Changing an exercise behaviour for physically inactive patients with breast cancer during chemotherapy- the critical role of nurse support: An implementation study

Purpose: This implementation study investigates the feasibility of a nurse-led pedometer intervention and motivational counselling for physically inactive people with breast cancer undergoing chemotherapy in a real-world oncology outpatient setting. It also evaluates the effectiveness of supportive conversations with specialized nurses in terms of behavior change. Methods: Nurses were trained through an 8-h educational program to deliver the intervention. Patients received a pedometer at the start of chemotherapy and attended individual nurse-led counselling sessions every three weeks, focusing on activity levels, motivational factors, and goal setting. Follow-up continued until one year after baseline. The study comprises of qualitative data in form of interviews and quantitative data from a questionnaire to evaluate the feasibility. Results: Twenty patients participated. Motivational counselling by nurses was seen as fundamental for increasing physical activity. Eight out of 19 patients increased or maintained the number of steps they took during chemotherapy. At one-year follow-up, 12 patients were still using the pedometer, and 16 patients felt motivated by the nurses’ conversations. Four themes emerged from interviews: 1) supportive and motivating conversations, 2) pedometers provide comfort and discomfort, 3) behavioral changes in everyday life, and 4) ownership and commitment. Conclusions: Nurse-led conversations and pedometers have high impact on change health behaviors in physically inactive people undergoing oncological treatment for breast cancer. The intervention can be easily implemented as it required few resources and minor structural changes.