Autonomy is not but competence and relatedness are associated with physical activity among colorectal cancer survivors

• Published in: Supportive care in cancer Vol. 29; no. 3; pp. 1653 - 1661
• Main Authors: Kim, Kyoung-A, Chu, Sang Hui, Oh, Eui Geum, Shin, Sang Joon, Jeon, Justin Y., Lee, Yun Jin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-03-2021; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Analysis; Cancer survivors; Cancer Survivors - psychology; Cancer therapies; Care and treatment; Colorectal cancer; Colorectal Neoplasms - mortality; Colorectal Neoplasms - psychology; Exercise; Exercise - psychology; Female; Health behavior; Health surveys; Humans; Male; Medical diagnosis; Medical prognosis; Medicine; Medicine & Public Health; Metabolism; Middle Aged; Mortality; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Patients; Personal Autonomy; Physical fitness; Regression analysis; Rehabilitation Medicine; Social aspects; Surveys; Surveys and Questionnaires; Survival Analysis; Survivor; Young Adult; South Korea; Self-determination theory; Competence; Autonomy; Physical activity; Colorectal cancer survivors; Relatedness
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-020-05661-0

Purpose
The main objective of this study was to use the framework of the self-determination theory, incorporating both internal and external sources of motivation, to identify factors influencing physical activity among colorectal cancer survivors (CRC-S) in Korea.
Method
In total, 242 patients at a university-affiliated hospital in Seoul, Korea, responded to a descriptive survey, which comprised questionnaire sets including the Global Physical Activity Questionnaire and the Patient Health Questionnaire. Motivation was then assessed on three scales: the Treatment Self-Regulation (autonomy), Perceived Competence (competence), and the multidimensional Scale of Perceived Social Support (relatedness). Logistic regression analysis was then used to identify factors associated with physical activity.
Result
The mean physical activity score was 16.07 metabolic equivalent hours per week, and only 23.3% of patients had an appropriate level of exercise. In the logistic regression analysis, physical activity was associated with competence (odds ratio (OR) = 1.36, 95% confidence interval (CI): 1.06–1.74), relatedness (OR = 1.11, 95% CI: 1.04–1.18), depression (OR = 0.84, 95% CI: 0.75–0.94), and stage I or II disease (OR = 3.33, 95% CI: 1.28–1.86). This study indicated that competence, relatedness, depression, and the disease stage contributed to physical activity among these subjects while autonomy did not.
Conclusion
Future interventions to achieve the recommended levels of physical activity among CRC-S could benefit from taking into account the disease stage as well as psychosocial factors including motivation and depression.