Exploration of exercise motivation and adherence among individuals living with cancer following participation in a structured group-based exercise program

Abstract

Background/Objectives: Previous literature has found that exercise participation for individuals living with cancer has a multitude of benefits and is recommended for rehabilitation following cancer treatment. It has been suspected that more of these benefits may be obtained in a structured group-based exercise program due to the safe environment and support from instructors/group members. Exploration utilizing the Self-determination Theory was used to determine differences in exercise participation immediate versus long-term post participation in a structured group-based program. Furthermore, fulfillment of the basic psychological needs (autonomy, competence, relatedness) was assessed to determine different factors that influence motivation over time. Method: For both Phase One and Phase Two of this study 10 semi-structured interviews were conducted with women aged 37 years and older, living with cancer, and who were recruited from a structured group-based exercise program. All participants completed the Medical History Assessment form which gathered information regarding lifestyle factors and general health. Using NVivo and the basic psychological needs as a theoretical framework exercise motivation was explored for both Phase One and Phase Two. Results: According to participants interviewed immediate post program (Phase One), fulfillment of autonomy, competence, and relatedness was achieved while participating in a structured group-based exercise program. Participants indicated that the safe and comfortable atmosphere, as well as the support from the group played an important role in fostering their motivation towards exercise. Those participants interviewed long-term post program (Phase Two) had varied outcomes. Four participants continued exercise in a structured group-based exercise program and indicated that fulfillment of the basic psychological needs still remained present and impacted their adherence to exercise. The remaining participants had significantly lower levels of exercise participation and indicated a variety of barriers (e.g., injury, retirement) influencing exercise engagement. The lack of group support negatively impacted exercise outcomes for the less active individuals in this phase. Conclusion: The findings revealed that exercise in a structured group-based exercise program may provide more of the benefits associated with exercise for individuals living with cancer. Fulfillment of all three basic psychological needs did impact exercise motivation, which was evident for those who continued exercise over time. Further investigation into the role of the needs and long-term exercise participation for individuals living with cancer is necessary to gain a better perspective on how exercise programs can be modified appropriately for this population.