• Simone Møller Hede
  • Jacqueline Capion Lemming
  • Eva Hjorth Larsen
4. term, Public Health, Master (Master Programme)
Title: Older cancer survivors with late effects and group-based physical activity – a qualitative study of the
perceived motivational factors and barriers.

Background: The development of improved cancer treatment options has caused a larger number of cancer
patients to survive their cancer disease. However in 60 % of the cases cancer survivors experience late
effects, as a consequence of the cancer treatment they have received. The late effects can be of physical,
mental and/or social character, and can affect the cancer survivor’s quality of life negatively. Group-based
physical activity has shown to be an effective intervention in relation to reducing the late effects. However a
low level of physical activity exists among cancer survivors with late effects, which especially is a problem
amongst the 65+-year-olds.

Aim: The aim of the thesis is to explore which barriers and motivational factors older cancer survivors with
late effects experience in relation to group-based physical activity. This knowledge is used to develop a
group-based physical activity intervention for older cancer survivors with late effects. The aim of the intervention
is to increase the physical activity level of this group.

Methods: A qualitative study and a literature study were performed. Two focus group interviews were
executed in relation to the qualitative study: An interview with seven participants from a self-help-group
(mean age = 69.7), and an interview with seven participants from a physical activity intervention (mean
age=69.5). All of the participants were older female cancer survivors with late effects, who had had different
cancer diagnoses. The literature study was undertaken in the following databases: PsycInfo, PubMed,
Cinahl, Cochrane, Sociological Abstracts, Embase and Scopus. Furthermore Aron Antonovsky’s theory about
Sense of coherence and Albert Bandura’s theory about Self-Efficacy was used in relation to the interpretation
of the collected data.

Results: The thesis found that older cancer survivors experience inner motivation in relation to physical
activity caused by the physical and mental benefits in relation to reducing the late effects. Furthermore the
social companionship with equals was experienced as an outer motivator. The differentiation of the physical
activity was experienced as a motivator in regards to the cancer survivors who had a high level of selfefficacy,
and can cause inactivity for cancer survivors with low levels of self-efficacy. Furthermore experiencing
pain, fear of injuries, physical late effects, feeling different during physical activity, doubt of their
body’s abilities, not wanting to talk about cancer, lack of performance improvement and not finding physical
activity meaningful were all inner barriers in relation to physical activity. The outer barriers were lack
of guidance from the health professionals, lack of social support, payment, comorbidities, full-time job, distance
and traffic. Furthermore the thesis found that older cancer survivors can experience severe mental
late effects, and that psychological counseling can reduce these. The cancer survivors experience physical
late effects as having a negative social consequence. Furthermore participation in group-based physical
activity is experienced as advantageously in regards to reducing late effects. Social support from close relatives
is experienced as important in relation to participating in physical activity. Moreover a discrepancy
was found in relation to how cancer survivors’s social network can think of them as healthy again, even
though they perceive themselves as still being sick. Furthermore it was found that older cancer survivors
with late effects can perceive themselves as sick when they compare themselves to the general population,
and that they can perceive themselves as older than they are because of the late effects.

Conclusion: The identified barriers and motivational factors were used to establish eight recommendations.
From these recommendations an intervention for older cancer survivors with late effects were constructed,
which consisted of three elements: group-based physical activity, discussion groups and socialiazing.
The intervention can contribute to enhancing the physical activity level of older cancer survivors
with late effects, which can reduce their late effects.
Publication date1 Jun 2016
Number of pages119
ID: 234521052