Exploring engagement in a personalised therapeutic exercise programme for women diagnosed with breast cancer

Aim Breast cancer is the most common cancer in women in New Zealand, with 2,575 new diagnoses in 2007. There is increasing evidence that physical activity may have a beneficial effect on quality of life, physical outcomes and even survival for women with breast cancer. The purpose of this study was to explore the impact of an exercise program designed for women diagnosed with breast cancer from their perspective, and to explore the process of engagement with that program, attempting to identify key elements which could inform other initiatives in the future. Study design This was a qualitative descriptive study. Women diagnosed with breast cancer who had taken part in the exercise programme were purposefully sampled for a range of ages, ethnicities, level of reconstructive surgery, programme participation and pre-diagnosis activity levels. Potential participants were initially approached by the programme organisers for permission for the researchers to contact them. Consenting women took part in a semi-structured interview. An iterative thematic approach was taken in the analysis. Results Sixteen women were interviewed within 22 months of diagnosis. Several themes emerged about what encouraged them to take part in the programme, what kept them engaged and what their perceptions of the programme benefits were (reported by Cummins et al). This paper focuses on the key themes relating to engagement:- the individual focus and holistic care; professional knowledge; generation of physical benefit and sense of wellbeing; providing safe boundaries; and relationship with the therapist. Conclusion The concept of person centeredness appeared to underpin these findings. The physiotherapists’ knowledge and responsiveness to the women they were working with allowed them to deliver a holistic programme not limited to physical exercises, but also included providing information and support for skills relevant to moving from the acute situation of cancer diagnosis and treatment to ‘living’ with the diagnosis and its consequences