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PURPOSE: To gain insight into how survivors of breast cancer (SBCs) with cancer-related fatigue (CRF) self-monitor and manage exercise dose in the context of daily life, and how they identify an optimal exercise dose. PARTICIPANTS & SETTING: 11 SBCs with CRF who reported weekly exercise were recruited from a breast cancer center at a large urban hospital in the northeastern region of the United States. METHODOLOGIC APPROACH: One-on-one semistructured interviews were conducted using a descriptive phenomenologic method. Inductive data analysis was performed within and across cases. FINDINGS: The following themes emerged: examining the impact of exercise, finding an optimal dose, and remaining flexible to sustain exercise. Participants used trial and error to explore exercise dose, examining the effects of varying doses on daily life. These effects had behavioral implications and resulted in a nonlinear process and the perception that an optimal exercise dose is dynamic within the context of daily life. IMPLICATIONS FOR NURSING: Strategies to support SBCs with CRF to efficiently achieve optimal exercise doses with fewer setbacks may improve individuals' ability to self-manage and mitigate CRF. This study's findings provide practical approaches for nurses to encourage the initiation and adoption of exercise behaviors after treatment for breast cancer. [ABSTRACT FROM AUTHOR]

Looks at resultative constructions in Korean and English and shows that their basic features follow from general properties of prediction and argument saturation. The analysis is formulated in the framework of head-driven phrase structure grammar (HPSG). (Author/VWL)

Objective Survivors of breast cancer with persistent cancer-related fatigue (CRF) report less exercise participation compared with survivors of breast cancer without CRF. Although CRF predicts other domains of self-efficacy among survivors, the effect of CRF on exercise self-efficacy (ESE)—an important predictor of exercise participation—has not been quantified. This study examined the relationship between CRF, ESE, and exercise participation and explored the lived experience of engaging in exercise among survivors of breast cancer with persistent CRF. Methods Fifty-eight survivors of breast cancer (3.7 [SD = 2.4] years after primary treatment) self-reported CRF, ESE, and exercise participation (hours of moderate-intensity exercise per week). Regression and mediation analyses were conducted. Survivors who reported clinically significant CRF and weekly exercise were purposively sampled for 1-on-1 interviews (N = 11). Thematic analysis was performed across participants and within higher versus lower ESE subsets. Results Greater CRF predicted lower ESE (β  = −0.32) and less exercise participation (β  = −0.08). ESE mediated the relationship between CRF and exercise participation (β  = −0.05, 95% CI = −0.09 to −0.02). Qualitative data showed that survivors of breast cancer with higher ESE perceived exercise as a strategy to manage fatigue, described self-motivation and commitment to exercise, and had multiple sources of support. In contrast, survivors with lower ESE described less initiative to manage fatigue through exercise, greater difficulty staying committed to exercise, and less support. Conclusions Survivors of breast cancer with persistent CRF may experience decreased ESE, which negatively influences exercise participation. Clinicians should screen for or discuss confidence as it relates to exercise and consider tailoring standardized exercise recommendations for this population to optimize ESE. This may facilitate more sustainable exercise participation and improve outcomes. Impact This study highlights the behavioral underpinnings of CRF as a barrier to exercise. Individualized exercise tailored to optimize ESE may facilitate sustainable exercise participation among survivors of breast cancer with CRF. Strategies for clinicians to address ESE are described and future research is suggested. Lay Summary Women with fatigue after breast cancer treatment may have lower confidence about their ability to engage in exercise. Individually tailoring exercise to build confidence as it relates to exercise may result in more consistent exercise and better health-related outcomes. [ABSTRACT FROM AUTHOR]