Abstract
BackgroundNo tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers.MethodsA lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale.ResultsThe final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (>0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach’s alpha = 0.93) and test-retest reliability (ICC = 0.67, p < 0.01).ConclusionsA valid and reliable lymphedema-specific subscale has been developed to assess exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.
Highlights
No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema
Despite growing evidence on the importance of engaging in exercise post-cancer, findings from breast cancer studies suggest that approximately 55% do not engage in nationally recommended levels of physical activity [11,12], and nearly 60% report declines in physical activity following their cancer diagnosis [13]
This study has led to the development of a valid and reliable exercise barriers self efficacy scale to assess confidence in ability to exercise when faced with barriers experienced by individuals with cancer-related lymphedema
Summary
No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. Participation in physical activity has been associated with less exacerbation of lymphedema-related symptoms in breast cancer survivors [16]. Understanding exercise barriers and self-efficacy for individuals with cancer-related lymphedema will aid international physical activity behaviour change strategies post-cancer diagnosis. This information can be used to enhance adherence in the exercise and cancer efficacy trials needed in those cancer types for which less is known about the effects of exercise on lymphedema (e.g., gynaecologic, head and neck)
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