Exploring Motivation for Engaging in Exercise During the First Six Months of Childhood Cancer Treatment: A Qualitative Study

Purpose: To improve the understanding of what influences the motivation of children and adolescents diagnosed with cancer to engage in exercise during the first six months of treatment. Materials and Methods: Qualitative design using semistructured interviews with children (6–17 years) diagnosed with cancer (n = 12) and their parents (n = 12). A deductive thematic analysis based on self-determination theory was applied. Results: Three predefined themes described different aspects of motivation for exercise during treatment. Amotivation: Treatment-related illness and fatigue causing amotivation was described as a dominant barrier. Exercise driven by negative reinforcements facilitated short-term exercise engagement but was perceived as amotivation. Controlled Regulation: Exercise regulated by exercise professionals could facilitate and introject positive experiences with exercise (i.e., ameliorated side effects) and create confidence in physical capabilities. Autonomous Self-Regulation: An autonomy-supportive approach using cocreation and age-appropriate and treatment-regulated exercise, facilitated trust, and confidentiality with exercise professionals. Conclusion: Motivation for exercise is a dynamic interplay that can be facilitated or negatively affected by treatment, parents, peers, and external regulation. Exercise interventions should use an individual and autonomy-supportive approach, encompassing treatment-related daily variations of physical capacity. Externally regulated motivation can facilitate exercise on a short-term basis when children are inactive or hesitant to engage in exercise.