Factors promoting and impeding exercise behaviour in patients with colorectal cancer and comorbid diabetes during chemotherapy in Zhejiang, China: a qualitative study.

Abstract

To explore factors influencing exercise behaviour during chemotherapy in patients with colorectal cancer and comorbid diabetes, providing reference for developing management plans and clinical practice. This was a qualitative study using a descriptive phenomenological approach. Semi-structured interviews were conducted with a guide informed by existing literature on exercise behaviour in chronic disease populations; the Health Belief Model (HBM) served as a sensitising framework to ensure broad coverage of relevant experiential domains. Data were analysed using Colaizzi's seven-step phenomenological method, and the inductively derived themes were subsequently organised using the HBM as a post-hoc interpretive framework. Department of Medical Oncology, Zhongshan Hospital, Fudan University (Shanghai, China), in May and June 2023. 11 patients with colorectal cancer and comorbid diabetes undergoing chemotherapy. The mean age of the 11 patients was 58.09±7.70 years. The mean duration of colorectal cancer was 0.88±0.91 years, and the mean duration of diabetes was 9.24±7.75 years. Based on the HBM, three themes and six sub-themes were identified: Perceived Benefits of Exercise (physical benefits, psychosocial benefits), Perceived Barriers to Exercise (health status and chemotherapy-related side effects, psychological apprehension) and Cues to Action for Exercise (social support, professional guidance). Given the multifaceted challenges faced by patients with colorectal cancer and comorbid diabetes in exercise management, healthcare professionals should prioritise health education and diversify the formats of patient instruction. Providing effective social support and professional guidance may help address the identified barriers and facilitate exercise adherence during chemotherapy. However, as this is a small, single-centre qualitative study, the relationship between exercise adherence and long-term prognosis requires further investigation in larger, longitudinal studies.