Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24
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Item A randomized, feasibility trial of an exercise and nutrition‐based rehabilitation programme (ENeRgy) in people with cancer(Wiley, 2021-10-05) Hall, Charlie C.; Skipworth, Richard J.E.; Blackwood, Honor; Brown, Duncan; Cook, Jane; Diernberger, Katharina; Dixon, Elizabeth; Gibson, Valerie; Graham, Catriona; Hall, Peter; Haraldsdottir, Erna; Hopkinson, Jane; Lloyd, Anna; Maddocks, Matthew; Norris, Lucy; Tuck, Sharon; Fallon, Marie T.; Laird, Barry J.A.Background: Despite rehabilitation being increasingly advocated for people living with incurable cancer, there is limited evidence supporting efficacy or component parts. The progressive decline in function and nutritional in this population would support an approach that targets these factors. This trial aimed to assess the feasibility of an exercise and nutrition based rehabilitation programme in people with incurable cancer. Methods: We randomized community dwelling adults with incurable cancer to either a personalized exercise and nutrition based programme (experimental arm) or standard care (control arm) for 8 weeks. Endpoints included feasibility, quality of life, physical activity (step count), and body weight. Qualitative and health economic analyses were also included. Results: Forty‐five patients were recruited (23 experimental arm, 22 control arm). There were 26 men (58%), and the median age was 78 years (IQR 69–84). At baseline, the median BMI was 26 kg/m2 (IQR: 22–29), and median weight loss in the previous 6 months was 5% (IQR: −12% to 0%). Adherence to the experimental arm was >80% in 16/21 (76%) patients. There was no statistically significant difference in the following between trial arms: step count − median % change from baseline to endpoint, per trial arm (experimental −18.5% [IQR: −61 to 65], control 5% [IQR: −32 to 50], P = 0.548); weight − median % change from baseline to endpoint, per trial arm (experimental 1%[IQR: −3 to 3], control −0.5% [IQR: −3 to 1], P = 0.184); overall quality of life − median % change from baseline to endpoint, per trial arm (experimental 0% [IQR: −20 to 19], control 0% [IQR: −23 to 33], P = 0.846). Qualitative findings observed themes of capability, opportunity, and motivation amongst patients in the experimental arm. The mean incremental cost of the experimental arm versus control was £‐319.51 [CI −7593.53 to 6581.91], suggesting the experimental arm was less costly. Conclusions: An exercise and nutritional rehabilitation intervention is feasible and has potential benefits for people with incurable cancer. A larger trial is now warranted to test the efficacy of this approach.Item Stages of exercise behaviour change: a pilot study of measurement validity(Institute of Health Promotion and Education, 2008) Bulley, Catherine; Donaghy, Marie; Payne, A.; Mutrie, N.Objectives: The Stage of Exercise Behaviour Change (SEBC) scale is used to monitor physical activity levels and change in a variety of contexts. However, there is insufficient conceptual discussion relating to its use and a lack of objective evidence for its validity. Pilot work was undertaken to explore the issues involved in validating a SEBC scale using objective monitoring of exercise behaviour, and subsequent discussion aims to inform future validity studies. Design: Estimates of of physical activity energy expenditure (kilocalories) were calculated for 20 participants, while minutes spent in moderate and vigorous activity were extrapolated from heart rate data in 23 participants. The SEBC scale was completed after a three-day objective monitoring period. Data were compared descriptively and using analysis of variance. Results: Inter-stage differences in objective measurements of energy expenditure and minutes of vigorous activity participation provided hierarchical confirmation of the SEBC scale. Conclusions: Objectively monitored exercise partcipation supported previous work in its confirmation of the Stage of Change hierarchy. However, in order to build confidence in the tool, it will be necessary to explore minutes of exercise participation over a six-month period. This would enable comparison of objectively monitored activity levels against the threshold level of exercise described as the target behaviour. Suggestions are made as to how this could be carried out. A word of caution is provided in relation to current use of SEBC tools in measurement contexts.