Self-management for Adult Patients With Cancer

Hammer, Marilyn J.; Ercolano, Elizabeth; Wright, Fay; Dickson, Victoria Vaughan; Chyun, Deborah; Melkus, Gail D’Eramo

doi:10.1097/ncc.0000000000000122

Cited by 85 publications

(72 citation statements)

References 67 publications

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“…Similar to previous reviews, we found substantial variability in all aspects of the interventions. This variability may hamper replication, scale‐up, and integration into practice.…”

Section: Discussionsupporting

confidence: 87%

Self‐management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories

et al. 2019

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Objective Self‐management has been proposed as a strategy to help cancer patients optimize their health and well‐being during survivorship. Previous reviews have shown variable effects of self‐management on outcomes. The theoretical basis and psychoeducational components of these interventions have not been evaluated in detail. We aimed to evaluate the evidence for self‐management and provide a description of the components of these interventions. Methods We conducted a systematic review of self‐management interventions for adults who had completed primary cancer treatment by searching MEDLINE, EMBASE, PsychINFO, CINAHL, Scopus, Cochrane Database of Systematic Reviews, National Institutes of Health Clinical Trials Registry, and Cochrane CENTRAL Registry of Controlled Trials. We included experimental and quasiexperimental designs. Data synthesis included narrative and tabular summary of results; heterogeneity of interventions and outcomes precluded meta‐analysis. Study quality was evaluated using the Cochrane risk of bias tool or the risk of bias of nonrandomized studies tool. Results Forty‐one studies published between 1994 and 29 March 2018 were included. Studies were predominantly randomized controlled trials and targeted to breast cancer survivors. A variety of intervention designs, psychoeducational components, and outcomes were identified. Less than 50% of the studies included a theoretical framework. There was variability of effects across most outcomes. Risk of bias could not be fully assessed. Conclusions There are limitations in the design and research on self‐management interventions for cancer survivors that hinder their translation into clinical practice. Further research is needed to understand if these interventions are an important type of support for cancer survivors.

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“…Similar to previous reviews, we found substantial variability in all aspects of the interventions. This variability may hamper replication, scale‐up, and integration into practice.…”

Section: Discussionsupporting

confidence: 87%

Self‐management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories

et al. 2019

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“…The self-care advice directly related to the reported concerns was another important asset that could enable the patients to take an active part. Guiding patients with cancer in self-care management is essential for functional status and HRQoL [35]. In our previous study, we found that strategies for self-care management for patients with prostate cancer are rare in the literature, and in interviews with patients, they expressed scarce experience of support or information about self-care activities during treatment [5].…”

Section: Discussionmentioning

confidence: 99%

Early detection and management of symptoms using an interactive smartphone application (Interaktor) during radiotherapy for prostate cancer

Sundberg

Wengström

Blomberg

et al. 2017

Support Care Cancer

146

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PurposePatients undergoing radiotherapy for prostate cancer suffer from a variety of symptoms which influence health-related quality of life. We have developed an application (Interaktor) for smartphones and tablets for early detection, reporting and management of symptoms, and concerns during treatment for prostate cancer. The study evaluates the effect on symptom burden and quality of life when using the application for real-time symptom assessment and management during radiotherapy for localized prostate cancer.MethodsA non-randomized controlled study was used at two university hospitals in Sweden where 64 patients constituted a control group and 66 patients made up an intervention group. The intervention group was asked to report symptoms via the application daily during the treatment as well as 3 weeks after. The EORTC QLQ-C30 and its module PR25 and the Sense of Coherence questionnaire were administered at three time points in both groups.ResultsThe intervention group rated significantly lower levels of fatigue and nausea at the end of radiotherapy. Moreover, they had significantly less burden in emotional functioning, insomnia, and urinary-related symptoms at the end of treatment as well as 3 months later compared with the control group. In the multivariate analyses, with education and sense of coherence as covariates, the intervention group still significantly rated emotional functioning (p = 0.007), insomnia (p = 0.017), and urinary-related symptoms (p = 0.008) as better than the control group at T2.ConclusionStudy findings suggest that Interaktor could be an efficient mHealth tool for facilitating supportive care needs during cancer treatment.

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“…Outpatients, who are by definition outside the hospital setting, must employ a number of self-management strategies to cope with their cancer symptoms and treatment. When these coping strategies fail, the patients’ unmet needs may require prompt access to care professionals [48]. A possible explanation of the association between high ITW intensity and positive perception of Prompt access to care is that ITW is aimed at improving care coordination by facilitating appropriate referral mechanisms to the relevant team member [49].…”

Section: Discussionmentioning

confidence: 99%

Effects of interdisciplinary teamwork on patient-reported experience of cancer care

Tremblay

Roberge

Touati

et al. 2017

BMC Health Serv Res

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BackgroundInterdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients’ perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity.MethodsThe study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West’s seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables.ResultsOutpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89–8.41). High ITW intensity also positively affected patients’ perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25–4.51), Person-centred response (OR = 2.11; CI = 1.05–4.24], and Continuity of care (OR = 2.18; CI = 1.07–4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68–2.52) or Quality of the care environment (OR = 0.66; CI = 0.31–1.39).ConclusionsThis study provides empirical evidence, from the patient’s perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2166-7) contains supplementary material, which is available to authorized users.

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Self-management for Adult Patients With Cancer

Abstract: Guiding patients with cancer in self-care management is important for overall functional status and quality of life. Further investigation and tailored interventions are warranted.

Cited by 85 publications

References 67 publications

Self‐management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories

Self‐management interventions for cancer survivors: A systematic review and evaluation of intervention content and theories

Early detection and management of symptoms using an interactive smartphone application (Interaktor) during radiotherapy for prostate cancer

Effects of interdisciplinary teamwork on patient-reported experience of cancer care

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