CANWELL: USING EXERCISE TO EMPOWER PEOPLE WITH CANCER

Abstract

<p>People with cancer face many challenges related to their disease and its associated treatments. This dissertation consists of two studies directly evaluating the effects of exercise on cancer survivors who participated in a community-based exercise program (CanWell program) and a measurement paper that evaluated a measure of symptom burden. The first study outlines the development and effectiveness of the CanWell program as measured by the 6-minute walk test, STEEP treadmill test, Functional Cancer Therapy Assessment – General, and the Edmonton Symptom Assessment System (ESAS). This study found that participants in the CanWell program have significantly improved physical abilities, improved quality-of-life, and lower levels of cancer disease burden. The second study was conducted to evaluate the long-term exercise compliance, facilitators and barriers to continuation of exercise. Outcome measures used were similar to those in the first study with a survey explored facilitators and barriers to exercise. The results of this study found that while CanWell graduates were able to maintain the functional levels (no change in 6-minute walk test), there were significant reductions in exercise aerobic abilities (time on treadmill). The main exercise barriers included fatigue, cost, and return to work. In the last study, the measurement properties of the ESAS were investigated using Rasch analysis leading to a revised scoring algorithm to meet unidimensionality and interval scaling. The ESAS scores from study #1 were re-analyzed using the new interval-level scoring scheme. This Rasch-based scoring resulted in different conclusions than the traditional ordinal scaling.</p>