Kirshbaum, Marilyn, Crank, Helen, Hembrough, Dave, Hardy, Denise and McConnell, Anoushka (2010) The group cohesion factor of a dragon boat race training prgramme following treatment for breast cancer in the UK. In: 16th International Conference on Cancer Nursing (ICCN), March 7 - 11, 2010, Atlanta, Georgia, USA. (Submitted)

There is increasing evidence that exercise and physical activity after breast cancer treatment can attenuate treatment related side effects and accelerate both physical and psychological recovery. However, the numbers of survivors engaging in physical activity and exercise after completion of treatment are low owing to lack of motivation and self-discipline, and to over cautious advice from health-care professionals. Dragon Boat Racing is a team sport that has been adopted recently by breast cancer survivors, which was first evaluated for its safety and beneficial effects on arm lymphoedema in Canada by McKenzie in 1996.
Group cohesion is an important factor in team based training, which impacts performance in athletes. Amongst breast cancer survivors this factor can be viewed as a mechanism for active social support and potentially provide a significant motivational force which supports adherence to a beneficial structured exercise programme.
Aim and Method
A single cohort longitudinal study was designed to explore group cohesiveness from participating in a 20 week Dragon Boat Race Training Programme with fellow breast cancer survivors culminating in a competitive race. A progressive exercise training programme was designed to develop sport specific fitness. Opened ended questionnaires and complementary focus groups were used to gather qualitative data from a sample of 13 self selected women at four time points: baseline, 6 weeks, 20 weeks, and 3 months post intervention. All participants were at least 3 months post treatment (excluding hormone therapy) for primary breast cancer and ranged between 36-72 years of age. Four women had clinically diagnosed mild arm lymphoedema. Scientific and ethical reviews were obtained.
Exceptional motivational support was recounted by participants and reflected in training adherence rates up to 94%. From self reports, adherence was due to commitment, partner support, group support, responsibility to the group and camaraderie. Participants felt that the Dragon Boat race training experience provided fitness, fun, laughter, pride and a sense of belonging. The most beneficial aspect of being part of the group was being with likeminded people, friendship, regularity and encouragement. Difficulties included family commitments and sometimes self motivation when energy levels were low and body was aching.
Exceptional group cohesion was attributed to assisting the high levels of motivation and adherence to the training programme. Upon completion, most women expressed the desire to continue exercising regularly.
This structured, team-based group training programme has useful implications for health care professionals and breast cancer survivors to assist rehabilitation and promote an active lifestyle.

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