ABSTRACT
BACKGROUND: Two prevalent unmet supportive care needs reported by the non-small cell lung cancer (NSCLC) population include the need to manage fatigue and attain adequate exercise to meet the physical demands of daily living. Yet, there are no guidelines for routine rehabilitative support to address fatigue and exercise for persons with NSCLC during the critical transition from hospital to home after thoracotomy. OBJECTIVE: The objective of this study was to evaluate the feasibility, acceptability, safety, and changes in study end points of a home-based exercise intervention to enhance perceived self-efficacy for cancer-related fatigue (CRF) self-management for persons after thoracotomy for NSCLC transitioning from hospital to home. INTERVENTIONS/METHODS: Guided by the principles of the Transitional Care Model and the Theory of Symptom Self-management, a single-arm design composed of 7 participants with early-stage NSCLC performed light-intensity walking and balance exercises in a virtual reality environment with the Nintendo Wii Fit Plus. Exercise started the first week after hospitalization for thoracotomy and continued for 6 weeks. RESULTS: The intervention positively impacted end points such as CRF severity; perceived self-efficacy for fatigue self-management, walking, and balance; CRF self-management behaviors (walking and balance exercises); and functional performance (number of steps taken per day). CONCLUSIONS: A home-based, light-intensity exercise intervention for patients after thoracotomy for NSCLC is feasible, safe, well tolerated, and highly acceptable showing positive changes in CRF self-management. IMPLICATIONS FOR PRACTICE: Beginning evidence suggests that a light-intensity in-home walking and balance intervention after hospitalization for thoracotomy for NSCLC is a potentially effective rehabilitative CRF self-management intervention. Next steps include testing of this health-promoting self-management intervention in a larger-scale randomized controlled trial.
Subject(s)
Carcinoma, Non-Small-Cell Lung/nursing , Exercise Therapy/nursing , Fatigue/nursing , Lung Neoplasms/nursing , Postoperative Care/nursing , Self Care , Thoracotomy/nursing , Aged , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/therapy , Fatigue/etiology , Fatigue/therapy , Feasibility Studies , Female , Humans , Lung Neoplasms/complications , Lung Neoplasms/therapy , Male , Middle Aged , Patient Selection , Quality of Life , Self Care/methods , Surveys and Questionnaires , Time Factors , Treatment Outcome , WalkingABSTRACT
This research examined the effects of instructional set on Internet use by low-income adults during a 16-month longitudinal study. Participants (n = 117) received instructions that focused on either the Internet's communication tools or its information tools. Internet use was continuously and automatically recorded. Survey measures of computer and Internet experiences, affect and attitudes were obtained to examine their mediational role in the relationship between instructional set and Internet use. Results indicated that instructions focused on the Internet's information tools led to greater Internet use than instructions focused on its communication tools or only basic instructions about how to use the Internet. Implications for reducing the digital divide are discussed.
