Motivational interviewing and oncology
As survival after cancer has improved, so has the need for rehabilitation to address its debilitating effects and the side effects of its treatment. Exercise-based rehabilitation assists cancer survivors to improve their physical and psychosocial functioning through addressing impairments, reducing symptom burden and providing support.
One goal of oncology rehabilitation is to improve physical activity levels. High levels of moderate-intensity physical activity are associated with improved cancer outcomes, including increased survival, reduced disease recurrence, and fewer side-effects such as fatigue.
However, cancer survivors often reduce their physical activity during treatment and have difficulty regaining their pre-morbid physical activity levels after treatment completion.
Motivational interviewing is a patient-centered style of behavioural counselling that aims to increase physical activity through addressing ambivalence about behaviour change. It differs from other behaviour change interventions, such as health coaching, because the primary emphasis is on people producing their own arguments for change.
A recent randomised trial with 46 participants and 7 weeks follow-up compared oncology rehabilitation with vs. without motivational interviewing.
The primary outcome was the amount of moderate-intensity physical activity, but the study showed strongly that this outcome wasn't improved by motivational interviewing. Although the secondary outcomes also had non-significant results, some looked worthy of further investigation.
For example, the effect of motivational interviewing on sedentary time was intriguing. The confidence interval spanned from a negligible increase in sedentary time to a major decrease in sedentary time. Although further research is needed to determine size and direction of the true effect (if any), that looks promising.
The results for the outcomes 'daily step count' and 'light-intensity physical activity' were similar; they were statistically non-significant but the confidence intervals certainly showed that the possibility of substantial beneficial effects definitely haven't been ruled out yet.
In the meantime, low levels of physical activity remain an issue for people after oncology rehabilitation; therefore, support to increase physical activity beyond rehabilitation is needed.
Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!
> From: Dennett et al., J Physiother 64 (2018) 255-263 (Epub ahead of print). All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.