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Assessment 3: Implementing Evidence-Based Practice

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Student Name

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Capella University

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NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population
Health
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Prof. Name
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MAR 24, 2024

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Implementing Evidence-Based Practice for Enhancing
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Physical Activity Among Cancer Survivors
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Greetings, I am Jessica. Cancer, a formidable adversary within our society, maintains its
reputation as one of the most lethal diseases, marked by low survival rates. Often,
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cancer receives diagnosis in its advanced stages, necessitating aggressive treatments

like radiation and chemotherapy for survival. Recent statistics from the American
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Cancer Society reveal a notable decline in overall cancer mortality trends from 1991 to
2017, amounting to a substantial 29% decrease (Siegel et al., 2019). Globally,
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projections estimated approximately 19.3 million new cancer cases (excluding

non-melanoma skin cancer) and around 10.0 million cancer-related deaths in 2020
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(Hanahan, 2022). The term "cancer" encompasses a spectrum of diseases, each with
its unique symptoms, treatment modalities, and prognoses. Cancer exerts profound
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impacts on the physical, emotional, and social well-being of individuals from the
moment of diagnosis through the journey of treatment and survival. While recent
advancements in research, prevention strategies, diagnostics, and therapeutics have
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significantly improved cancer prognoses for many patients, there remains an ongoing
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imperative for continued research, early detection methods, efficacious treatments, and
robust support systems to further enhance cancer prevention, management, and the
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overall quality of life for those affected by this disease.

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PICOT Inquiry

Cancer necessitates lifestyle modifications conducive to maintaining a cancer-free

existence. Dietary adjustments, exercise regimens, medication adherence, and dietary
selections play pivotal roles in managing physiological equilibrium. Our PICOT question
endeavors to explore the impact of exercise programs on the quality of life among
cancer survivors compared to standard care or non-exercise interventions within a
six-month timeframe. To elaborate, our focus is on the population of cancer survivors,
where the intervention under scrutiny is participation in an exercise program, juxtaposed
with standard care or absence of exercise programs, with the desired outcome being an
improvement in quality of life within six months.

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Strategic Plan of Action

Exercise emerges as a catalyst for substantive life changes. Similarly, integrating

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exercise programs into the routines of cancer patients offers invaluable assistance in
fostering transformative lifestyles. Spanning a six-month course, our program extends
tailored regimens encompassing walking and low-intensity exercises to newly recovered

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cancer patients, fostering vitality and vigor. The action blueprint entails incentivizing
recently recovered individuals to embrace physical activities like walking and moderate

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exercises to cultivate salubrious habits. Scholarly inquiries underscore the significant
positive impacts of exercise on cancer survivors, often touted as a staple
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recommendation within patient regimens. Notably, studies featuring breast cancer
survivors underscored the remarkable positive responses elicited by exercise during
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follow-up routines. Additionally, systematic reviews collating evidence from the cancer
exercise literature corroborate the manifold benefits of exercise across various cancer
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types and stages (Stout et al., 2017). Optimal exercise intensity, falling within the
moderate to vigorous spectrum, emerges as pivotal in ameliorating physical function
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and mitigating adverse effects associated with cancer-related impairments (Cormie et

al., 2017).
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Needs Assessment
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A preliminary needs assessment assumes primacy, aimed at discerning the nuanced

exercise requisites and preferences of cancer survivors. This entails leveraging
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methodologies such as focus groups, surveys, and professional consultations to glean

insights into individualized exercise needs.
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Review of Evidence
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Subsequently, a comprehensive literature review ensues, serving to illuminate best
practices and evidence-backed strategies. This scholarly exploration elucidates the
efficacy of exercise in cancer survivorship, offering insights into optimal guidelines,
protocols, and exercise modalities.

Recommendations for Practice Enhancement

Informed by the needs assessment outcomes, tailored practice enhancements are

crafted, encompassing personalized guidelines, protocols, exercise frequencies,
intensities, durations, and modalities optimized to suit individual patient profiles.

Timeline Development

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A structured intervention plan is devised, accompanied by a delineated timeline,
facilitating milestone identification and deadline adherence for each operational phase.

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Implementation of Practice Enhancements

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Concurrently, the identified practice enhancements are operationalized according to the
established timeline, leveraging requisite tools and resources to effectuate change.

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Identification of Tools and Resources
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A comprehensive array of tools and resources is curated, encompassing educational
materials for both cancer survivors and healthcare providers, requisite exercise
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equipment, and funding avenues for program inception and execution.

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Evaluation of Impact

Subsequent to implementation, the impact of practice enhancements is meticulously

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evaluated, focusing on health outcomes and quality of life among cancer survivors. Data
collection mechanisms encompass exercise participation rates, physical functioning
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metrics, and pertinent health outcomes.

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Stakeholders and Potential Hurdles

Key stakeholders pivotal to project implementation include cancer survivors, healthcare

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practitioners spanning oncologists, nurses, and physical therapists, cancer support

organizations, certified exercise professionals, and researchers. Identified barriers to
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implementation encompass knowledge gaps among both cancer survivors and

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healthcare providers regarding the benefits of exercise, limited access to exercise

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facilities, financial constraints impeding program participation, and physical limitations or
comorbidities hindering engagement in specific exercise modalities.

Outcome Evaluation

Outcome criteria are multifaceted, spanning participation rates, changes in physical

function and quality of life among participating cancer survivors, and pertinent
cancer-related outcomes including recurrence and mortality rates.

Value and Relevance

The evidence advocating for practice enhancements aimed at integrating exercise into
cancer survivorship care is resoundingly compelling and eminently relevant. Exercise

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emerges as a potent adjunct in cancer survivorship, conferring multifaceted benefits
spanning improved physical function, quality of life, and cancer-related outcomes. This
evidential bedrock, underscored by systematic reviews and meta-analyses, underscores

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the imperative for practice innovations geared towards harnessing the transformative
potential of exercise in cancer survivorship (Czosnek et al., 2021).

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References

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● Cormie, P., Zopf, E. M., Zhang, X., & Schmitz, K. H. (2017). The Impact of
Exercise on Cancer Mortality, Recurrence, and Treatment-Related Adverse
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Effects. Epidemiologic Reviews, 39(1), 71–92.
https://doi.org/10.1093/epirev/mxx007
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● Campbell, K. L., Winters-Stone, K., Wiskemann, J., May, A. M., Schwartz, A. L.,
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Courneya, K. S., … & Schmitz, K. H. (2019). Exercise guidelines for cancer

survivors: consensus statement from international multidisciplinary roundtable.
Medicine and Science in Sports and Exercise, 51(11), 2375.
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● Czosnek, L., Richards, J., Zopf, E., Cormie, P., Rosenbaum, S., & Rankin, N. M.
(2021). Exercise interventions for people diagnosed with cancer: a systematic
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review of implementation outcomes. BMC Cancer, 21(1), 1-25.

● Ferioli, M., Zauli, G., Martelli, A. M., Vitale, M., McCubrey, J. A., Ultimo, S.,
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Capitani, S., & Neri, L. M. (2018). Impact of physical exercise in cancer survivors
during and after antineoplastic treatments. Oncotarget, 9(17), 14005–14034.
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https://doi.org/10.18632/oncotarget.24456
● Siegel, R. L., Miller, K. D.,
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Fuchs, H. E., & Jemal, A. (2022). Cancer statistics, 2022. CA: a Cancer Journal
for Clinicians, 72(1), 7-33.
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● Hanahan, D. (2022). Hallmarks of cancer: new dimensions. Cancer Discovery,
12(1), 31-46.
● Stout, N. L., Baima, J., Swisher, A. K., Winters-Stone, K. M., & Welsh, J. (2017).
A Systematic Review of Exercise Systematic Reviews in the Cancer Literature
(2005-2017). PM & R : The Journal of Injury, Function, and Rehabilitation,
9(9S2), S347–S384. https://doi.org/10.1016/j.pmrj.2017.07.074

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