Nurse-led Physical Activity Program Among Breast Cancer Survivors

Change in general health-related quality of life, as measured using the The European Organization for Research and Treatment of Cancer (EORTC) developed a cancer-specific core questionnaire (QLQ-C30), from baseline to 12 and 24 weeks. QLQ-C30 is composed of 30 items assessing global perceived health status and QoL. These items are grouped in five functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning); three symptom scales (fatigue, nausea \& vomiting, and pain); six single item scales. Responses are coded on a scale of 0 to 4 where 0 is not at all and 4 is very much. A rise in the functional dimension score and a fall in the symptom dimension score signify an improvement in QoL. High general well-being dimension scores are indicative of a QoL. The computation yields scores for every dimension out of a possible 100, with scores ranging from 0 to 100.

Change in health-related quality of life-Breast Cancer Specified, as measured using the EORTC-QLQ-BR23, from baseline to 12 and 24 weeks. QLQ-BR23 questionnaire has 23 items to assess functional scales (body image), sexual functioning, sexual enjoyment, and future perspective); symptom scales (systemic therapy side effects, breast symptoms, arm symptoms, and upset by hair loss). The total score range of the scale is 0-100. A high quality of life is indicated by a low score in the symptom dimension and a high score in the functional dimension of the scale.

Change in BMI, as measured objectively with digital scales, from baseline to to 12 and 24 weeks.

Change in fatigue, as measured by the The Functional Assessment of Chronic Illness Treatment-Fatigue Scale (FACIT-F), from baseline to 12 and 24 weeks. The FACIT-F Scale is composed of 13 expressions that measure the fatigue that the patients had in the last seven days.7 The expressions on the scale consist of Likert type question form which is scored between 0 and 4 and con- sists of ''Not at all'', ''A little bit'', ''Somewhat'', ''Quite a bit'', and ''Very much''. The total score range of the scale is 0-52. The higher the scale score, the lower the fatigue level of the patient.

Change in self-efficacy for exercise, as measured by the The Exercise Self-efficacy Scale, from baseline to 12 and 24 weeks. Responses 18 items, ranging from 0 (cannot do it) to 100 (definitely can do it), are summed, with higher values representing higher efficacy beliefs for exercises.

Change in outcome expectations for exercise, as measured by the Multidimensional Outcome Expectations for Exercise Scale, from baseline to 12 and 24 weeks. Responses for three subscales (physical subscale, social subscale, self-evaluative subscale), ranging from 1 (strongly disagree) to 5 (strongly agree), are summed, with higher values representing higher outcome expectations for exercise.

Change in self-regulation, as measured using by self-report questionnaire, from baseline to 12 and 24 weeks. Responses to two subscales (Exercise goal-setting, Exercise planning and scheduling), ranging from 1 (does not describe) to 5 (describes completely), are averaged to yield two subscales. Higher subscale scores represent higher self-regulation.

Change in social support, as measured by the Multidimensional Perceived Social Support Scale, from baseline to 12 and 24 weeks. Responses for three factors (Family participation, Friend participation, a special person participation), ranging from 1 to 7, are summed, with higher values representing higher perceived social support.

Change in perceived environment, as measured using the Physical Activity Neighborhood Environment Scale (PANES) survey, from baseline to 12 and 24 weeks. PANES is a 17-item measure perceived attributes of the neighborhood environment related to physical activity. Concepts assessed by PANES include residential density (1 item), access to destinations (3 items), pedestrian and bicycling facilities (4 items), recreational facilities (1 item), aesthetic qualities (1 item), social environment (1 item), street connectivity (1 item), traffic safety (2 items), crime safety (2 items), and household motor vehicles (1 item). With the exception of the residential density and household motor vehicle questions, items ranging ranging from 1 (strongly disagree) to 5 (strongly agree), as well as don't know or doesn't apply response option.