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Year : 2021  |  Volume : 4  |  Issue : 1  |  Page : 88-92

Do oncology nurses have sufficient knowledge of exercise oncology? A mini narrative review

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, Italy

Date of Submission09-Oct-2020
Date of Decision04-Feb-2021
Date of Acceptance04-Feb-2021
Date of Web Publication26-Mar-2021

Correspondence Address:
Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/crst.crst_315_20

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There is a need to broaden the knowledge of oncology nurses about exercise prescription and recommendations for the improvement of quality of life and physical and mental health of patients with cancer and survivors. In addition, oncology nurses need to have comprehensive knowledge regarding the physiological mechanisms underlying these improvements. Through this mini review, we aimed to describe the level of expertise of nurses in the field of exercise oncology and identify appropriate solutions to improve this knowledge. Articles concerning exercise and oncology nursing practices published between January 1996 and September 2020 were searched in the PubMed electronic database; relevant articles were selected, full-text articles were assessed, and important information was extracted. A standard exercise oncology curriculum needs to be developed and implemented for oncology nursing practitioners and those training in oncology nursing. Oncology nurses should be trained in exercise oncology, rehabilitation, and exercise prescription and follow-up. This could boost the rate of adherence to self-managed/home-based exercise routine among cancer survivors.

Keywords: Cancer care, exercise promotion, oncology nursing, oncology, exercise

How to cite this article:
Okechukwu CE. Do oncology nurses have sufficient knowledge of exercise oncology? A mini narrative review. Cancer Res Stat Treat 2021;4:88-92

How to cite this URL:
Okechukwu CE. Do oncology nurses have sufficient knowledge of exercise oncology? A mini narrative review. Cancer Res Stat Treat [serial online] 2021 [cited 2021 Jun 24];4:88-92. Available from: https://www.crstonline.com/text.asp?2021/4/1/88/312081

  Introduction Top

Over the last few years, the awareness regarding the effectiveness of exercise therapy in improving the physical and mental health of cancer survivors has increased.[1] However, there is still a need to expand the knowledge among oncology nurses about exercise prescription and recommendations for the improvement of quality of life (QOL) and physical and mental health of patients with cancer and survivors. There is also a need to improve their understanding of the physiological mechanisms underlying these beneficial effects of exercise therapy.[2] Australasian oncology nurses give their patients exercise advice and promote exercise before, during, and after cancer treatment; the positive outcome of this counseling is an enhanced QOL, mental health, and physical fitness among patients with cancer and survivors under their care.[3] Absenteeism, lack of appropriate facilities, and risk to patients are some of the notable barriers to physical activity among cancer survivors.[3] However, despite these barriers, Australasian oncology nurses frequently promote active living among patients with cancer during various phases of treatment because they believe that exercise is beneficial for these patients.[3] Cancer clinics should assist oncology nurses in promoting physical activity among their patients and to maintain an effective collaboration with clinical exercise physiologists and physiotherapists.[3]

Nearly half of the Dutch oncology nurses offering guidance on nutrition and exercise recognized themselves as having insufficient knowledge to be able to offer advice on exercise.[4] Oncology nurses participating in regular professional training could immensely benefit from advanced courses in exercise oncology and palliative care in oncology.[4] Therefore, professional training for oncology nurses should include physical activity interventions and rehabilitation for patients with cancer. Oncology nurses should collaborate with physiotherapists and exercise oncologists to deliberate on the ideal exercise regimen that can be tailored and prescribed for cancer survivors based on their individual health status, functional capacity, and preferences.[4] Moreover, there is a need to utilize the e-learning platforms and effective didactic methods for educating oncology nurses in the assessment of physical activity levels, lifestyle counseling, and exercise recommendation in cancer care.[5]

Experts in clinical nursing working in breast, prostate, and colorectal cancer treatment units in the United Kingdom are experienced in the areas of physical activity and health promotion, especially in the use of physical activity promoting applications in cancer care.[6] Clinical nurse leaders working in oncology centers in the United States of America also have comprehensive knowledge and skills in the management of cancer-related fatigue and in designing evidence-based interventions to treat fatigue in patients with cancer; these interventions include adapting and evaluating tailored exercise strategies for patients with cancer.[7]

Several German oncology nurses have revealed that they were hindered from promoting physical activity among patients with cancer because of the lack of structural support and expertise in the field.[8] Online learning platforms could be utilized for training oncology nurses in exercise oncology. Online modules might be effective in improving the knowledge of the nurses in promotion of health, prevention of cancer-related fatigue and cognitive impairment with the help of physical activity, and improvement in the health-related QOL as well as in the general assessment skills in exercise oncology for patients with cancer.[9] Through this review, we aimed to assess the level of knowledge of exercise oncology among oncology nurses.

  Methods Top

The PubMed electronic database was searched for articles concerning exercise and oncology nursing practice published between January 1996 and September 2020 using the following MeSH terms: “Exercise promotion” OR “oncology nurses” OR “cancer care” OR “health promotion.” Relevant articles were selected, full-text articles were assessed, and important information was extracted. Articles published in languages other than English were excluded. A total of 19 studies were included in this review. The selection process for articles is outlined in [Figure 1].
Figure 1: Preferred Reporting Items for Systematic Reviews and meta-analyses flow diagram for the selection of articles in PubMed database

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  Implementing Exercise Oncology Courses in Oncology Nursing Training and Practice Top

There is a need for the implementation of advanced training courses in exercise oncology for oncology nurses, encompassing exercise recommendation and follow up during cancer treatment.[10] Moreover, oncology nurses should endeavor to advance their expertise in the guidelines and safety of exercise recommendations for patients with cancer; they are also required to use their knowledge in clinical and exercise oncology concomitantly to endorse and promote physical activity regimens as a part of the treatment plan for patients with cancer.[11] Informative and educational programs are required to ensure that nurses undergoing specialized training in oncology and oncology nurse practitioners are familiar with the clinical importance of exercise therapy tailored to their patients' needs before, during, and after active cancer treatments and the need to encourage patients with cancer to adhere to their exercise routine.[12] To actualize this goal, a standard exercise oncology curriculum should be developed, drafted, and implemented in the oncology nursing specialization programs and training courses.[13] Through specialized courses in exercise oncology, oncology nurses could get trained in collaborative strategies, clinical instrumentations in cancer rehabilitation, and individualization of physical exercise in patients with cancer.[13]

  Discussion Top

Oncology nurses play a unique role in the health-care team for cancer prevention and treatment. They can educate, care for, and support their patients during chemotherapy, radiotherapy, prerehabilitation, and postoperative recovery. An exercise informatics intervention directed by nurses was found to be safe and effective in improving the health-related QOL, reducing cancer-related symptoms, and improving the nutritional status and cardiopulmonary fitness among patients with cancer. This demonstrates the importance of enhancing oncology nurses' knowledge in exercise oncology for effective health-care delivery.[14] It is important for oncology nurses to be able to recognize new challenges and developments in cancer treatment and research, especially in the area of exercise oncology. This will enable oncology nurses to play a significant role in designing and implementing effective strategies to deliver exercise interventions to cancer survivors in hospitals and community-based settings.[15] Maintaining an exercise routine is important for improving the QOL and decreasing the treatment-induced cardiovascular toxicity, cognitive decline, and fatigue among cancer survivors. Many patients with cancer are not physically active, and hence, do not meet the physical activity guidelines. Such patients need the advice and support of oncology nurses to adhere to these guidelines. For professional and safety reasons, individualized exercise therapy should be tailored, prescribed, and supervised by a team comprising cardiologists, certified clinical exercise physiologists, and physiotherapists. However, oncology nurses could ensure that cancer survivors continue their home-based exercise regimen/self-managed exercise routine through tele-health platforms, telephone calls, and feedback.[16] There is a need to implement hospital-based exercise-oncology programs in order to improve the QOL and the physical and mental health of patients with cancer [Table 1].
Table 1: Effectiveness of hospital-based exercise oncology programs

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  Conclusion Top

Many oncology nurses have insufficient knowledge regarding exercise assessment and recommendation for the management of cancer. Therefore, oncology nurses should be trained in exercise oncology and rehabilitation as well as in exercise prescription and follow-up. This could boost the adherence to self-managed/home-based exercise routine among cancer survivors, thereby improving their overall well-being and fitness. Oncology nurses with a good knowledge of exercise oncology can ensure that the patients adhere to their personalized exercise routine through constant communication using tele-health platforms or through telephone calls. However, to actualize this goal, a standard exercise oncology curriculum should be developed and implemented for oncology nursing practitioners and for those training in oncology nursing.[19]

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Conflicts of interest

There are no conflicts of interest.

  References Top

Jones LW, Alfano CM. Exercise-oncology research: Past, present, and future. Acta Oncol 2013;52:195-215.  Back to cited text no. 1
Karvinen KH, McGourty S, Parent T, Walker PR. Physical activity promotion among oncology nurses. Cancer Nurs 2012;35:E41-8.  Back to cited text no. 2
Keogh JW, Pühringer P, Olsen A, Sargeant S, Jones LM, Climstein M. Physical activity promotion, beliefs, and barriers among Australasian oncology nurses. Oncol Nurs Forum 2017;44:235-45.  Back to cited text no. 3
van Veen MR, Hoedjes M, Versteegen JJ, van de Meulengraaf-Wilhelm N, Kampman E, Beijer S. Improving oncology nurses' knowledge about nutrition and physical activity for cancer survivors. Oncol Nurs Forum 2017;44:488-96.  Back to cited text no. 4
Cantwell M, Walsh D, Furlong B, Moyna N, McCaffrey N, Boran L, et al. Healthcare professionals' knowledge and practice of physical activity promotion in cancer care: Challenges and solutions. Eur J Cancer Care (Engl) 2018;27:e12795.  Back to cited text no. 5
Roberts AL, Potts HW, Stevens C, Lally P, Smith L, Fisher A. Cancer specialist nurses' perspectives of physical activity promotion and the potential role of physical activity apps in cancer care. J Cancer Surviv 2019;13:815-28.  Back to cited text no. 6
McGowan K. Physical exercise and cancer-related fatigue in hospitalized patients: Role of the clinical nurse leader in implementation of interventions. Clin J Oncol Nurs 2016;20:E20-7.  Back to cited text no. 7
Haussmann A, Ungar N, Gabrian M, Tsiouris A, Sieverding M, Wiskemann J, et al. Are healthcare professionals being left in the lurch? The role of structural barriers and information resources to promote physical activity to cancer patients. Support Care Cancer 2018;26:4087-96.  Back to cited text no. 8
Karvinen KH, Balneaves L, Courneya KS, Perry B, Truant T, Vallance J. Evaluation of online learning modules for improving physical activity counseling skills, practices, and knowledge of oncology nurses. Oncol Nurs Forum 2017;44:729-38.  Back to cited text no. 9
O'Hanlon E, Kennedy N. Exercise in cancer care in Ireland: A survey of oncology nurses and physiotherapists. Eur J Cancer Care (Engl) 2014;23:630-9.  Back to cited text no. 10
Smith SL. Physical exercise as an oncology nursing intervention to enhance quality of life. Oncol Nurs Forum 1996;23:771-8.  Back to cited text no. 11
Schmitz KH, Campbell AM, Stuiver MM, Pinto BM, Schwartz AL, Morris GS, et al. Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. CA Cancer J Clin 2019;69:468-84.  Back to cited text no. 12
Dalzell MA, Smirnow N, Sateren W, Sintharaphone A, Ibrahim M, Mastroianni L, et al. Rehabilitation and exercise oncology program: Translating research into a model of care. Curr Oncol 2017;24:e191-8.  Back to cited text no. 13
Chang YL, Tsai YF, Hsu CL, Chao YK, Hsu CC, Lin KC. The effectiveness of a nurse-led exercise and health education informatics program on exercise capacity and quality of life among cancer survivors after esophagectomy: A randomized controlled trial. Int J Nurs Stud 2020;101:103418.  Back to cited text no. 14
Basen-Engquist K, Parker NH. Making exercise standard in cancer care. In: Schmitz K, editors. Exercise Oncology. Cham: Springer; 2020. p. 369-87.  Back to cited text no. 15
Cormie P, Atkinson M, Bucci L, Cust A, Eakin E, Hayes S, et al. Clinical oncology society of Australia position statement on exercise in cancer care. Med J Aust 2018;209:184-7.  Back to cited text no. 16
Santa Mina D, Au D, Auger LE, Alibhai SM, Matthew AG, Sabiston CM, et al. Development, implementation, and effects of a cancer center's exercise-oncology program. Cancer 2019;125:3437-47.  Back to cited text no. 17
Stevinson C, Fox KR. Role of exercise for cancer rehabilitation in UK hospitals: A survey of oncology nurses. Eur J Cancer Care (Engl) 2005;14:63-9.  Back to cited text no. 18
Lanni TB, Brown E, Kuwajerwala N, Stromberg J, Gustafson G, Wood R, et al. Implementation of an oncology exercise and wellness rehabilitation program to enhance survivorship: The Beaumont health system experience. J Community Support Oncol 2014;12:87-91.  Back to cited text no. 19


  [Figure 1]

  [Table 1]


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