Physical Activity and Posttraumatic Growth in Gynecologic Cancer Survivors

• Author / Creator

  Crawford, Jennifer J

• Background: Posttraumatic growth (i.e., positive psychological growth following a traumatic event) is a desired outcome of a cancer diagnosis, however, there is limited research examining interventions to foster experiences of growth. The benefits of physical activity for cancer survivors have been well documented and include improved physical functioning, symptom management, overall quality of life, decreased anxiety and depression, and possibly a lower risk of recurrence and longer survival. Few studies to date, however, have examined the potential role of physical activity in facilitating posttraumatic growth. Purpose: The purpose of my dissertation was to examine the potential role of physical activity in promoting posttraumatic growth in gynecologic cancer survivors. Methods: Study 1 was a population-based, mailed cross-sectional survey of 621 gynecologic cancer survivors diagnosed between 1986 and 2013 identified through the Alberta Cancer Registry. The survey consisted of measures of self-reported aerobic and resistance exercise, “adventure/extreme sport” participation, and posttraumatic growth. Study 2 examined the feasibility and preliminary efficacy of a wall climbing intervention in 35 gynecologic cancer survivors. The primary outcome was feasibility and the primary efficacy outcome was posttraumatic growth as assessed by the Posttraumatic Growth Inventory. Results: In paper 1 from Study 1, one third (32.9%) of gynecologic cancer survivors were meeting aerobic exercise guidelines and 19.0% were meeting strength exercise guidelines. Those meeting the combined exercise guidelines reported more favorable scores for the Posttraumatic Growth Inventory (p=0.014), the Negative Impact of Cancer Scale (p<.001) and several of its subscales compared to those meeting only one or neither guideline. In paper 2 from Study 1, 12.1% of gynecologic cancer survivors reported participating in extreme/adventure activities in the past year but 41.1% were interested in trying extreme/adventure activities. Moreover, neither participation nor interest in extreme/adventure activities was associated with posttraumatic growth; however, “exercise growth” (i.e., the extent to which GCS changed their physical activity after diagnosis) was significantly associated with all posttraumatic growth indicators (ps<.001). For Paper 3 from Study 1, correlates for participation and interest in extreme sport adventure activities were meeting the aerobic exercise guideline, better general health, having cervical or ovarian cancer, being employed, and being healthy weight. In paper 1 from Study 2, the Gynecologic Cancer Survivors Wall Climbing for Total Health (GROWTH) trial was feasible and resulted in significant improvement in objective health-related and functional fitness. Of the 512 GCS recruited to participate, 35 (7%) were randomized. The median adherence to the wall climbing intervention was 13.5/16 (84%) sessions. In paper 2 from Study 2, the GCS in the wall climbing intervention reported significantly higher posttraumatic growth in the areas of new possibilities and personal strength. Conclusions: Preliminary evidence suggests that exercise—especially if it is novel, challenging, and/or risky—may promote certain aspects of posttraumatic growth in gynecologic cancer survivors. Preliminary data suggests that wall climbing is feasible for gynecologic cancer survivors and may also lead to improvements in physical functioning and positive psychological health. Larger phase II and III trials are needed to confirm the type, volume, and intensity of exercise that may promote posttraumatic growth in gynecologic cancer survivors. Moreover, additional trials are warranted to determine the potential breadth of benefits that may result from a wall climbing intervention.

• Subjects / Keywords

  • Physical activity
  • Exercise
  • Oncology
  • Gynecologic cancer
  • Posttraumatic growth
  • Benefit finding

• Graduation date

  Fall 2016

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3XG9FK1Z

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.