Barriers and facilitators to physical activity in men with prostate cancer: a qualitative and quantitative systematic review

TY - JOUR

T1 - Barriers and facilitators to physical activity in men with prostate cancer: a qualitative and quantitative systematic review

AU - Fox, Louis

AU - Wiseman, Theresa

AU - Cahill, Declan

AU - Beyer, Katharina Laura

AU - Peat, Nicola

AU - Rammant, Elke

AU - Van Hemelrijck, Mieke

PY - 2019/10/16

Y1 - 2019/10/16

N2 - Objective: Existing research indicates that moderate-to-vigorous physical activity (PA) alleviates treatment side-effects, and is associated with survival, in men with prostate cancer. We aimed to ascertain the state of research investigating barriers and facilitators to PA in men with prostate cancer, and synthesise existing qualitative research on this topic. Methods: A systematic review of qualitative and quantitative studies was conducted. MEDLINE, Embase, PsycINFO, Web of Knowledge, CINAHL, PEDro, OATD and WorldCat were searched to June 2019, for quantitative studies investigating causes or predictors of PA; or qualitative studies describing patient-reported barriers/facilitators to PA, amongst men with prostate cancer of any stage. Thirty-two studies (n=17 quantitative; n=15 qualitative) were included from 3,698 screened articles. Results: Heterogeneity and unsystematic reporting of quantitative study methods prohibited a quantitative data synthesis. Thematic synthesis of qualitative studies produced five analytical themes: individual needs by treatment pathway; self-determination and its relationship with prostate cancer-related events; co-ordination and support of the clinical care team; individual preferences in discrete aspects of PA engagement style; and the potential for a bidirectional facilitative relationship between structured group PA and spontaneous peer support. Both qualitative and quantitative studies indicated incontinence as a barrier. Conclusions: Unsystematic reporting of interventions hinders a robust quantitative understanding of behavioural intervention research in this subject area. Good co-ordination of multidisciplinary care personnel could facilitate PA, by enabling a more comprehensive approach to targeting social cognitive processes. Well-timed intervention and access to highly individualised PA support, including optional group PA classes, seem to also be important facilitators.

AB - Objective: Existing research indicates that moderate-to-vigorous physical activity (PA) alleviates treatment side-effects, and is associated with survival, in men with prostate cancer. We aimed to ascertain the state of research investigating barriers and facilitators to PA in men with prostate cancer, and synthesise existing qualitative research on this topic. Methods: A systematic review of qualitative and quantitative studies was conducted. MEDLINE, Embase, PsycINFO, Web of Knowledge, CINAHL, PEDro, OATD and WorldCat were searched to June 2019, for quantitative studies investigating causes or predictors of PA; or qualitative studies describing patient-reported barriers/facilitators to PA, amongst men with prostate cancer of any stage. Thirty-two studies (n=17 quantitative; n=15 qualitative) were included from 3,698 screened articles. Results: Heterogeneity and unsystematic reporting of quantitative study methods prohibited a quantitative data synthesis. Thematic synthesis of qualitative studies produced five analytical themes: individual needs by treatment pathway; self-determination and its relationship with prostate cancer-related events; co-ordination and support of the clinical care team; individual preferences in discrete aspects of PA engagement style; and the potential for a bidirectional facilitative relationship between structured group PA and spontaneous peer support. Both qualitative and quantitative studies indicated incontinence as a barrier. Conclusions: Unsystematic reporting of interventions hinders a robust quantitative understanding of behavioural intervention research in this subject area. Good co-ordination of multidisciplinary care personnel could facilitate PA, by enabling a more comprehensive approach to targeting social cognitive processes. Well-timed intervention and access to highly individualised PA support, including optional group PA classes, seem to also be important facilitators.

KW - exercise

KW - physical activity

KW - prostate cancer

KW - rehabilitation

KW - self-management

KW - survivorship

UR - http://www.scopus.com/inward/record.url?scp=85074837419&partnerID=8YFLogxK

U2 - 10.1002/pon.5240

DO - 10.1002/pon.5240

M3 - Review article

SN - 1057-9249

VL - 28

SP - 2270

EP - 2285

JO - Psycho-Oncology

JF - Psycho-Oncology

IS - 12

ER -