title: Survivors speak: a qualitative analysis of motivational factors influencing breast cancer survivors' participation in a sprint distance triathlon.
abstract: OBJECTIVE
  To examine motivational factors influencing breast cancer survivors to participate in triathlon training, complete a triathlon and maintain an exercise thereafter.
  
  
  BACKGROUND
  Routine exercise has been shown to improve quality of life and reduce recurrence for breast cancer survivors. Yet physical and psychological factors present barriers for initiating and maintaining an exercise routine. Research is limited in exploring factors of exercise motivation from the survivor's perspective.
  
  
  METHODS
  Qualitative design using focus groups and individual follow-up phone interviews to explore motivation for exercise initiation and maintenance.
  
  
  METHODS
  One to two weeks after completing a triathlon, 11 breast cancer survivors who trained together participated in one of three focus groups to discuss their experience. Five months post triathlon 6 of the 11 participants were successfully contacted and phone interviews were conducted to explore exercise maintenance. Focus groups and interviews were analysed using content and thematic analysis.
  
  
  RESULTS
  Five themes emerged (1) Champion for Exercise, (2) Part of a Team, (3) Everyone Had a Story, (4) Not Really Exercise and (5) What Do We Do Now? Overall, survivors recognised their need for lifestyle change (e.g. moving from a sedentary lifestyle to a more active one). More importantly, they identified the team approach to exercise initiation was crucial in their success in sustaining a behavioural change.
  
  
  CONCLUSIONS
  Emphasis needed on developing team exercise training programmes for survivors. Nurses can play a critical role in discussing with survivors, the benefits of exercise initiation and maintenance.
  
  
  CONCLUSIONS
  Breast cancer survivors are hesitant to initiate routine exercise. Training with women who share a common lived experience increases the likelihood of success. Nurses are in a position to encourage breast cancer survivors to participate in group exercise programmes as a way to improve quality of life.
authors.affiliation: College of Nursing, Marquette University, Milwaukee, WI, USA.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Robinson
authors.affiliation: College of Nursing, Marquette University, Milwaukee, WI, USA.
authors.forename: Linda B
authors.initials: LB
authors.lastname: Piacentine
authors.affiliation: Department of Physical Therapy, Aurora Health Care, Milwaukee, WI, USA.
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Waltke
authors.affiliation: Department of Exercise Science, Marquette University, Milwaukee, WI, USA.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Ng
authors.affiliation: University of Wisconsin School of Medicine & Public Health, Surgical Breast Oncology, Aurora Research Institute, Aurora Health Care, Milwaukee, WI, USA.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Tjoe
mesh_terms: D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D017144:Focus Groups; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*
keywords: behavioural change; breast cancer; exercise; motivation; survivorship