Nadine Ungar1, Angeliki Tsiouris2, Alexander Haussmann3, Florian Herbolsheimer3,4, Joachim Wiskemann2, Karen Steindorf3, Monika Sieverding1. 1. Institute of Psychology, Heidelberg University, Heidelberg. 2. Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Hospital Heidelberg, Heidelberg. 3. Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg. 4. Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm.
Abstract
OBJECTIVE: While in the past cancer patients were advised to rest, recent research revealed various beneficial effects of physical activity, including increased treatment tolerability during cancer treatment and prolonged survival, which has led to a paradigm shift in relevant guidelines. This study examined if this paradigm shift from rest to activity has been consolidated in health care professionals' (HCP') attitude. It was investigated if the two dimensions of attitude (rest and activity) are endorsed empirically within the theory of planned behavior (TPB). Differences between physicians and nurses were examined. METHODS: Five hundred forty seven physicians and 398 nurses treating breast, prostate, or colorectal cancer patients completed a cross-sectional questionnaire. To assess attitude toward physical activity during cancer treatment, we developed a 15-item scale, which included original statements of HCP. TPB variables were assessed. RESULTS: A factor analysis revealed the proposed distinction of attitude into two dimensions. The activity-paradigm was stronger represented in HCP' attitude compared with rest-paradigm (Mactivity-paradigm = 4.1 versus Mrest-paradigm = 2.7, p < 0.001). Additionally, the activity-paradigm had higher exploratory power in explaining intention to recommend physical activity in cancer patients. However, the rest-paradigm was able to explain intention to recommend physical activity over and above activity-paradigm (ΔR2 = 0.05). Nurses had higher scores on the rest-paradigm than physicians. CONCLUSIONS: The activity-paradigm has already been consolidated in HCP' minds. However, the rest-paradigm is still present in the daily routine of oncology physicians and nurses. Addressing concerns and insecurities related to supporting cancer patients in maintaining or building up a physically active lifestyle is a very important educational task.
OBJECTIVE: While in the past cancerpatients were advised to rest, recent research revealed various beneficial effects of physical activity, including increased treatment tolerability during cancer treatment and prolonged survival, which has led to a paradigm shift in relevant guidelines. This study examined if this paradigm shift from rest to activity has been consolidated in health care professionals' (HCP') attitude. It was investigated if the two dimensions of attitude (rest and activity) are endorsed empirically within the theory of planned behavior (TPB). Differences between physicians and nurses were examined. METHODS: Five hundred forty seven physicians and 398 nurses treating breast, prostate, or colorectal cancerpatients completed a cross-sectional questionnaire. To assess attitude toward physical activity during cancer treatment, we developed a 15-item scale, which included original statements of HCP. TPB variables were assessed. RESULTS: A factor analysis revealed the proposed distinction of attitude into two dimensions. The activity-paradigm was stronger represented in HCP' attitude compared with rest-paradigm (Mactivity-paradigm = 4.1 versus Mrest-paradigm = 2.7, p < 0.001). Additionally, the activity-paradigm had higher exploratory power in explaining intention to recommend physical activity in cancerpatients. However, the rest-paradigm was able to explain intention to recommend physical activity over and above activity-paradigm (ΔR2 = 0.05). Nurses had higher scores on the rest-paradigm than physicians. CONCLUSIONS: The activity-paradigm has already been consolidated in HCP' minds. However, the rest-paradigm is still present in the daily routine of oncology physicians and nurses. Addressing concerns and insecurities related to supporting cancerpatients in maintaining or building up a physically active lifestyle is a very important educational task.
Keywords:
attitude; cancer; health care professionals; nurses; oncology; paradigm shift; physical activity; physicians; rest paradigm; theory of planned behavior
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