Understanding physical activity behavior in patients with bladder cancer before and after radical surgery: A qualitative interview study

Introduction Physical activity interventions for patientswith bladder cancer undergoing radical cystectomy have a positive impact on their preoperative status and postoperative recovery. However, before setting up such interventions, it is important to understand the underlying reasons (i.e. determinants) of the patient to participate and adhere in physical activity interventions. Objectives This qualitative study aimed to explore the determinants of physical activity in bladder cancer patients before and after radical cystectomy. Methods A qualitative interview study was conducted using a semi-structured interview guide. At Ghent University Hospital, thirty interviews were carried out with bladder cancer patients who underwent radical cystectomy. The interviews were audio-taped and transcribed verbatim. Framework analysis was used to analyze the data. Constant comparison between and within interviews was applied until final topics were derived from interpreting the data. Results Physical activity behavior in patients with bladder cancer is determined multifactorial with condition-related (e.g. urinary symptoms, comorbidities), therapy-related (e.g. fatigue, diarrhea), patient-related (e.g. outcome expectations, coping skills, definitions of PA), social/economic related (e.g. social support, attractive environment), and health system related factors (e.g. physicians' advice, information). A detailed overview of the determinants is shown in figure 1. Conclusions This qualitative study gives insight into the factors influencing physical activity behavior in bladder cancer patients undergoing radical cystectomy.The results of this study can guide the development of theory-based behavior change interventions to increase physical activity in bladder cancer patients.