen
                2182-438X
                09 April 2020
                2020
                : 8
                : 1
                : 188-203
                Affiliations
                [a ]Faculdade de Educação Física e Desporto, Universidade Lusófona de Humanidades e Tecnologias , Lisboa, Portugal
                [b ]Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana , Lisboa, Portugal
                [c ]Faculdade de Medicina, Universidade de Coimbra , Coimbra, Portugal
                [d ]ISPA - Instituto Universitário de Ciências Psicológicas, Sociais e da Vida, Lisboa, Portugal
                [5]Universidade de Aveiro, Departamento de Educação e Psicologia, Aveiro, Portugal
                [6]CINTESIS - Center for Health Technology and Services Research, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
                Author notes
                [* ]Estrada da Costa, 1495-687 Cruz Quebrada. brodrigues@ 123456fmh.ulisboa.pt
                Article
                pch.v8i1.315
                10.5964/pch.v8i1.315
                f61ee416-9b01-4070-94f9-950b0c55f65b
                Copyright @ 2020

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 February 2019
                : 11 June 2019
                Categories
                Empirical Articles

                Psychology
                cancer,physical activity,COM-B,oncologistas,fisiologistas do exercício,promoção de atividade física,exercise physiologist,cancro,oncologists

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