title: Experience of barriers and motivations for physical activities and exercise during treatment of pediatric patients with cancer.
abstract: BACKGROUND
  Due to growing evidence about the value of exercise in pediatric cancer patients, the purpose of this study was to determine factors that influence participation in physical activities and exercise in children and adolescents during treatment.
  
  
  METHODS
  This cross-sectional qualitative study included 40 pediatric cancer patients during intensive treatment. Patients were recruited at the Department for Pediatric Hematology and Oncology, University Hospital of Muenster where a supervised exercise program has been implemented for hospital stays. The qualitative approach included semi-structured guideline interviews, transcription and coding based on grounded theory. Four major topics were discussed in the interviews: (1) values and beliefs, (2) barriers to exercise, (3) motivations to exercise, and (4) encouragement from parents and physicians.
  
  
  RESULTS
  Patients reported mainly positive attitudes toward physical activities during treatment and the local exercise program was desired and valued as essential for engaging in exercise during in-patient stays. Identified barriers included physical, psychological, and organizational aspects. Motivational aspects were based on improvements in physical fitness and mental well-being. Parents' behavior related to physical activities of their children differed between being supportive, inhibiting, and inert. Few patients received information about exercise during treatment by their physicians.
  
  
  CONCLUSIONS
  Interventions that aim at maintaining physical activities during treatment and eliminating exercise barriers are required due to the patients' positive attitudes and multiple motivations toward exercise. These interventions need to be supervised and should include health-counseling programs for patients, parents, and physicians to underline the importance of physical activities in childhood cancer patients.
authors.affiliation: Department of Pediatric Hematology and Oncology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Götte
authors.forename: Sabine
authors.initials: S
authors.lastname: Kesting
authors.forename: Corinna
authors.initials: C
authors.lastname: Winter
authors.forename: Dieter
authors.initials: D
authors.lastname: Rosenbaum
authors.forename: Joachim
authors.initials: J
authors.lastname: Boos
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005069:Evaluation Studies as Topic; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009042:Motivation; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D011379:Prognosis; D055815:Young Adult
keywords: barriers; exercise; motivations; pediatric cancer patients; physical activity; qualitative study