Using Motivational Interviewing With Parents in Encouraging Their Children With Cancer to Adopt and Maintain Regular Physical Activity

Despite the mortality rates among cancer patients have been greatly reduced as a result of medical advances in cancer screening and treatment in recent decades, cancer itself and the adverse effects of treatment are still threatening to young cancer patients, with vast destruction in both physical and psychological aspects. In particular, cancer-related fatigue is the most commonly reported symptom among children with cancer and its effect is long-lasting, remaining for years after treatment. Childhood cancer patients undergo chemotherapy and/or radiotherapy that impairs their normal body tissue and fitness. Consequently, cardiorespiratory function and muscle strength decrease, and fatigue is inevitable. More importantly, these complications do not disappear, but continue for months or even years after completion of therapy. All these adverse effects clearly exert both short-term and long-term effects on children and adolescents, severely decreasing their quality of life.

Increasing concern has been placed on the benefits of regular physical activity among young cancer patients to improve cardiovascular fitness, ameliorate fatigue, and reduce some of the adverse effects of cancer and its treatment, including obesity, and osteoporosis. Various studies have shown improvements in quality of life among young patients undergoing cancer treatment by performing regular physical activity. However, the literature review found that most young cancer patients maintain a lower level of physical activity than before their diagnosis.

In a cross-sectional study to examine the physical activity levels and factors that affect their regular physical activity of Hong Kong Chinese childhood cancer survivors, the results revealed a significant decline in physical activity levels in childhood cancer survivors compared with their premorbid situation. In particular, an increasing number of cancer survivors took part in light-intensity activities, whereas a decreasing number of them participated in moderate to vigorous activity.

Another recent study revealed that the current physical activity levels of Hong Kong young cancer patients were markedly reduced when compared with their pre-morbid situation.The amount of time spent in high-intensity activity declined dramatically from 30.3% before diagnosis to only 1.3% during treatment. Moreover, they were significantly less active in performing physical exercise, and reported lower levels of quality of life than their healthy counterparts. These findings reveal a crucial obligation of health care professionals to advocate the significance of regular physical activity among young cancer patients.

There are some reasons to explain why Hong Kong Chinese children undergoing cancer treatment and childhood cancer survivors reported low physical activity levels. Similar to reports in the Western literature, to avoid cancer- or treatment-related fatigue, children are often advised by their parents or even healthcare professionals to take more rest and to reduce their amount of physical activity. In particular, the philosophy of Confucianism focuses on restoring harmony in our bodies to attain health, and this is strongly ingrained in the Hong Kong Chinese population. In this cultural context, cancer and other diseases are regarded as destroying harmony, whereas physical inactivity or rest restore harmony. As a result, childhood cancer patients and survivors are always resting, and they reduce vigorous activities as advised by their parents.