Healthy behaviors are associated with positive outcomes for cancer survivors with ostomies: a cross-sectional study
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Healthy behaviors are associated with positive outcomes for cancer survivors with ostomies: a cross-sectional study Julia Mo 1 & Cynthia A. Thomson 2 & Virginia Sun 3 & Christopher S. Wendel 4 & Mark C. Hornbrook 5 & Ronald S. Weinstein 6 & Elizabeth Ercolano 7 & Marcia Grant 3 & Zuleyha Cidav 8 & Ruth C. McCorkle 7 & Robert S. Krouse 1 Received: 17 June 2020 / Accepted: 5 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Cancer survivors (CS) with ostomies may face challenges in sustaining physical activity (PA) levels and maintaining healthy diets. This analysis describes lifestyle behaviors and their relationships with health-related quality of life (HRQOL) in CS with ostomies. Methods This is a cross-sectional, secondary analysis of a multisite randomized self-management education trial for CS with ostomies. The baseline self-reported measures were queried on aerobic PA and diet using the City of Hope Quality of Life Ostomy measure, and the Self-Efficacy to Perform Self-Management Behaviors questionnaire (SE). PA was compared against the American Cancer Society PA guidelines for CS. Relationships between PA and HRQOL were evaluated using multiple linear regression, stratified by BMI. Results Among 200 responders, fewer than 20% met or exceeded the PA guideline for cancer survivors; overall, confidence in the ability to perform gentle or aerobic PA was moderate (6/10 on the SE). Overall HRQOL (p = 0.038), psychological wellbeing (p = 0.017), and physical strength (p = 0.025) were associated with increased PA. Almost half (48.7%) of CS reported a special diet. CS with urostomies were less likely to report diet adjustments after their ostomy surgeries (OR: 0.16, 95% CI [0.08– 0.38]) than CS with fecal ostomies. Conclusions Better HRQOL is associated with PA guideline achievement among CS with ostomies. Additionally, diet adjustments were reported more frequently in CS with fecal ostomies. Our findings bear clinical relevance for designing ostomy selfmanagement and lifestyle recommendations for CS with ostomies. Implications for Cancer Survivors The evaluation of lifestyle behaviors may be an especially important focus for CS with ostomies. Keywords Ostomy . Diet . Physical activity . HRQOL . Self-efficacy
Ruth C. McCorkle is deceased. This paper is dedicated to his memory. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11764-020-00940-5) contains supplementary material, which is available to authorized users. * Robert S. Krouse [email protected] 1
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Department of Surgery, University of Pennsylvania, 3400 Spruce St., 4 Silverstein, Philadelphia, PA 19104, USA Mel & Enid Zuckerman College of Public Health and University of Arizona Cancer Center, Tucson, AZ, USA Division of Nursing Research and Education, City of Hope, Duarte, CA, USA
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College of Medicine, University of Arizona, Tucson, AZ, USA
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Center for Health Research, Kaiser Permanente, Portland, OR, USA
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Arizona Telemedicine P
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