Abstract
BackgroundCancer survivorship results in an increased number of physical and psychosocial health issues. Engaging in physical activity in natural environments is often thought of as restorative. Despite the potential benefits of engaging in physical activity in natural environments there are no sustainable community-based programs for cancer survivors that employ this form of physical activity. This study aims to evaluate the impact of an 8-week trail-walking (TW) program on anxiety in a population of adult cancer survivors.MethodsThe TW program consisted of two trail walks per week for 8 weeks led by a hiking guide. Individuals were eligible to participate if they were 19 years or older, were a cancer survivor, were not on active immunotherapy, and had medical clearance from their physician for physical activity. While 12 participants signed up for the program, 9 participants (N = 9, 8 F, 1 M) completed the program. A mixed methodology included pre-and-post quantitative program surveys and post-program interviews. Questionnaires measured generalized anxiety, sleep disturbances, self-efficacy, self-esteem, psychological well-being and depression as well as pre-and-post hike state anxiety. Data was analysed using paired t-tests. Interviews were transcribed verbatim and an inductive thematic analysis was conducted to consolidate meaning and identify themes using NVivo 11 software.ResultsAverage attendance was 74% of the 16 hikes. There was no significant reduction in the primary outcome of generalized anxiety (p = .38). There was a significant reduction in perceived stress after 8-weeks (p = .03) and a significant reduction in state anxiety after TW (p < .001). None of the other secondary outcomes were statistically significant (p > .05). Four overarching themes, or benefits, emerged from qualitative data analysis: (a) benefits of program design (b) physical benefits, (c) psychological benefits, and (d) social benefits.ConclusionsThese findings demonstrate the utility of a TW program for cancer survivors in order to promote physical, psychological and social health. Feasibility of a TW program would be contingent on access to natural areas for TW and an instructor-led program with other cancer survivors.
Highlights
Cancer survivorship results in an increased number of physical and psychosocial health issues
Individual fitness levels and experience in trail walking varied from beginner to advanced
There was a significant reduction in perceived stress (p= .03), and a significant reduction was seen when comparing the mean pre and post state anxiety scores of all 16 trail walks over the 8-weeks (p < 0.001)
Summary
Cancer survivorship results in an increased number of physical and psychosocial health issues. For cancer survivors who develop chronic conditions, they display higher symptom prevalence, especially in sensation abnormality, pain, and fatigue, when compared to individuals without cancer [18]. They are at increased risk of functional loss, secondary cancers, and chronic diseases, making them a high-risk group often targeted for behavioral interventions [14]. When a person is diagnosed with cancer, major life adjustments need to be made due to the many physical, emotional, social, and financial demands involved [21]. These demands can feel overwhelming even when the individual has access to the best coping techniques. Cancer survivors often report feelings of loneliness and fear and admit to becoming hypervigilant to physical sensations as lingering memories spur on feeling of anxieties of cancer recurrence [35]
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