title: The implementation of an oncologist referred, exercise self-management program for older breast cancer survivors.
abstract: BACKGROUND
  With increased breast cancer survivor rates among older women, the negative outcomes of breast cancer treatment may linger for years.
  
  
  METHODS
  We designed and implemented an oncologist referred, exercise self-management program to increase physical activity and health-related quality of life using a pretest-posttest, single group design. We recruited 34 breast cancer survivors seen for a follow-up oncology visit at two university cancer treatment centers. Women with a mean age of 59.6 years (S.D.=66) comprised the sample. Average time since diagnosed was 3.1 years; 45% had stage I breast cancer and 55% had stage II; 62% received chemotherapy and 59% received a mastectomy. Following a baseline assessment on exercise support, self-efficacy, barriers and benefits; quality of life; and a functional performance test, subjects participated in self-management classes and received telephone support. Participants (n=30) repeated the assessment at 6-months. We compared scores between time periods using t-tests.
  
  
  RESULTS
  Older women increased frequency of weekly, moderate physical activities (p<or=0.04), and weekly caloric expenditure (p<or=0.02). Perceived exercise barriers (p<or=0.02), aerobic endurance (p<0.04) and lower body strength (p<0.03) approached significance, and health-related quality of life (p<or=0.001) significantly improved.
  
  
  CONCLUSIONS
  An exercise self-management format referred by an oncologist is efficacious for implementing a lifestyle modification change among older breast cancer survivors.
authors.affiliation: Center of Excellence on Implementing Evidence Based Practice, HSRD, Roudebush VAMC, Indianapolis, IN 46202, USA. tdamush@iupui.edu
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Damush
authors.forename: Anthony
authors.initials: A
authors.lastname: Perkins
authors.forename: Kathy
authors.initials: K
authors.lastname: Miller
mesh_terms: D001943:Breast Neoplasms / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D007196:Indiana; D008875:Middle Aged; D011788:Quality of Life; D012017:Referral and Consultation; D012648:Self Care; D020377:Self Efficacy