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  • him br him Patient s wife expressed motivation to

    2020-08-18

    him.”
    him.” “Patient's wife expressed motivation to adhere to recommendations
    and stated that going through this process with her husband has
    changed the way she looks at her own health.”
    Seeing benefits “Exercise helped improve symptoms of leg cramps throughout the night.” “Caregiver states that there are moments of increased anxiety
    from walking “Noted decreased anxiety as compared to the first session.” however when she engages in activities this decreases.”
    “They both stated that prior to surgery they increased their steps because they were
    preparing for guests on Easter. They both showed me the steps listed in the app and
    were excited to see the numbers increase over time.”
    “Reports that his back pain had diminished at home, which he and wife attributed to
    increased walking.”
    postoperative recovery and quality of life were endorsed by both pa-tients and FCGs as barriers to physical activity.
    3.1.5. Theme 5: Other Roles and Responsibilities
    Multiple roles and responsibilities for patients and FCGs posed a sig-nificant challenge for patient and FCG engagement in the physical activ-ity intervention. In addition to their cancer diagnosis, many patients also served as the primary caregiver for their spouses with medical issues. Full-time employment, chores, other caregiving responsibilities, and their fluctuating demands were major barriers to adherence. For some FCGs, the demands of work and caregiving for several family members with medical issues was overwhelming; thus, they were unable to focus on physical activity.
    3.1.6. Theme 6: Other Engagements/Unexpected Life Events
    Patients and FCGs reported unexpected life events and additional engagements that limited their ability to stay physically active. The need to schedule and attend multiple MD appointments in the
    preoperative setting made it Y27632 difficult to set aside time for walking. Un-expected life events, such as car accidents, additional medical issues, and unanticipated long distance travels limited participants' ability to engage in the intervention.
    As a result of multiple roles and responsibilities and unanticipated life events, lack of time was a significant barrier to physical activity. Patients and FCGs who travel from out of town for surgery had very lim-ited time to engage in the walking program. For many participants, busy daily schedules and the need to make multiple trips between home, hospital, and MD visits was a primary barrier to walking.
    An important intrapersonal barrier to intervention adherence in-cluded individual preferences, such as lack of motivation. This factor was endorsed by both patients and FCGs as a primary barrier to physical activity engagement. Decreased motivation after surgery, preference for
    sedentary lifestyle, disinterest, dislike of structured programs, and “lazi-ness” were significant challenges to walking.
    3.1.9. Theme 9: Not Accustomed to Physical Activity
    A lack of personal history of physical activity engagement was a common intrapersonal factor that resulted in disinterest and dislike of walking. For some patients and FCGs, preference for sedentary lifestyles, coupled with lack of socialization, posed a significant challenge to phys-ical activity engagement. Others preferred leisurely activities over a more structured exercise. Because Acceptor splicing site were “active” leisurely, the need for structured walking programs were not necessary.
    As walking was the primary component of the physical activity in-tervention, environmental and weather were important factors in phys-ical activity behavior. Weather and temperature patterns, such as rain and hot days, limited participant's ability and willingness to walk. Additionally, access to places to walk with flat, even surfaces was impor-tant. Hills, uneven walking surface, and rainy weather were barriers to physical activity.
    3.2. Facilitators to Intervention Adherence
    Many participants reported physical activity as a part of their daily routine. Patients and FCGs engaged in many structured physical activity and exercise, including going to the gym, weight-lifting, hiking, yoga, and use of resistance bands. Participants also reported regular participa-tion in sports, such as tennis and golfing. Among others, the merging of leisurely physical activity and social interactions (walking with friends) helped with overcoming barriers, and served as an effective motivator.
    The use of coping strategies to counter anxiety and stress served as an important facilitator of adherence to physical activity. Participants endorsed positive coping strategies, such as church/faith communities, prayers, social activities and interactions, distraction activities, and use of mind-body approaches (i.e. meditation) as helpful with managing anxiety and stress. This resulted in participant's ability to focus on phys-ical activity engagement. Distraction activities, such as cleaning, mopping/vacuuming, were helpful in attempts to “control” indoor ac-tivities. For others, knowing physical activity can reduce stress moti-vated them to stay active.