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.