Effects of a Culturally Sensitive Exercise Program on Fatigue, Sleep, Mood, and Symptom Distress among Thai Women with Breast Cancer Receiving Adjuvant Chemotherapy: A Pilot Randomized Controlled Trial
Year: 2013
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Breast cancer is a disease with a global burden for women.In Thailand, a Southeast Asian country, the total number of Thai women with newly diagnosed breast cancer patients makes up 47.8% of all new cancer patients (National Cancer Institute -Thailand, 2011).Cancerrelated fatigue is a distressing multidimensional symptom associated with cancer diagnosis and treatment.Fatigue, sleep disturbance, mood disturbance, and symptom distress were chosen for evaluation in the present study.In Western culture, evidence has shown that exercise decreases fatigue for women with breast cancer during adjuvant chemotherapy.Unique Thai cultural beliefs and health practices affect symptom management.The purpose of this pilot study was to develop a 12-week culturally sensitive exercise program (CSEP) and to preliminarily examine the program's effects on fatigue, sleep disturbance, mood disturbance, and symptom distress at baseline, 4, 7 and 10 weeks in Thai women with breast cancer during active adjuvant chemotherapy.Twenty-three eligible women from the oncology outpatient clinic of a cancer center in Thailand were randomly assigned to either an experimental group (n = 11), which received the CSEP, or to a control group (n = 12), which received equal care and attention without the CSEP.Data from individual interviews indicated that the CSEP developed in this study was feasible and relevant to their lifestyle.Walking was reported as the preferred exercise for Thai women being treated for early-stage breast cancer.Educational information presented in an exercise booklet format was appropriate in the context of educational level and Thai cultural background.Participants in the CSEP group reported adherence to daily steps walked with an average of 5,920 steps (SD = 1,523) from baseline to post intervention and showed a trend toward improving symptoms with mean change scores.Participants in the CSEP had a significantly iii greater increase in physical fitness measured by a 12-minute walk test than participants in the control group at post intervention.Participants in the CSEP group also had lower levels of fatigue, mood disturbance, and symptom distress.Using generalized estimating equation analyses revealed that a significant group difference was found for the trajectory of mood disturbance.No group differences were found in the changing scores over time in fatigue, sleep disturbance, and symptom distress.Preliminary results suggest that the CSEP was culturally sensitive and successfully increased physical activity in Thai women.The CSEP can be replicated in a large population of Thai women during active adjuvant chemotherapy.Nurses need to be aware that physical activity may be an effective intervention for managing multidimensional symptoms in women with breast cancer actively receiving adjuvant chemotherapy.Nurses can encourage and establish an exercise intervention to decrease severity of fatigue and women's distress from its related symptoms.iv
Author: Wipasiri Naraphong
Institution: University of Cincinnati
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: University of Cincinnati
OpenAlex ID: W2284430834