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Keep moving: patients with myeloma talk about exercise and fatigue.

PURPOSE/OBJECTIVES
To learn about the feelings, beliefs, and experiences of patients with multiple myeloma implementing an exercise program in the context of an aggressive tandem peripheral stem cell transplant protocol.


RESEARCH APPROACH
Qualitative naturalistic (constructionist).


SETTING
International referral center for the treatment of multiple myeloma.


PARTICIPANTS
Purposive nonprobability sample of 12 men and 9 women with multiple myeloma aged 38-70 enrolled in the exercise arm of a randomized trial of epoetin alfa with or without exercise as an intervention to decrease cancer-related fatigue.


METHODOLOGIC APPROACH
Verbatim transcripts of tape-recorded, in-depth interviews analyzed for thematic content using content analysis and constant comparison.


FINDINGS
Themes included (a) belief systems, which encompassed participants' beliefs about exercise and epoetin alfa, philosophy, and self-concept, (b) social context, which included life before cancer, social environment, and social system congruence, and (c) intersection between belief systems and social context, which were participants' experience appraisals. All participants believed that exercise could be helpful and would recommend exercise to other patients with cancer in a similar situation. Most believed that lack of activity contributed to decreased energy.


MAIN RESEARCH VARIABLE
Patients' experience of implementing exercise in the context of treatment for multiple myeloma.


CONCLUSIONS
Complex interactions between participants' beliefs and social context and experience appraisal influenced their ability to adhere to an exercise program during aggressive treatment for multiple myeloma.


INTERPRETATION
Through careful assessment, clinicians can capitalize on belief and social systems that support adherence to exercise as an intervention to ameliorate fatigue for patients with cancer who are undergoing prolonged aggressive treatment.