ABSTRACT:
Background; Cancer is a major health crisis worldwide. Advanced cancer treatment improves patients’ survival rate; however, the quality of life (QOL) is compromised due to treatment side effects. Cancer-related-fatigue (CRF) is frequently experienced (80-90%). Physical exercise (PE) reduces CRF considerably1. At the study site, quality department audit report shows frequent interruption during cancer treatment due to high CRF levels. In 2021, a total of 188 patients withheld their radiation treatment due to CRF. No published study found sufficiently addressing oncology nurses’ knowledge level on the benefits of PE for cancer patients during treatment in Kingdom of Bahrain. Study aimed to assess the current knowledge level of oncology nurses regarding the PE for cancer patients undergoing treatment: Objectives/purpose: This study was to measure the associations between participants’ demographic characteristics and their level of knowledge regarding PE for patients with cancer. The study aimed to assess the current knowledge level of oncology nurses regarding the PE for cancer patients undergoing treatment. Methods: An online questionnaire, adopted from Roberta Anderson (2018)2, was administered to assess oncology nurses’ knowledge. Online survey shared with all oncology nurses (324 nurses) chosen through convenience sampling for the descriptive cross-sectional study at the Oncology Center in Bahrain. 185 responses out of the 244 recorded were effectively completed and analyzed. Data was analyzed using SPSS version 25; descriptive analyses were utilized to describe the demographic characteristics and level of knowledge, and parametric inferential statistics was used to measure the association between variables. The Results: Sample size offers 177 participants (5% margin error and 95% confidence level). Participants demonstrated low level of knowledge (42.2%) regarding PE for oncology patients. Demographic characteristics were not associated with the knowledge level. Firstly, the statistical analysis showed a weak correlation between participants’ knowledge level and length of clinical experience (p<0.0001) Secondly, the correlation between the length of the oncology clinical experience and participant’s knowledge indicated weak correlation (p=0.006). Finally, participants who reported to have received previous training on PE for cancer patients scored significantly higher (p=0.020) Conclusion and Implementation: The study has successfully assessed the current knowledge level of oncology nurses on PE benefits for cancer patients. The statistical treatment of data has demonstrated the correlations between the dimensions explored. The study result will incorporate evidence-based guidelines on PE for cancer patients into formal education programmes to be implemented as strategy.
Cite this article:
Shaima Hamad Faraj. Assessing Oncology Nurses’ Knowledge about Physical Exercise for Cancer patients under Treatment: A Cross-sectional Study. A and V Pub International Journal of Nursing and Medical Research. 2025;4(3):111-5. doi: 10.52711/ijnmr.2025.23
Cite(Electronic):
Shaima Hamad Faraj. Assessing Oncology Nurses’ Knowledge about Physical Exercise for Cancer patients under Treatment: A Cross-sectional Study. A and V Pub International Journal of Nursing and Medical Research. 2025;4(3):111-5. doi: 10.52711/ijnmr.2025.23 Available on: https://ijnmronline.com/AbstractView.aspx?PID=2025-4-3-1
REFERENCES:
1. Sung, Hyuna, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2021; 71(3): 209-249.
2. Anderson, Roberta. Educating Oncology Nurses on the Benefits of Patient Exercise. Diss. Walden University, 2018.
3. Zugazagoitia, Jon, et al. Current challenges in cancer treatment. Clinical Therapeutics. 2016; 38(7): 1551-1566.
4. Price, Pat, and Karol Sikora, eds. Treatment of cancer. CRC Press, 2020.
5. Friedenreich, Christine M., Charlotte Ryder‐Burbidge, and Jessica McNeil. Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Molecular Oncology. 2021; 15(3): 790-800.
6. Avgerinos, Konstantinos I., et al. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism 2019; 92: 121-135.
7. Ferioli, Martina, et al. Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget 2018; 9(17): 14005.
8. Cantwell, M., et al. Healthcare professionals' knowledge and practice of physical activity promotion in cancer care: challenges and solutions. European Journal of Cancer Care. 2018; 27(2): e12795.
9. Tranchita, Eliana, et al. The beneficial role of physical exercise on anthracyclines induced cardiotoxicity in breast cancer patients. Cancers. 2022; 14(9): 2288.
10. Fabi, A., et al. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Annals of Oncology. 2020; 31(6): 713-723.
11. Berger, Ann M., et al. Cancer-related fatigue, version 2.2015. Journal of the National Comprehensive Cancer Network 13.8 (2015): 1012-1039.
12. Levkovich, Inbar, Miri Cohen, and Khaled Karkabi. The experience of fatigue in breast cancer patients 1–12month post-chemotherapy: A qualitative study. Behavioral Medicine. 2019; 45(1): 7-18.
13. Hilfiker, Roger, et al. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment: a systematic review incorporating an indirect-comparisons meta-analysis. British Journal of Sports Medicine. 2018; 52(10): 651-658
14. Galunas, Laura. The Impact of a Nurse-Led Exercise Activity for Cancer-Related Fatigue in Patients with Leukemia. Clinical Journal of Oncology Nursing. 2022; 26(3).
15. Udechukwu, Stella N. The role of healthcare providers in using the knowledge of sickle cell trait to mitigate health problems in African American Clients. 2021.
16. Van Veen, Merel R. Improving oncology nurses’ knowledge about nutrition and physical activity for cancer survivors. 2017; 44(4): 488-496.
17. Patel, Alpa V., et al. American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Medicine and Science in Sports and Exercise. 2019; 51(11): 2391.
18. Siegel, Rebecca L., et al. Cancer statistics, 2021. CA: A Cancer Journal for Clinicians. 2021; 71(1): 7-33.
19. Ramasubbu, Saravana Kumar, et al. Quality of life and factors affecting it in adult cancer patients undergoing cancer chemotherapy in a tertiary care hospital. Cancer Reports. 2021; 4(2): e1312.
20. Zugazagoitia, Jon, et al. Current challenges in cancer treatment. Clinical Therapeutics. 2016; 38(7): 1551-1566.
21. Price, Pat, and Karol Sikora, eds. Treatment of Cancer. CRC Press, 2020.
22. Nayak, Lakshmi, et al. PD-1 blockade with nivolumab in relapsed/refractory primary central nervous system and testicular lymphoma. Blood, The Journal of the American Society of Hematology. 2017; 129(23): 3071-3073.
23. Ramasubbu, Saravana Kumar, et al. Quality of life and factors affecting it in adult cancer patients undergoing cancer chemotherapy in a tertiary care hospital. Cancer Reports. 2021; 4(2): e1312.
24. Berger, Ann M., et al. Cancer-related fatigue, version 2.2015. Journal of the National Comprehensive Cancer Network. 2015; 13(8): 1012-1039.
25. Yang, Songwei, et al. A narrative review of cancer-related fatigue (CRF) and its possible pathogenesis. Cells. 2019; 8(7): 738.
26. Price, Pat, and Karol Sikora, Eds. Treatment of Cancer. CRC Press, 2020.
27. Fabi, A., et al. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Annals of Oncology. 2020; 31(6): 713-723.
28. Charalambous, Andreas, and Christiana Kouta. Cancer related fatigue and quality of life in patients with advanced prostate cancer undergoing chemotherapy. BioMed Research International. 2016: 1: 3989286.
29. Freene, Nicole, Rachel Davey, and Steven M. McPhail. Frequency of a very brief intervention by physiotherapists to increase physical activity levels in adults: a pilot randomised controlled trial. BMC Sports Science, Medicine and Rehabilitation. 2019; 11: 1-9.
30. Freene, Nicole, Rachel Davey, and Steven M. McPhail. Frequency of a very brief intervention by physiotherapists to increase physical activity levels in adults: a pilot randomised controlled trial. BMC Sports Science, Medicine and Rehabilitation. 2009; 11: 1-9.
31. Alderman, Georgina, et al. Health care professionals’ knowledge and attitudes toward physical activity in cancer patients: a systematic review. Seminars in Oncology Nursing. 2020; 36(5).
32. Ladwa, Rahul, et al. Telehealth cancer-related fatigue clinic model for cancer survivors: a pilot randomised controlled trial protocol (the T-CRF trial). BMJ Open. 2022; 12(5): e059952.
33. Kessels, Ellen, Olga Husson, and Christina M. Van der Feltz-Cornelis. The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis. Neuropsychiatric Disease and Treatment. 2018: 479-494.
34. Ferioli, Martina, et al. Impact of physical exercise in cancer survivors during and after antineoplastic treatments. Oncotarget. 2018; 9(17): 14005.
35. Avancini, Alice, et al. Physical activity and exercise in lung cancer care: will promises be fulfilled? The Oncologist. 2020; 25(3): e555-e569.\
36. Twomey, Rosie, et al. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer. 2018; 18: 1-19.
37. Twomey, Rosie, et al. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer. 2018; 18: 1-19.
38. Tranchita, Eliana, et al. The beneficial role of physical exercise on anthracyclines induced cardiotoxicity in breast cancer patients. Cancers. 2022; 14(9): 2288.
39. Meneses-Echávez, José Francisco, Emilio González-Jiménez, and Robinson Ramírez-Vélez. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015; 15: 1-13.
40. Linda Abbott, D. N. P. Energy Through Motion©: An activity intervention for cancer-related fatigue in an ambulatory infusion center. Clinical Journal of Oncology Nursing. 2017; 21(5): 618.
41. Büntzel, Jens, et al. Cancer patients' knowledge and acceptance of physical activities for rehabilitation. In Vivo. 2017; 31(6): 1187-1192.
42. Okechukwu, Chidiebere Emmanuel, et al. Precautionary measures before tailoring and commencing a tele-supervised home-based exercise oncology program for older patients with cancer and post-treatment cancer survivors in the COVID-19 era. Journal of Geriatric Oncology. 2022; 13(2): 241-244.
43. McFarland, Daniel C., et al. Cancer-related fatigue. Psycho-Oncology. 2021: 265-75.
44. Okechukwu, Chidiebere Emmanuel. Do oncology nurses have sufficient knowledge of exercise oncology? A mini narrative review. Cancer Research, Statistics, and Treatment. 2021; 4(1): 88-92.
45. Bourmaud, A., et al. Cancer-related fatigue management: evaluation of a patient education program with a large-scale randomised controlled trial, the PEPs fatigue study. British Journal of Cancer. 2017; 116(7): 849-858.
46. Nadler, Michelle, et al. Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators. Supportive Care in Cancer. 2017; 25: 2297-2304.
47. Michael, Christina M., et al. Prehabilitation exercise therapy for cancer: A systematic review and meta‐analysis. Cancer Medicine. 2021; 10(13): 4195-4205.
48. Subba, Rhea, et al. Pathophysiology linking depression and type 2 diabetes: Psychotherapy, physical exercise, and fecal microbiome transplantation as damage control. European Journal of Neuroscience. 2021; 53(8): 2870-2900.
49. McCourt, Orla, et al. Physical activity during and after haematological cancer treatment: a cross-sectional survey of haematology healthcare professionals in the United Kingdom. Journal of Multidisciplinary Healthcare. 2021: 1659-1671.
50. van Veen, Merel R. Improving oncology nurses’ knowledge about nutrition and physical activity for cancer survivors. 2017 44.4 (2017): 488-496.
51. Büntzel, Jens, et al. Cancer patients' knowledge and acceptance of physical activities for rehabilitation. In Vivo. 2017; 31(6): 1187-1192.
52. Haussmann, Alexander, et al. The influence of cancer patient characteristics on the recommendation of physical activity by healthcare professionals. International Journal of Behavioral Medicine. 2020; 27: 65-78.
53. McCourt, Orla, et al. Physical activity during and after haematological cancer treatment: a cross-sectional survey of haematology healthcare professionals in the United Kingdom. Journal of Multidisciplinary Healthcare. 2021: 1659-1671.
54. Shing, D. H. Factors related to oncology nurses’ exercise counseling for management of fatigue of women during treatment for breast cancer. Nurse Care Open Acces J. 2017; 2(3): 77-83.
55. Nieswiadomy, Rose Marie, and Catherine Bailey. Foundations of Nursing Research. 2018.
56. Rahman, M. Masudur, et al. Biomedical research in developing countries: Opportunities, methods, and challenges. Indian Journal of Gastroenterology. 2020; 39: 292-302.
57. Setia, Maninder Singh. Methodology series module 3: Cross-sectional studies. Indian Journal of Dermatology. 2016; 61(3): 261-264.
58. Kesmodel, Ulrik S. Cross‐sectional studies–what are they good for?. Acta obstetricia et gynecologica Scandinavica. 2018; 97(4): 388-393.
59. Stratton, Samuel J. Population research: convenience sampling strategies. Prehospital and Disaster Medicine. 2021; 36(4): 373-374.
60. Burdick, Laura, et al. Physicians', nurses' and community health workers' knowledge about physical activity in Brazil: A cross-sectional study. Preventive Medicine Reports. 2015; 2: 467-472.
61. Almazrou, Saja H., et al. Barriers to and Facilitators of adherence to clinical practice guidelines in the Middle East and North Africa Region: A Systematic Review. Healthcare. MDPI. 2020; 4(8).
62. Valiee, Sina, and Ghader Salehnejad. Barriers to and Facilitators of nurses' adherence to clinical practice guidelines: a qualitative study. Creative Nursing. 2020; 26(1): e1-e7.
63. Pueyo-Garrigues, María, et al. NURSES’knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: a cross-sectional study. Nurse Education in Practice. 2022; 58: 103277.
64. Parajuli, Jyotsana, and Judith Hupcey. A systematic review on oncology nurses’ knowledge on palliative care. Cancer Nursing 2021; 44(5): E311-E322.
65. Sharour, Loai Abu. Oncology nurses’ knowledge about exploring chemotherapy related-Extravasation care: A cross-sectional study. Clinical Epidemiology and Global Health. 2020; 8(3): 780-784.
66. Wake, Addisu Dabi. Knowledge and associated factors towards palliative care among nurses in Ethiopia: A systematic review and meta-analysis. SAGE Open Medicine. 2022; 10: 20503121221092338.
67. Gigli, Kristin Hittle, et al. Factors associated with nurses’ knowledge of and perceived value in evidence-based practices. American Journal of Critical Care. 2020; 29(1): e1-e8.
68. Tamang, Nira, et al. COVID-19: a National Survey on perceived level of knowledge, attitude and practice among frontline healthcare Workers in Nepal. BMC Public Health. 2020; 20: 1-10
69. Admass, Biruk Adie, et al. Knowledge and attitude of Ethiopian oncology nurses about cancer pain management: national survey. Cancer Management and Research. 2020: 9045-9055.
70. Kyei-Frimpong, Jamie, et al. Exercise as medicine: providing practitioner guidance on exercise prescription. Preventive Medicine Reports. 2021; 22: 101323.
71. Karvinen, Kristina. Evaluation of online learning modules for improving physical activity counseling skills, practices, and Knowledge of Oncology Nurses. 2017; 44(6): 729-738.
72. Anderson, Roberta. Educating Oncology Nurses on the Benefits of Patient Exercise. Diss. Walden University. 2018.
73. Keogh, Justin WL. Physical activity promotion, beliefs, and barriers among Australasian Oncology Nurses. 2017; 44(2): 235-245.
74. Climstein, Michael, et al. Physical Activity Promotion, Beliefs, and Barriers Among Australian Oncology Nurses. 2017.
75. Fisher, A., et al. Recall of physical activity advice was associated with higher levels of physical activity in colorectal cancer patients. BMJ Open. 2015; 5(4): e006853.
76. Shimizu, Yoichi, et al. Physical activity, and exercise behavior of Japanese breast cancer survivors: A nationwide Cross-Sectional Survey. 2023.
77. Santa Mina, Daniel, et al. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement. Current Oncology. 2018; 25(2): 149.