Congress Abstracts 2004

45

INCREASING EXERCISE ADHERENCE IN A CLINICAL TRIAL EVALUATING THE EFFECTIVENESS OF EXERCISE ON CANCER TREATMENT-RELATED FATIGUE. Amy Bositis, BSN, RN, Theresa Swift Scanlon, MS, RN, Pamela Sue Hall, MS, CRNP, and Victoria Mock, DNSc, RN, AOCN^®, FAAN, Johns Hopkins University School of Nursing, Baltimore, MD.

Assisting people in maintaining an exercise program is a challenge for healthcare providers. This challenge is enhanced when working with a group of patients newly diagnosed with cancer who are undergoing therapy. Nurses play a significant role in this process because of their knowledge in patient education and adherence theories, and because of their sustained relationship with patients throughout treatment. In this ongoing, randomized, clinical trial, a home-based walking program is evaluated as a mitigator of cancer treatment-related fatigue. The research nurses have employed a variety of motivational techniques to improve patient adherence.

Research shows that adherence rates are low for individuals beginning an exercise program. Therefore, to implement a research study that uses exercise as its intervention, it is necessary to use theory-based and research-based interventions. The Social Support and Social Network concept guides this intervention because it proposes that behavior is the product of supportive social networks, which can include relationships, supportive aids, praise, and information. The exercise intervention uses prescribed goal setting, accountability, social support, and mechanical feedback to improve adherence.

Patients assigned to the exercise group receive a variety of research-based interventions to improve adherence such as an exercise booklet and video to reinforce the teaching of the exercise program and emphasize the potential benefits of exercise. The patients are “coached” during the intervention by the research nurse who gives the exercise prescription, monitors the patient’s progress and symptoms, and revises the walking prescription every two weeks. Patients are asked to walk with a supportive friend or family member. Daily logs and recording of steps from a pedometer also serve to monitor and motivate.

Exercise adherence is measured by self-report on the weekly logs and is correlated with the pedometers. These are inexpensive and convenient tools for the patient and offer the nurse insight on the patient’s experience and adherence. The study is ongoing but our methods show preliminary effectiveness.

Oncology nurses, because of their ongoing relationship with patients, have the opportunity to implement interventions that promote exercise during therapy. Furthermore, nurses can assess motivational triggers in patients and choose appropriate methods to help them maintain their exercise goals.