Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Exercise motivation in men with prostate cancer receiving ADT: a theory-driven qualitative approach (#439)

Jasmine Yee 1 2 , Harriet Naismith 1 , Gabrielle Blomson 2 , Kristen Bartel 1 , Renée Bultijnck 1 3 , Julia Hunter 4 , Thilo Schuler 4 , Gabrielle Metz 4 , Patrick Horsley 4 , Lisa Parker 4 , Claire King 4 , George Hruby 4 , Thomas Eade 4 , Andrew Kneebone 4 , Haryana Dhillon 1 5 , Rachel Campbell 1
  1. CeMPED, School of Psychology, The University of Sydney, Campderdown, NSW, Australia
  2. Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
  3. Department of Human Structure and Repair, Ghent University, Ghent, East Flanders, Belgium
  4. Department of Radiation Oncology, Northern Sydney Cancer Centre, St Leonards, NSW, Australia
  5. Psycho-Oncology Cooperative Research Group (PoCoG), School of Psychology, The University of Sydney, Campderdown, NSW, Australia

Aims: Androgen deprivation therapy (ADT) is associated with side effects deleterious to quality of life. Whilst exercise is an effective strategy to improve fatigue and other treatment-related symptoms, few men with prostate cancer engage in sufficient levels of exercise. Lack of motivation presents a key barrier to exercise participation. Self-Determination Theory (SDT) specifies the quality, rather than quantity, of motivation as essential for optimal engagement in health behaviours. We aimed to explore what motivates engagement with exercise in men on ADT through the theoretical lens of SDT.

Methods: We conducted a qualitative study with men receiving ADT for prostate cancer through the Radiation Oncology Clinic, Northern Sydney Cancer Centre. Men participated in semi-structured interviews exploring topics related to exercise behaviour and perceptions. Interviews were transcribed and exercise motivation themes identified and analysed according to SDT concepts until data saturation.

Results: Twenty-four men, median age 74y (range 45-88y; ECOG 0: 92%, metastatic: 26%) participated. Three exercise motivation themes were identified: 1) type of motivation; 2) psychological needs fostering motivation; and, 3) motivational strategies supporting psychological needs. Types of exercise motivation varied between men and included intrinsic motivation (for enjoyment) and external motivation (for anticipated benefits, out of guilt or to comply with other’s demands). Techniques to improve psychological need satisfaction include providing choice over exercise programming (home vs gym), healthcare providers communicating reasons exercise is important, structured and tailored guidance by exercise professionals, and support for exercise by family and friends.

Conclusions: Grounded in SDT, our results provide novel insights into why men with prostate cancer are motivated to exercise and how social and healthcare contexts influence motivation. These findings highlight the importance of considering exercise motivation when discussing, referring, and designing tailored exercise interventions for men with prostate cancer to facilitate psychological need-supportive strategies to optimise exercise engagement.