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Background: Cancer’s rising incidence and growing survivor population underscore the need for strategies to enhance health and quality of life. Outdoor physical activity (PA) settings may provide unique benefits, yet evidence in this context is scarce. This systematic review aims to evaluate the impact of outdoor PA and exercise interventions on the health and well-being of cancer survivors.

Methods: A systematic search was conducted in PubMed, Web of Science, and PsycINFO databases from their inception until April 23, 2024. Studies included randomized controlled trials (RCTs) and non-RCTs involving outdoor PA or exercise interventions for cancer survivors. The search strategy adhered to PRISMA guidelines, and the quality of studies was assessed using the PEDro scale.

Results: Twelve studies involving 712 cancer survivors were included, comprising 7 RCTs and 5 non-RCTs. Four studies compared outdoor exercise to indoor exercise instead of a usual care control group, and one used a crossover design. The interventions varied in frequency, intensity, time, and type, with Nordic walking and walking being the most common. Key findings indicated significant improvements in mental health, PA levels, muscular fitness, body composition, and exercise motivation. However, the impact on vital signs and sleep quality was inconclusive due to the limited number of studies and variability in interventions.

Conclusions: Outdoor PA, including structured exercise interventions, substantially benefits cancer survivors, particularly in enhancing mental health and physical fitness. Despite the promising findings, further research is needed to explore long-term effects, the benefits for different cancer types and age groups, and the underlying mechanisms of these interventions. Health practitioners should consider incorporating outdoor activities into cancer rehabilitation programs.

Objective: The Serious Illness Care Program was developed to support goals and values discussions between seriously ill patients and their clinicians. The core competencies, that is, the essential clinical conversation skills that are described as requisite for effective serious illness conversations (SICs) in practice, have not yet been explicated. This integrative systematic review aimed to identify core competencies for SICs in the context of the Serious Illness Care Program. 

Methods: Articles published between January 2014 and March 2023 were identified in MEDLINE, PsycINFO, CINAHL, and PubMed databases. In total, 313 records underwent title and abstract screening, and 96 full-text articles were assessed for eligibility. The articles were critically appraised using the Joanna Briggs Institute Critical Appraisal Guidelines, and data were analyzed using thematic synthesis.

Results: In total, 53 articles were included. Clinicians' core competencies for SICs were described in 3 themes: conversation resources, intrapersonal capabilities, and interpersonal capabilities. Conversation resources included using the conversation guide as a tool, together with applying appropriate communication skills to support better communication. Intrapersonal capabilities included calibrating one's own attitudes and mindset as well as confidence and self-assurance to engage in SICs. Interpersonal capabilities focused on the clinician's ability to interact with patients and family members to foster a mutually trusting relationship, including empathetic communication with attention and adherence to patient and family members views, goals, needs, and preferences.

Conclusions: Clinicians need to efficiently combine conversation resources with intrapersonal and interpersonal skills to successfully conduct and interact in SICs.

Life expectancy among young cancer survivors has increased in the last decades. Unfortunately, young cancer survivors might still experience mental and physical issues due to cancer treatment. Moreover, although physical activity is a valid tool for increasing social support and reducing the risk of obesity, sedentary behaviour is very common among young cancer survivors.Therefore, the current pilot study aims to estimate lack of social support impact on physical activity practice on mental health and quality of life. A sample of 69 Italian young cancer survivors (60% females) were included in the study and physical activity, anxiety, depression and quality of life were assessed by self-reported questionnaires. The results showed that a lack of social support for exercising was connected to higher depressive symptoms, while no influence was detected on anxiety. Concerning quality of life, the analysis of variance model showed a significant effect of the lack of social support on physical mobility but not on self-care, usual activities, pain and discomfort and general health. In conclusion, integrating physical activity in young cancer survivors' life-style, considering cancer-related side effects, might enhance their mental health and quality of life by providing social support at the same time. Healthcare professionals shoulde valuate the feasibility and support adapted physical activity programmes for young cancer survivors, to reduce the risk of depression and obesity, among others.

Background: Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non-pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors.

Methods: The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web-based software COVIDENCE. Sleep outcomes assessed through self-reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta-analytic syntheses were performed on sleep quality and insomnia.

Results: A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (−19%) and sleep disturbance (−17.3%). The meta-analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p < 0.01, 95% CI: 0.07–0.49 and d = 0.43, SE: 0.20, Z = 2.18, p = 0.029, 95% CI: 0.07–0.49, respectively).

Conclusion: RT interventions of 60 minutes per session, performed 2–3 times a week for 12 weeks, with exercise intensity ranging from 60% to 80% of one-repetition maximum can be administered to cancer survivors, aiming to improve sleep outcomes.

This narrative review aimed to identify young cancer survivors’ behaviours, experiences, and perspectives concerning physical activity, and identify useful strategies for promoting a healthy lifestyle. A manual search on the following databases was conducted: PubMed, Scopus, and Web of Science. The search was conducted between June 1, 2023, and April 12, 2024. Articles published from database inception up to April 12, 2024, were retrieved. Articles published in any language were considered. Perspectives including ideas, perceived barriers, and facilitators have been identified. Young cancer survivors seem to engage in physical activity as a useful coping strategy to regain normality and keep healthy after the cancer diagnosis. Although emotional and social support seems fundamental to increase participation, several other factors, including physical limitations, fatigue, sex, cancer type, and socio-economic status can influence physical activity participation. For those engaged in physical activity, the preferred activities are walking, biking, going to the gym, and exercising at home, while the least preferred are exercising at the hospital or boot camp-based exercises. Yoga is more frequently chosen by those still under treatment. Young cancer survivors appear to have unique needs different from those of adult cancer survivors. Mode of treatment delivery, increased awareness concerning the effects of physical activity, including families and friends, connecting survivors, and providing social support together with increasing motivation are key strategies for the promotion of physical activity in young cancer survivors. Fitness and healthcare professionals should consider these aspects to increase young cancer survivors' involvement in physical activities.

Purpose Over the past few decades, the incidence of cancer among adolescents and young adults (AYA) has been increasing. The impact of behaviors, such as physical activity (PA) and nutrition, on disease progression, prognosis, and overall health and quality of life for AYA cancer survivors is of significant importance. This systematic review aims to evaluate the effectiveness of PA and diet interventions for AYA cancer survivors and to critically evaluate existing literature, gaps, and limitations.

Methods A search of literature was conducted in PubMed, Science Direct, Scopus, and Google Scholar following the PRISMA guidelines. Twenty-two studies were included from online databases from 2012 to 2022, 13 of which were randomized controlled trials.

Results Most interventions were related to PA, with only four studies including nutrition or Diet interventions. The interventions were generally feasible and acceptable to AYA cancer survivors, and digitally based PA interventions were commonly used. PA interventions mainly comprised aerobic and resistance training and were individualized. Overall, this review found various PA and diet interventions for AYA cancer survivors that were feasible and well-accepted, but gaps in knowledge and design still exist.

Conclusions This systematic review underscores the importance of conducting more research on diet interventions for YCS.

Aim: To illuminate nurses' experiences of communicating with families in home health care.

Design: A qualitative inductive approach.

Background: An increasing number of ageing and sick people are being granted home health care. Nurses' duties involve caring for both patients and their families, which includes the important task of meeting and talking with them.

Methods: Fourteen registered nurses working in home health care in Sweden participated in individual narrative semistructured interviews. The interviews were analysed with content analysis. To make sure all components of the study were clear, the Standards for Reporting Qualitative Research checklist was used as a guide.

Result: Communication with families was viewed as a crucial action for building rapport to facilitate the involvement and support of families in difficult situations. The nurses highlighted the struggles they sometimes faced in communication when they found it difficult to reach the family. When the communication was supportive for the family, the nurses felt that they were empowering the family members to empower themselves.

Conclusion: This study highlights the vital role of communication in home health care nursing. Effective communication fosters trust and enables nurses to meet family needs.

Implications for the Profession: Effective communication between nurses and families in home health care is crucial from a health care perspective. Building reciprocal relationships fosters trust, enabling nurses to efficiently identify and address family needs and enhancing the quality of care.

Patient or Public Contribution: No patient or public contribution.

Background: With an increased number of people living with multiple progressive diseases, online education courses have been created to address the growing need for competence in palliative care. However, there is limited knowledge about the form and content of these courses, or of participants’ experiences. This study aims to map the status, content, and evaluation of online palliative care courses in Sweden.

Methods: This exploratory study used both quantitative and qualitative methods. The study process involved searching for online palliative care courses on the web and through contact with Swedish palliative care organisations, and then participating in these courses, surveying education providers, and analysing and validating responses. Quantitative data were analysed using descriptive statistics, while thematic analysis was applied to the free-text responses.

Results: Nine online courses provided by five different organisations were mapped. These courses educated over 30 000 healthcare professionals, predominantly assistant nurses and registered nurses. There was a large discrepancy between the number of people who enrolled in and the number who completed the online courses. Shortcomings identified related to lack of systematic evaluation from the participants’ perspectives, if and how knowledge was integrated into clinical practice, and difficulties in making the courses sustainable.

Conclusion: Overarching and national systems for online education are needed. These would require sustainability considerations and guidelines for implementation, evaluation and follow-up of non-university-based online educational initiatives in palliative care. In addition, it is crucial for employers to support professionals undergoing such education, ensuring that they are given opportunities to share their feelings and discuss any challenging thoughts that arise during and after the course.

Objective: The main project objectives will be to characterize the lifestyle behaviours of young cancer survivors (YCS) and to examine the associations of physical activity, balanced nutrition and sustainability and nature behaviours with mental well-being and quality of life.

Methods: The present cross-sectional project will include YCS between 15 to 39 years from Germany, Greece, Italy, Portugal, Spain, and Sweden. Sociodemographic aspects and disease history will be collected. The International Physical Activity Questionnaire and The International Fitness Scale will be applied to assess physical activity and sedentary levels; and self-reported fitness, respectively. The questionnaire on adherence to the Mediterranean diet will evaluate healthy diet habits, and a short set of questions will cover the environmental quality of residence of the participants, as well as their outdoor habits. In addition, the EQ‐5D‐5L instrument will measure health-related quality of life, and the Hospital Anxiety and Depression Scale will collect depression and anxiety symptoms.

Results: It is hypothesised that positive lifestyle behaviours, such as increasing physical activity and following balanced nutrition, may correlate with improved mental well-being and quality of life in YCS. These findings have the potential to deepen our understanding of the intricate interplay between cancer, lifestyle and mental health

Background: The Serious Illness Care Programme was developed to promote more, better and earlier serious illness conversations. Conversations about goals and values are associated with improved experiences and outcomes for seriously ill patients. Clinicians’ attitudes and beliefs are thought to influence the uptake and performance of serious illness conversations, yet little is known about how clinicians perceive the impact of these conversations on patients. This study aimed to explore physicians’ perceptions regarding the impact of serious illness conversations for patients.

Methods: The Serious Illness Care Programme was implemented as a quality improvement project in two hospitals in Southern Sweden. Focus group evaluation discussions were conducted with 14 physicians and inductive thematic analysis was undertaken.

Results: The results revealed that physicians considered potential perils and optimised potential payoffs for patients when engaging in serious illness conversations. Potential perils encompassed inappropriate timing, damaging emotions and shattering hopes. Potential payoffs included reflection time, secure space, and united understandings.

Conclusions: Physicians depicted a balance in evaluating the perils and payoffs of serious illness conversations for patients and recognised the interrelation of these possibilities through continual assessment and adjustment.