Thursday, October 14, 2010

Improving Quality of Life Through Exercise

When implementing any exercise program, it is crucial to consider the individual needs of the participants. However, it is also important to be familiar with the particular needs of the population that you are serving. Many populations have specific issues and concerns that can impact the effectiveness of the program.  For breast cancer survivors, quality of life is one major concern and an exercise program geared for this population needs to address that issue.

First, let’s define quality of life. As defined in Gill and Williams (2008), quality of life (QoL) is “a broad, integrative construct, comprising the person’s perceived physical, social and psychological well-being” (p. 177). And Gill et al. (as cited in Gill & Williams, 2008) proposed a hierarchy of well-being that further delineated these three categories into: social well-being, physical well-being (including physical health symptoms, physical fitness, and physical functioning), cognitive well-being, emotional well-being, and spiritual well-being. This holistic approach to quality of life allows for the various personal definitions of quality of life among individuals and addresses the multifaceted aspects of quality of life.

An exercise program’s main purpose is to address physical quality of life issues, as research supports the notion that physical activity can improve quality of life (Gill & Williams, 2008). Breast cancer survivors have been weakened by illness and treatment. Exercise offers a road to recovery from the physical effects on their body. However, there is great variance among breast cancer survivors:  age, length of illness, severity of illness, and physical activity level prior to illness can all impact the exercise needs and abilities of the individual. Offering a variety of types of exercise allows not only for these individual differences but also provides a more comprehensive approach to physical rehabilitation. Offering enjoyable types of activities that are not normally associated with “exercise” such as dancing can help motivate participants who might be disinclined to participate in more traditional types of exercise.

The good news is that an exercise program can actually address more than just the physical aspects of quality of life. Milne, Guilfoyle, Gordon, Wallman, and Courneya (2007) found that participants in an exercise program often focused more on the social benefits of the exercise program. They saw the main benefit of the exercise program not as the physical benefits, but the social benefits of a shared experience with others who had experiences similar to theirs. Social support has been found to be an important predictor of successful recovery from breast cancer (Kroenke, Kubzansky, Schernhammer, Holmes, & Kawachi, 2006), so an exercise program that encourages socialization among participants can serve a dual purpose. One could even argue that this socialization can improve the emotional well-being of the participants by giving them opportunities to have discussions with other survivors in various stages of recovery. For example, a newly recovering participant may find comfort in talking with a survivor who has been in recovery for several years.

Additionally, Milne et al. (2007) found that exercise gave breast cancer survivors a sense of mastery over their own bodies. In both the effects of breast cancer and its treatment, women felt as if their own bodies were turned against them. Exercise allowed them a way of returning that control to themselves. Although this could be seen as an indicator of physical well-being (and it is), this can also be seen as a sign of cognitive well-being. The participants are returning to a way of thinking positively about their bodies and repairing their mind-body connection. It’s also important to recognize that women need to regain control over their lives as well as bodies. Andersen, Bowen, Morea, Stein, & Baker (2009) found that the long-term prognosis for breast cancer survivors improved if the survivors felt that they had more power over the decision making in their follow-up care. In an exercise program, then, it is not only important to assess individual needs but to allow the individual to have a say in what form that program takes.

In conclusion, an exercise program can improve quality of life for breast cancer survivors (as well as other populations) in a variety of different ways. Keeping these aspects in mind when creating the program can help to enhance the positive effects of the program and improve the chances of recovery for all of the participants.

 

References

Andersen, M., Bowen, D., Morea, J., Stein, K., & Baker, F. (2009). Involvement in decision-

     making and breast cancer survivor quality of life. Health Psychology, 28(1), 29-37.

     doi:10.1037/0278-6133.28.1.29.

 

Gill, D. L., & Williams, L. (2008). Psychological dynamics of sport and exercise (3rd

     Ed.). Champaign, IL: Human Kinetics.

 

Kroenke, C. , Kubzansky, L. , Schernhammer, E. , Holmes, M. , & Kawachi, I. (2006).

     Social networks, social support, and survival after breast cancer diagnosis. Journal of

     Clinical Oncology, 24(7), 1105-1111.

 

Milne, H., Guilfoyle, A., Gordon, S., Wallman, K., & Courneya, K. (2007). Personal accounts

      of exercise and quality of life from the perspective of breast cancer survivors. Quality of

     Life Research, 16(9), 1473-1481. doi:10.1007/s11136-007-9251-z.

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