Developing and Evaluating the Psychometric Properties of the Nurses' Exercise Beliefs Scale.

Background and Purpose: No instrument exists that measures oncology nurses' exercise beliefs for women with breast cancer experiencing cancer-related fatigue. This article reports on the psychometric evaluation of the Nurses' Exercise Beliefs scale. Method: There were 20 items generated for the scale from a review of the literature. An expert panel review achieved content validity of the scale. The scale was administered to 387 registered nurses and the data were analyzed. Results: The scale content validity index (S-CVI) was .85. A 2-factor solution explained 50.4% of the variance in exercise beliefs, supporting construct validity. The factors were exercise benefits beliefs (8 items, α = .94) and exercise barriers beliefs (12 items, α = .81). Conclusions: The findings support the subscales as valid and reliable tools.Keywords: cancer-related fatigue; exercise barriers; exercise benefits; beliefsExercise is a useful therapy in reducing cancer-related fatigue (CRF) and improving vigor and vitality during chemotherapy treatment, especially when done at moderate levels for at least 15 min three to five times weekly (Cherry & Bush 2005; Courneya & Friedenreich, 1999; Kangas, Bovbjerg, & Montgomery, 2008; Mock, 2003; Stricker, Drake, Hoyer, & Mock, 2004). To achieve this positive patient outcome, it is recom- mended that health care professionals counsel their patients to follow a prescribed exercise regime (American Cancer Society [ACS], 2012; National Comprehensive Cancer Network [NCCN], 2011). However, health care professionals do not consistently meet the exercise counseling needs of patients (Mills & Sullivan, 1999; Rogers et al., 2006).It is possible that health care professionals' exercise beliefs may influence their exercise counseling activities. Exercise beliefs are influenced by personal experience with exercise and influence healthy and chronically ill individuals' as well as health care professionals' adherence to exercise and exercise counseling by health care professionals (Blaney et al., 2010; Brown, 2005; Frank, Tong, Lobelo, Carrera, & Duperly, 2008; Grubbs & Carter, 2002; Kaewthummanukul, Brown, Weaver, & Thomas, 2005; Lee, Huang, & Kao, 2005; Mancuso et al., 2006; Robbins, 2004; Rogers et al., 2006).Exercise beliefs refer to the perceived advantages and disadvantages of exercising and the evaluation of the potential outcomes (Gardner & Hausenblas, 2004). Exercise beliefs can also be viewed as beliefs about the benefits/facilitators of and barriers to exercise and are perceived by health professionals as well as healthy and ill individuals (Blaney et al., 2010; Brown, 2005; Grubbs & Carter, 2002; Stutts, 2002). The benefits and advantages of exercising are positive factors and outcomes of exercising, whereas the barriers and disadvantages of exercising are the obstacles and negative outcomes of exercising. These perceived benefits and barriers can influence an individual's level of participating in exer- cise activities (Brown, 2005; Grubbs & Carter, 2002; Mancuso et al., 2006).BACKGROUND AND CONCEPTUAL FRAMEWORKBackgroundPatients with breast cancer report sharp increases in fatigue levels during the first 2 days following chemotherapy, lasting for up to 10 years in at least one-third of women (Bower et al., 2000; Kirshbaum, 2006; Schwartz, 2000). Almost 45% of patients with CRF do not exercise, citing physical, cognitive, and social reasons for not doing so (Kuchinski, Reading, & Lash, 2009; Pickett et al., 2002; Pinto, Rabin, & Dunsiger, 2009; Schwartz, 2000).Education and counseling about exercise as a treatment for CRF was shown to be an effective strategy for achieving patient adherence to a prescribed exercise regime, reducing fatigue in breast cancer patients experiencing CRF (de Nijs, Ros, & Grijpdonck, 2008). However, the literature indicates that health care professionals do not regularly counsel breast cancer patients about the benefits of exercise to combat CRF (Donovan & Ward, 2005; Mills & Sullivan, 1999; Rogers et al. …