Physical activity for cancer survivors

One of the most relevant issues linked to chronic diseases is the lack of adherence. According to the World Health Organization (WHO), adherence is a person’s behavior concerning taking medication, following a diet, and making changes in lifestyle in accordance with a medical or non-medical health professional recommendations. There is no consensual standard for what constitutes adequate adherence to treatment. Some trials consider rates of greater than 80 percent to be acceptable, whereas others consider rates of greater than 95 percent to be mandatory for adequate adherence. There are many different methods to assess adherence to treatment (e.g. medication possession ratio (MPR), adherence rating scales). Each method has advantages and disadvantages, and no method is considered the gold standard. Independently on the considered rate or assessment method, patient’s non-adherence to therapy and to healthy lifestyle behaviors is a well-recognized barrier to well-being. Many factors impact a patient’s ability and willingness to follow health recommendations. The WHO has identified five dimensions: social/economic, therapy-related, patient-related, condition-related and health-care related services. All this factors need to be accounted for, in order to implement actions that will increase adherence rates. As good starting point, the shared medical decision-making model and the fulfilment of a social community for cancer patients and survivors are efficient applications. The benefits of these patients’ participations are firstly cognitive. Using the Theory of Goals approach, the possibility to take part to discussions and decisions facilitates patients’ and survivors’ cognitive process of defocusing from irrelevant goals and strengthening the health relevant goals. The goal (or “regulatory state” as intended by the ToG) is the representation to which the system tries to adequate the world toward action. In this perspective, goals serve a directive function: they direct attention and effort toward goal-relevant activities and away from goal-irrelevant activities. A co-participation in deciding and setting the goals will increases personal commitment in goal achievement. Moreover, It is crucial to build together patients’ and survivors’ goals (intentions, needs, desires) that are “felt” (not only “known”) by patients and survivors, leading them toward actions that can be followed and achieved, with a consequent increasing in self-esteem and optimism.