Kemik Tümörü Rezeksiyonu Ameliyatı Olan Kanser Hastalarında Postoperatif Egzersizler İçin Süpervizör Tipinin Seçimini Etkileyen Faktörler - Nitel Bir Çalışma

Abstract

Amaç: Bu çalışmanın birincil amacı, kemik tümörü rezeksiyonu geçiren hastalarda postoperatif egzersizlerde süpervizör tercihini etkileyen motivasyonları ve engelleri araştırmaktı. İkincil amaç, süpervizör deneyiminin gelecekteki gözetim tercihlerini nasıl etkileyebileceği konusunda ön bilgiler sağlamaktı. Gereç ve Yöntem: Bu çalışmada tematik analiz yöntemi kullanılarak nitel bir araştırma yapıldı. Kemik tümörü rezeksiyonu ameliyatı geçiren olgular, süpervizör eşliğinde denetimli veya denetimsiz altı hafta süren egzersiz programlarına katıldı. Katılımcılarla hem egzersiz öncesi hem de sonrası dönemde yarı yapılandırılmış, derinlemesine görüşmeler yapıldı. Bulgular: Araştırma sonucunda, katılımcıların güvende hissetme, egzersizlerin doğru şekilde yapılmasını sağlama ve programa disiplinli bir şekilde uyma isteği nedenleriyle yüz yüze denetimli egzersizi tercih ettikleri sonucuna ulaşıldı. Zaman esnekliği ve ev konforu ise çevrimiçi süpervizörü seçmeyi teşvik etti. Olumsuz deneyimler, sağlık sistemi sorunları ve ulaşım zorlukları, katılımcıları yüz yüze süpervizör eşliğindeki denetimli egzersizi tercih etmekten alıkoydu. Teknik yetersizlikler, çevrimiçi süpervizör türünü seçmenin önündeki tek engel olarak bulundu. Sonuç: Öz disiplin, refakatçi ihtiyacı, ulaşım, kendine güvenme ihtiyacı gibi faktörler süpervizör tipini belirleyen en güçlü etkenlerdir.

Keywords

• Egzersiz
• hasta tercihleri
• nitel araştırma
• telerehabilitasyon

The Factors Affecting the Choice of Supervisor Type for Postoperative Exercises in Cancer Patients with Bone Tumor Resection Surgery - A Qualitative Study

Abstract

Objective: The primary aim of this study was to investigate the motivators and barriers influencing supervision preferences for postoperative exercises in patients undergoing bone tumor resection. The secondary aim was to provide preliminary insights into how the experience of supervision may affect future supervision preferences. This study aimed to investigate the motivators and barriers influencing supervisor preference for postoperative exercises in patients undergoing bone tumor resection and to evaluate the impact of experience with the preferred supervisor on future choices. Material and Methods: This study used a qualitative approach using thematic analysis. Participants who underwent bone tumor resection surgery participated in either supervised or non-supervised exercise programs lasting six weeks. Semi-structured, in-depth interviews were conducted with participants both before and after the exercise period. Results: The study concluded that participants preferred face-to-face supervised exercise to feel safe, perform exercises correctly, and follow the program with discipline. Time flexibility and the comfort of exercising at home encouraged the choice of online supervision. Negative experiences, issues within the health system, and transportation difficulties deterred participants from preferring face-to-face supervision. Technical inadequacies were identified as the sole barrier to choosing online supervisor type. Conclusion: Self-discipline, the need for companionship, transportation, and the need to feel confident are the strongest factors that determine the type of supervisor.

Keywords

• Telerehabilitation
• Exercise
• Qualitative Research
• Patient Preference

References

1. Ertin B, Kurt S. Evaluation of symptom control and functional quality of life in Turkish patients with cancer during chemotherapy. Eur J Oncol Nurs. 2022; 61:102239. doi: 10.1016/j.ejon.2022.102239.
2. Dalzell MA, Smirnow N, Sateren W, Sintharaphone A, Ibrahim M, Mastroianni L, et al. Rehabilitation and exercise oncology program: translating research into a model of care. Curr Oncol. 2017; 24(3):e191-e198. doi: 10.3747/co.24.3498.
3. Battista F, Duregon F, Vecchiato M, Ermolao A, Neunhaeuserer D. Sedentary lifestyle and physical inactivity: A mutual interplay with early and overt frailty. Nutr Metab Cardiovasc Dis. 2025 Jun;35(6):103971. doi: 10.1016/j.numecd.2025.103971.
4. Guerrero Romero L, Cepero González M, Rojas-Ruiz FJ. Physical activity in lower-extremity sarcoma survivors: specific recommendations and program design. J Phys Act Health. 2025 Mar 18;22(6):664-672. doi: 10.1123/jpah.2024-0745.
5. Grushina TI, Teplyakov VV. Physiotherapy in early rehabilitation of patients with bone sarcomas after arthroplasty of large bones and joints. Vopr Kurortol Fizioter Lech Fiz Kult. 2020;97(3):53-59.
6. Salakari MR, Surakka T, Nurminen R, Pylkkänen L. Effects of rehabilitation among patients with advances cancer: a systematic review. Acta Oncol. 2015;54(5):618-28. doi: 10.3109/0284186X.2014.996661.
7. Husebø AM, Karlsen B, Allan H, Søreide JA, Bru E. Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study. J Clin Nurs. 2015 Feb;24(3-4):500-10. doi: 10.1111/jocn.12633.
8. Clifford BK, Mizrahi D, Sandler CX, Barry BK, Simar D, Wakefield CE, et al. Barriers and facilitators of exercise experienced by cancer survivors: a mixed methods systematic review. Support Care Cancer. 2018 Mar;26(3):685-700. doi: 10.1007/s00520-017-3964-5.

9. Smith-Turchyn J, Richardson J, Tozer R, McNeely M, Thabane L. Physical activity and breast cancer: a qualitative study on the barriers to and facilitators of exercise promotion from the perspective of health care professionals. Physiother Can. 2016;68(4):383-390. doi: 10.3138/ptc.2015-84.
10. Agasi-Idenburg SC, Joosten MMJ, Hoedjes M, Buffart LM, Kampshoff CS, Stuiver MM. Can't I continue to exercise here? Exploring experiences, barriers, and facilitators for physical therapists and survivors of cancer to promote exercise maintenance. J Cancer Surviv. 2025 May 28. doi: 10.1007/s11764-025-01767-8.
11. Fiani B, Siddiqi I, Lee SC, Dhillon L. Telerehabilitation: development, application, and need for increased usage in the COVID-19 era for patients with spinal pathology. Cureus. 2020 Sep 21;12(9):e10563. doi: 10.7759/cureus.10563.
12. Jiang S, Xiang J, Gao X, Guo K, Liu B. The comparison of telerehabilitation and face-to-face rehabilitation after total knee arthroplasty: A systematic review and meta-analysis. J Telemed Telecare. 2018 May;24(4):257-262. doi: 10.1177/1357633X16686748
13. Muñoz-Tomás MT, Burillo-Lafuente M, Vicente-Parra A, Sanz-Rubio MC, Suarez-Serrano C, Marcén-Román Y, et al. Telerehabilitation as a therapeutic exercise tool versus face-to-face physiotherapy: A systematic review. Int J Environ Res Public Health. 2023 Feb 28;20(5):4358. doi: 10.3390/ijerph20054358.
14. Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Fernández-Lao C, Cantarero-Villanueva I, López-Barajas IB, et al. Mobile health and supervised rehabilitation versus mobile health alone in breast cancer survivors: Randomized controlled trial. Ann Phys Rehabil Med. 2020;63(4):316-324. doi: 10.1016/j.rehab.2019.07.007.
15. Schneider C, Reimann S, Schmid J, Bernhard J, Rabaglio M, Campbell KL, et al. Qualitative analysis of facilitators and barriers to centre- and home-based exercise training in breast cancer patients - a Swiss tertiary centre experience. Swiss Med Wkly. 2022 May 12;(19-20): Swiss Med Wkly. 2022;152:w30155. doi: 10.4414/smw.2022.w30155.
16. Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med. 2022 Jan;292:114523. doi: 10.1016/j.socscimed.2021.114523.
17. Salis F, Costaggiu D, Mandas A. Mini-mental state examination: optimal cut-off levels for mild and severe cognitive impairment. Geriatrics. 2023; 8(1): 12.
18. Galvao DA, Taaffe DR, Spry N, Cormie P, Joseph D, Chambers SK, Newton RU. Exercise preserves physical function in prostate cancer patients with bone metastases. Medicine and science in sports and exercise. 2017; 50(3): 393.
19. Mahat-Shamir M, Neimeyer RA, Pitcho-Prelorentzos S. Designing in-depth semi-structured interviews for revealing meaning reconstruction after loss. Death Stud. 2021;45(2):83-90. doi: 10.1080/07481187.2019.1617388.
20. Willig C, Roger WS. The SAGE handbook of qualitative research in psychology. Second edition. Sage, UK; 2017.
21. Çınaroğlu S. Türkiye’de iller düzeyinde sağlık personeli dağılımı ve daha etkin politika ihtiyacı. Hacettepe Sağlık İdaresi Dergisi. 2021; 24(2): 235-254.
22. Akpinar A, Özcan M, Ülker Toygar. Patient’s companions as a vulnerable group in Turkish hospitals: A descriptive study. J Eval Clin Pract. 2020;26(4):1196–204.
23. Keleş MN, Salameh T, Seven, M. Quality of life of caregivers of women receiving cancer treatment in Turkey. Florence Nightingale Journal of Nursing. 2023; 31(Suppl 1): 31. doi: 10.5152/FNJN.2023.22235.
24. Seçinti E, Yavuz HM, Selçuk, B. Feelings of burden among family caregivers of people with spinal cord injury in Turkey. Spinal cord. 2017; 55(8): 782-787. doi:10.1038/sc.2017.6.
25. Bıyık C. Smart cities in Türkiye: Approaches, advances and applications with greater consideration for future urban transport development. Energies. 2019; 12(12): 2308.
26. Dennett A, Harding KE, Reimert J, Morris R, Parente P, Taylor NF. Telerehabilitation’s safety, feasibility, and exercise uptake in cancer survivors: process evaluation. JMIR Cancer. 2021; 7(4):e33130. doi:10.2196/33130.
27. Seebacher B, Bergmann E, Geimer C, Kahraman T, Reindl M, Diermayr G. Factors influencing the willingness to adopt telerehabilitation among rehabilitation professionals in Austria and Germany: a survey comparing data before and during COVID-19. Disabil Rehabil. 2024 Mar;46(6):1149-1157. doi: 10.1080/09638288.2023.2193428.
28. Fealy S, McLaren S, Seaman CE, Nott M, Jones D, Irwin P, et al. Exploring the sociodemographic and health-related determinants of telehealth use among a cohort of older Australians during the COVID-19 pandemic: repeated cross-sectional study. JMIR Aging. 2024 Aug 23;7:e58594. doi: 10.2196/58594.
29. Brouwer CG, Tusscher MRT, de Roos BM, Gootjes EC, Buffart TE, Versteeg KS, et al. Experiences of patients with metastatic colorectal cancer participating in a supervised exercise intervention during chemotherapy. Supportive Care in Cancer.2025; 33(2): 82. https://doi.org/10.1007/s00520-024-09101-1.
30. Westphal T, Rinnerthaler G, Gampenrieder SP, Niebauer J, Thaler J, Pfob M, Fuchs D, Riedmann M, Mayr B, Reich B, Melchardt T, Mlineritsch B, Pleyer L, Greil R. Supervised versus autonomous exercise training in breast cancer patients: A multicenter randomized clinical trial. Cancer Med. 2018 Dec;7(12):5962-5972. doi: 10.1002/cam4.1851.
31. Sheldon KM, Prentice M. Self-determination theory as a foundation for personality researchers. Journal of personality. 2019; 87(1): 5-14. https://doi.org/10.1111/jopy.12360.