Background
Psychological constructs have been shown to independently effect health outcomes and overall quality of life in the psycho-oncology literature. Whilst exercise can positively influence psychological constructs, studies in oncology populations often limit their measurement to negative psychological constructs (e.g. depression), with limited evidence exploring positive psychological constructs (e.g. optimism). This systematic review aims to evaluate which psychological constructs and tools have been utilised, and which have been found to effectively respond to exercise, within the exercise oncology literature.
Methods
A systematic search of PubMed, EMBASE, CINAHL, and Cochrane was performed following the PRISMA guidelines for all publications up until February 2024. Randomised controlled trials that analysed the effects of exercise on any psychological constructs in any oncological population and only full-text articles published in English in peer-reviewed journals were included. All results were exported to Covidence and screened by two independent reviewers. Thematic analyses were conducted to review and allocate psychological constructs into conceptual categories. Study quality was assessed using the Delphi list tool.
Results
A total of 6166 articles were retrieved, with 186 studies included in the review. Forty-four tools were used, with EORTC, FACT, and SF-36 being the most used multidimensional tools, and HADS, CES-D, and BDI being the most used unidimensional tools. Psychological constructs and tools were thematically consolidated into three positive and three negative constructs. Positive constructs (63%) included quality of life (psychological), social, and generic well-being domains. Negative constructs (37%) included depression, anxiety, and generic distress domains. Most studies scored an average quality rating (N=162, 86%).
Conclusion
The current exercise oncology literature places an overemphasis on the influence of exercise on negative psychological constructs compared to positive psychological constructs. Future research should include measures of positive psychological constructs to confirm whether exercise can influence these findings.