Effectiveness of Adventure-Based Training in Reducing Fatigue Among Childhood Cancer Survivors

Abstract

Purpose/Objective: This study aimed to test the effectiveness of an adventure-based training program in reducing fatigue, improving physical activity levels and promoting quality of life among Hong Kong Chinese children cancer survivors. Background/Rationale: Fatigue is the most common physical concern reported by children who have survived cancer. Although regular physical exercise has been shown as an effective way to minimize or even reverse the effects of this treatment late effect, insufficient participation in physical activity remains a common problem in survivors of childhood cancer. Adventurebased training has recently been used among them to promote changes in exercise behavior. Nevertheless, it is unclear whether such a training programme can be effective in helping childhood cancer survivors relieve fatigue. More empirical evidence is needed to confirm its effectiveness. Description/Methods/Evaluation: A randomized controlled trial, two-group pretest and repeated posttest, between- within subjects design was employed in a pediatric outpatient clinic of a public acute care hospital and the Children’s Cancer Foundation. A total of 323 childhood cancer survivors were recruited. Participants in the experimental group received a four-day adventure-based training programme. Those in the control group were given the same amount of time and attention as the experimental group, but were thought to have no particular effect on the outcome variables. All of them were assessed for the fatigue, muscle strength, physical activity levels and quality of life at baseline, 6 and 12 months after the start of intervention. Outcome/Results/Findings: Participants in the experimental group reported significantly lower levels of fatigue (p =.02), but higher levels of physical activity (p < .001), muscle strength (p = .02) and quality of life (p = .05) than those in the control group at 6 and 12 months. Also, statistically significant differences were found in fatigue, physical activity levels, muscle strength and quality of life among participants in the experimental group from baseline to 12 months. Conclusion/Discussion: The adventure-based training programme was shown to have substantial effects on reducing fatigue, improving physical activity levels and promoting quality of life. Implications for Nursing: The study results are foreseen to extend the nurses’ role and responsibility in advocating this programme as well as to work as a partnership with multidisciplinary approach to effectivity reducing fatigue in children and adolescents who have survived cancer so as to improve their quality of life.