Investigating the impact of self‐management behaviours on quality of life and fear of recurrence in head and neck cancer survivors: A population‐based survey

Abstract

Objectives Emerging cancer‐survivorship research suggests that self‐management can lead to improved outcomes. However, research examining the impact of self‐management behaviours on quality of life (QoL) and fear of recurrence (FoR) in cancer survivors is lacking. This study investigated the relationship between self‐management behaviours and QoL and FoR following treatment for head and neck cancer (HNC). Methods Postal surveys were sent to 734 eligible HNC survivors (ICD10 C01‐C14; C32) in the Republic of Ireland who were 12‐ to 60‐months post diagnosis. QoL and FoR were measured using the Functional Assessment of Cancer Therapy (FACT‐G and Head and Neck Cancer Subscale) measure and Fear of Relapse/Recurrence Scale, respectively. Seven self‐management behaviours were measured using the Health Education Impact Questionnaire. Results Three hundred and ninety‐five HNC survivors completed surveys (50.3% response rate). After controlling for sociodemographic and clinical characteristics, self‐management behaviours accounted for 20% to 39.4% of the variance in QoL and FoR. Higher scores on positive and active engagement in life, constructive attitudes and approaches, and skill and technique acquisition were significantly associated with higher global QoL and lower FoR, whilst higher scores on positive and active engagement in life and constructive attitudes and approaches only were significantly associated with higher HNC‐specific QoL. Additionally, lower scores on self‐monitoring and insight were significantly associated with higher HNC‐specific and global QoL and lower FoR. Conclusions The findings highlight the potential utility of self‐management interventions promoting active problem solving, positive self‐talk, and skill acquisition amongst cancer survivors. However, increased self‐monitoring may relate to negative outcomes in HNC, a finding that warrants further investigation.

Quality of Life in Postoperative Colorectal Cancer Survivors: A Structural Equation Model

“…The self-management of patients is a behavioral factor that makes patients healthy and directly affects their quality of life. 15 Successful selfmanagement is the result of the use of knowledge, skills and confidence in dealing with the problem of illness, which can be achieved through postoperative symptom experience, social roles and stress-and-anxiety control at home, which can thus result in an improved quality of life. 16 Moreover, family caregiver support has a direct influence on patients' self-management ability.…”

Patient perspectives on surveillance after head and neck cancer treatment: A systematic review

“…Fear of recurrence was highlighted in 11 studies as a source of anxiety. 10,11,12,13,15,17,18,19,20,21,22 Two studies found fear of recurrence to be particularly problematic early on in surveillance, 12,17 acting as a barrier to managing emotions surrounding cancer diagnoses. 24 Eleven publications reported unmet needs regarding the management of fear of recurrence (N = 1322).…”

“…24 Eleven publications reported unmet needs regarding the management of fear of recurrence (N = 1322). 10,11,12,13,15,17,18,19,20,21,22 Breaking this down further, 1 study highlighted fear of recurrence as the top priority for patients during routine surveillance 11 and fear of recurrence lead to hypervigilance and reduced QoL. 20,21 3 of these 11 publications specifically reported that increased psychological support was necessary to deal with elements of survivorship and fear of recurrence 10,19,22 (N = 136).…”

“…10,11,12,13,15,17,18,19,20,21,22 Breaking this down further, 1 study highlighted fear of recurrence as the top priority for patients during routine surveillance 11 and fear of recurrence lead to hypervigilance and reduced QoL. 20,21 3 of these 11 publications specifically reported that increased psychological support was necessary to deal with elements of survivorship and fear of recurrence 10,19,22 (N = 136). One study highlighted that positive and active engagement with surveillance was associated with reduced fear of recurrence.…”

“…One study highlighted that positive and active engagement with surveillance was associated with reduced fear of recurrence. 20…”