{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:14:32Z","timestamp":1793222072863,"version":"4.5.0"},"reference-count":45,"publisher":"BMJ","issue":"8","funder":[{"name":"TrygFonden Denmark"},{"DOI":"10.13039\/501100009708","name":"The Novo Nordisk Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008363","name":"The Danish Cancer Society","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,7,5]]},"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore physically inactive breast and colon cancer patients\u2019 prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An explorative qualitative study guided the interpretive analysis of semistructured, open-ended interviews conducted at initiation of chemotherapy and after 12 weeks. The study was embedded in a pilot randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Participants were recruited from the Oncological Department at a hospital in Copenhagen, Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>33 patients with cancer, median age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist\u2019s PA recommendation and exercise, cancer nurse specialist\u2019s counselling prior to allocation to PA interventions or waitlist control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prediagnosis exercise had been excluded from patients\u2019 daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients to reconsider their attitudes and behaviour by accepting recruitment and participation in PA interventions during chemotherapy. Despite extensive side effects, most patients adhered to their PA commitment due to their perception of the bodily, emotional and social benefits and support of healthcare professionals, peers and family.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The patients\u2019 attitude towards exercise transformed from having no priority in patients\u2019 daily lives prediagnosis to being highly prioritised. This study identified four important phases in the exercise transformation process during the patients\u2019 treatment trajectory of relevance to clinicians in identifying, motivating and supporting physically inactive patients with cancer at long-term risk. Clinicians should address young, highly educated patients with cancer at onset of adjuvant chemotherapy due to their specific risk of a sedentary lifestyle resulting from being in stressful, ambitious careers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      Current Controlled Trials (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"ISRCTN24901641\" ext-link-type=\"isrctn\" specific-use=\"clinicaltrial results\">ISRCTN24901641<\/jats:ext-link>\n                      ), Stage: Qualitative results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-016689","type":"journal-article","created":{"date-parts":[[2018,12,11]],"date-time":"2018-12-11T12:02:07Z","timestamp":1544529727000},"page":"e016689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Rethinking exercise identity: a qualitative study of physically inactive cancer patients\u2019 transforming process while undergoing chemotherapy"],"prefix":"10.1136","volume":"7","clinical-trial-number":[{"clinical-trial-number":"isrctn24901641","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn24901641","registry":"10.18810\/isrctn","type":"results"}],"author":[{"given":"Lis","family":"Adamsen","sequence":"first","affiliation":[{"name":"The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark"},{"name":"Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Andersen","sequence":"additional","affiliation":[{"name":"The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Lillelund","sequence":"additional","affiliation":[{"name":"The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira","family":"Bloomquist","sequence":"additional","affiliation":[{"name":"The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Department 9701, Copenhagen, Denmark"},{"name":"Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,8,23]]},"reference":[{"key":"2025121603193255000_7.8.e016689.1","unstructured":"The Danish Health Data Authority. Cancer Incidence in Denmark: Danish cancer registry 2015. Copenhagen The Danish Health Data Authority; 2016."},{"key":"2025121603193255000_7.8.e016689.2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181e0c112"},{"key":"2025121603193255000_7.8.e016689.3","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12015"},{"key":"2025121603193255000_7.8.e016689.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e70","article-title":"Physical activity for cancer survivors: meta-analysis of randomised controlled trials","volume":"344","author":"Fong","year":"2012","journal-title":"BMJ"},{"key":"2025121603193255000_7.8.e016689.5","article-title":"Exercise for women receiving adjuvant therapy for breast cancer","volume":"9","author":"Furmaniak","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121603193255000_7.8.e016689.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.20.2479"},{"key":"2025121603193255000_7.8.e016689.7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.0855"},{"key":"2025121603193255000_7.8.e016689.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61031-9"},{"key":"2025121603193255000_7.8.e016689.9","article-title":"Interventions for promoting habitual exercise in people living with and beyond cancer","volume":"9","author":"Bourke","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121603193255000_7.8.e016689.10","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-005-2418-9"},{"key":"2025121603193255000_7.8.e016689.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.06.037"},{"key":"2025121603193255000_7.8.e016689.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2010.10.002"},{"key":"2025121603193255000_7.8.e016689.13","doi-asserted-by":"publisher","DOI":"10.1097\/01.NCC.0000270707.80037.4c"},{"key":"2025121603193255000_7.8.e016689.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-6787.2011.00214.x"},{"key":"2025121603193255000_7.8.e016689.15","doi-asserted-by":"publisher","DOI":"10.1089\/acm.1997.3.215"},{"key":"2025121603193255000_7.8.e016689.16","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1080\/0284186X.2016.1275776","article-title":"Self-reported physical activity behavior of breast cancer survivors during and after adjuvant therapy: 12 months follow-up of two randomized exercise intervention trials","volume":"56","author":"Schmidt","year":"2017","journal-title":"Acta Oncol"},{"key":"2025121603193255000_7.8.e016689.17","unstructured":"WHO. Global recommendations on physical activity for health. Geneva: World Health Organization, 2010."},{"key":"2025121603193255000_7.8.e016689.18","unstructured":"DHMA. Physical activity: recommendations for adults (18\u201364 years old). Copenhagen Danish Health and Medicines Authority; 2014. http:\/\/www.sst.dk\/English\/Health_promotion\/Physical_activity\/Recommendations_for_adults.aspx (accessed May 6 2015)."},{"key":"2025121603193255000_7.8.e016689.19","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.750"},{"key":"2025121603193255000_7.8.e016689.20","doi-asserted-by":"crossref","first-page":"720","DOI":"10.3109\/0284186X.2014.997836","article-title":"Social position and referral to rehabilitation among cancer patients","volume":"54","author":"Moustsen","year":"2015","journal-title":"Acta Oncol"},{"key":"2025121603193255000_7.8.e016689.21","doi-asserted-by":"publisher","DOI":"10.1093\/her\/cyl159"},{"key":"2025121603193255000_7.8.e016689.22","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.ejon.2010.01.027","article-title":"Women\u2019s perceptions of home-based exercise performed during adjuvant chemotherapy for breast cancer","volume":"14","author":"Ingram","year":"2010","journal-title":"Eur J Oncol Nurs"},{"key":"2025121603193255000_7.8.e016689.23","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1188\/10.ONF.321-330","article-title":"Physical activity in women receiving chemotherapy for breast cancer: adherence to a walking intervention","volume":"37","author":"Swenson","year":"2010","journal-title":"Oncol Nurs Forum"},{"issue":"3-4","key":"2025121603193255000_7.8.e016689.24","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/jocn.12633","article-title":"Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study","volume":"24","author":"Huseb\u00f8","year":"2015","journal-title":"J Clin Nurs"},{"key":"2025121603193255000_7.8.e016689.25","doi-asserted-by":"crossref","first-page":"609","DOI":"10.3109\/0284186X.2014.995777","article-title":"Cancer survivors\u2019 experience of exercise-based cancer rehabilitation - a meta-synthesis of qualitative research","volume":"54","author":"Midtgaard","year":"2015","journal-title":"Acta Oncol"},{"key":"2025121603193255000_7.8.e016689.26","doi-asserted-by":"crossref","unstructured":"Browall M , Mijwel S , Rundqvist H , et al . Physical activity during and after adjuvant treatment for breast cancer. Integr Cancer Ther 2016 (Epub ahead of print).doi:10.1177\/1534735416683807","DOI":"10.1177\/1534735416683807"},{"key":"2025121603193255000_7.8.e016689.27","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1016\/j.pec.2016.01.019","article-title":"Perceived barriers to and facilitators of being physically active during adjuvant cancer treatment","volume":"99","author":"Henriksson","year":"2016","journal-title":"Patient Educ Couns"},{"key":"2025121603193255000_7.8.e016689.28","unstructured":"Smith JA , Flowers P , Larkin M . Interpretative phenomenological analysis: theory, method and research. Los Angeles: SAGE, 2009."},{"key":"2025121603193255000_7.8.e016689.29","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2025121603193255000_7.8.e016689.30","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-003556","article-title":"At cancer diagnosis: a \u2018window of opportunity\u2019 for behavioural change towards physical activity. A randomised feasibility study in patients with colon and breast cancer","volume":"3","author":"M\u00f8ller","year":"2013","journal-title":"BMJ Open"},{"key":"2025121603193255000_7.8.e016689.31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjsem-2015-000021","article-title":"The challenge of preserving cardiorespiratory fitness in physically inactive patients with colon or breast cancer during adjuvant chemotherapy: a randomised feasibility study","volume":"1","author":"M\u00f8ller","year":"2015","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2025121603193255000_7.8.e016689.32","doi-asserted-by":"publisher","DOI":"10.1177\/1403494809352105"},{"key":"2025121603193255000_7.8.e016689.33","unstructured":"Flachs EM , Eriksen L , Koch MB , et al . The burden of disease in Denmark: diseases Vol. 382. Copenhagen: Danish Health Authority, 2015."},{"key":"2025121603193255000_7.8.e016689.34","unstructured":"Ekholm O , Kj\u00f8ller M , Davidsen M , et al . Health and morbidity in Denmark - development since 1987 Vol. 307. Copenhagen: National Institute of Public Health, 2006."},{"key":"2025121603193255000_7.8.e016689.35","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1002\/cncr.29786","article-title":"Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer","volume":"122","author":"Nyrop","year":"2016","journal-title":"Cancer"},{"key":"2025121603193255000_7.8.e016689.36","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.01.230"},{"key":"2025121603193255000_7.8.e016689.37","doi-asserted-by":"publisher","DOI":"10.1093\/her\/18.2.156"},{"key":"2025121603193255000_7.8.e016689.38","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29400"},{"key":"2025121603193255000_7.8.e016689.39","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/NCC.0b013e3181cdce2c","article-title":"Self-reported exercise during breast cancer treatment: results of a national survey","volume":"33","author":"Bernardo","year":"2010","journal-title":"Cancer Nurs"},{"key":"2025121603193255000_7.8.e016689.40","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1600-0838.2007.00767.x","article-title":"Struggling with cancer and treatment: young athletes recapture body control and identity through exercise: qualitative findings from a supervised group exercise program in cancer patients of mixed gender undergoing chemotherapy","volume":"19","author":"Adamsen","year":"2009","journal-title":"Scand J Med Sci Sports"},{"key":"2025121603193255000_7.8.e016689.41","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1123\/jpah.5.5.688","article-title":"Factors associated with exercise counseling and program preferences among breast cancer survivors","volume":"5","author":"Rogers","year":"2008","journal-title":"J Phys Act Health"},{"key":"2025121603193255000_7.8.e016689.42","first-page":"653","article-title":"Exercise despite pain--breast cancer patient experiences of muscle and joint pain during adjuvant chemotherapy and concurrent participation in an exercise intervention","volume":"23","author":"Andersen","year":"2014","journal-title":"Eur J Cancer Care"},{"key":"2025121603193255000_7.8.e016689.43","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1080\/03630242.2012.725707","article-title":"Women\u2019s perceived benefits of exercise during and after breast cancer treatment","volume":"52","author":"Bulmer","year":"2012","journal-title":"Women Health"},{"key":"2025121603193255000_7.8.e016689.44","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0b013e318236a3b3"},{"key":"2025121603193255000_7.8.e016689.45","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.1081"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-016689","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:19:41Z","timestamp":1765883981000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-016689"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":45,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2017,8,23]]},"published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1136\/bmjopen-2017-016689"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-016689","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}