Psychosocial health is associated with objectively assessed sedentary time and light intensity physical activity among lung cancer survivors
Introduction
Lung cancer is the leading cause of cancer death for both men and women in the United States. Five-year survival rates remain low and survival has not improved significantly despite newer therapies (Wang et al., 2015). Depression and anxiety are common comorbidities among individuals diagnosed with lung cancer. Recent population-based estimates indicating lung cancer survivors report among the highest levels of depression and anxiety compared to other cancer groups (Jensen et al., 2017).
A small body of literature indicates regular and sustained moderate to vigorous physical activity (MVPA) is associated with better patient reported outcomes such as health-related quality of life and reduced fatigue among lung cancer survivors (Coups et al., 2009). However these studies have relied on self-reported estimates of physical activity, which may have a substantial impact on observed levels of physical activity given self-reported assessment of activity may be prone to recall error and over-reporting (Ainsworth et al., 2012). Our previous research reported lung cancer survivors spend the majority of their waking hours in sedentary pursuits (D'Silva et al., 2017) [behaviours that are performed in a seated or reclining posture and require very low energy expenditure (≤1.5 metabolic equivalents)].
To date, no studies have examined associations of accelerometer-assessed activity and sedentary time with psychosocial health outcomes in this population. The primary objective of this study was to determine the associations of objectively-assessed sedentary time, light intensity physical activity, and MVPA with psychosocial health outcomes including depression symptoms, anxiety symptoms, satisfaction with life, and post traumatic growth among lung cancer survivors.
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Participants
The study was approved by the Health Research Ethics Board of Alberta and the Athabasca University Research Ethics Board. All lung cancer survivors were recruited from the Glans-Look Lung Cancer Database at the University of Calgary. The Glans-Look Database includes comprehensive medical information on all NSCLC patients diagnosed from 1999 to 2014 in Southern Alberta. Eligibility criteria for this study included (a) previous clinical and/or pathological diagnosis of NSCLC confirmed by chart
Participant characteristics
A total of 527 patients in the Glans-Look Registry satisfied the study eligibility requirements and were mailed a study invitation. Of these patients, 127 (24%) completed the study. Comparing the responders to those who did not respond, there were no significant differences in age, sex, or months since diagnosis.
Demographic and clinical characteristics of the sample are reported in Table 1. The mean age of the sample was 71 years (SD = 10.3) and 57% were female. The mean number of months since
Discussion
To our knowledge, this is the first study to examine associations of accelerometer-assessed light intensity and sedentary time among lung cancer survivors. We reported light intensity physical activity was significantly associated with SWL among survivors in the 50th percentile of SWL scores. Further, sedentary time was associated with depressive symptoms and SWL among survivors in the 50th percentile of the depressive symptom and SWL distributions. This suggests that associations appear
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