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Patient-centered Care

Patient-centered Care

Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...

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Reflective Engagement With a Digital Physical Activity Intervention Among People Living With and Beyond Breast

Michael C Robertson^1,2, Emily Cox-Martin³, Karen Basen-Engquist⁴

¹Department of Family and Preventive Medicine, TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.

JMIR Mhealth and Uhealth

|February 9, 2024

Summary

Digital interventions can help breast cancer survivors overcome physical activity barriers. Deeper reflection on intervention content, alongside adherence, predicted positive changes in psychological acceptance and motivation for physical activity.

Keywords:

acceptance and commitment therapy behavioral sciences exercise fatigue mindfulness motivation survivors of cancer

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Area of Science:

Behavioral Science
Digital Health
Oncology

Background:

Breast cancer survivors face barriers to physical activity, such as fatigue and pain.
Digital interventions promoting psychological acceptance and motivation may aid this population.
Intervention adherence and content internalization are key predictors of efficacy.

Purpose of the Study:

Characterize reflective processes in an 8-week acceptance- and mindfulness-based physical activity intervention for breast cancer survivors.
Explore the utility of a reflective process metric for predicting study outcomes.

Main Methods:

Content analysis of participants' written reflections on intervention usefulness.
Assessed depth of reflection using a 0-4 framework (0=description, 4=critical reflection).
Used multiple linear regression to assess if adherence and reflection depth predicted outcomes.

Main Results:

Higher levels of reflection (dialogic, transformative, critical) were associated with personal insight and perspective change.
Intervention adherence predicted increased muscle-strengthening exercise and decreased sleep disturbance.
Deeper reflection predicted increased psychological acceptance and motivation for physical activity.

Conclusions:

A method for assessing reflective processes in digital interventions for breast cancer survivors was identified.
Both intervention adherence and depth of reflection predicted study outcomes.
Deeper reflection is linked to improved determinants of sustained behavior change.