Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 6/2016

01-12-2016 | Review

Cancer survivors’ perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis

Authors: Laura Coffey, Orla Mooney, Simon Dunne, Linda Sharp, Aileen Timmons, Deirdre Desmond, Eleanor O’Sullivan, Conrad Timon, Rachael Gooberman-Hill, Pamela Gallagher

Published in: Journal of Cancer Survivorship | Issue 6/2016

Login to get access

Abstract

Purpose

Self-management interventions improve patient outcomes across a range of long-term conditions but are often limited by low uptake and completion rates. The aim of this paper was to conduct a meta-synthesis of qualitative studies exploring cancer survivors’ views and experiences of engaging with adjustment-focused self-management interventions in order to inform the development of future interventions targeting this population.

Methods

Four electronic databases were systematically searched. Studies that used qualitative methods to explore cancer survivors’ views and experiences of engaging with adjustment-focused self-management interventions were included. A meta-ethnographic approach was used to synthesize the findings.

Results

Thirteen studies met the inclusion criteria. Engaging with adjustment-focused self-management interventions enabled cancer survivors to gain emotional and informational support from peers and/or facilitators in an open, non-judgemental environment, become empowered through enhancing knowledge and skills and regaining confidence and control, and move beyond cancer by accepting illness experiences, reprioritising goals and adopting a positive outlook. However, the extent to which they engaged with, and benefited from, such interventions was mitigated by diverse preferences regarding intervention design, content and delivery. Personal obstacles to engagement included low perceived need, reticence to discuss cancer-related experiences and various practical issues.

Conclusions

Cancer survivors derive a range of benefits from participating in adjustment-focused self-management interventions; potential barriers to engagement should be addressed more comprehensively in intervention marketing, design and delivery.

Implications for Cancer Survivors

The findings suggest some key considerations for the development and implementation of future adjustment-focused self-management interventions that may help to optimize their appeal and effectiveness among cancer survivors.
Appendix
Available only for authorised users
Literature
1.
Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002;48(2):177–87.CrossRefPubMed
2.
Boger E, Ellis J, Latter S, Foster C, Kennedy A, Jones F, et al. Self-management and self-management support outcomes: a systematic review and mixed research synthesis of stakeholder views. PLoS One. 2015;10(7):e0130990.CrossRefPubMedPubMedCentral
3.
Galdas P, Darwin Z, Kidd L, Blickem C, McPherson K, Hunt K, et al. The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies. BMC Public Health. 2014;14:1230.CrossRefPubMedPubMedCentral
4.
Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1–7.CrossRefPubMed
5.
Warsi A, Wang PS, LaValley MP, Avorn J, Solomon DH. Self-management education programs in chronic disease: a systematic review and methodological critique of the literature. Arch Intern Med. 2004;164(15):1641–9.CrossRefPubMed
6.
Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L, et al. Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med. 2005;143(6):427–38.CrossRefPubMed
7.
Panagioti M, Richardson G, Small N, Murray E, Rogers A, Kennedy A, et al. Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis. BMC Health Serv Res. 2014;14(1):356.CrossRefPubMedPubMedCentral
8.
McCorkle R, Ercolano E, Lazenby M, Schulman‐Green D, Schilling LS, Lorig K, et al. Self‐management: enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin. 2011;61(1):50–62.CrossRefPubMedPubMedCentral
9.
Gao W, Yuan C. Self‐management programme for cancer patients: a literature review. Int Nurs Rev. 2011;58(3):288–95.CrossRefPubMed
10.
Trappenburg J, Jonkman N, Jaarsma T, van Os-Medendorp H, Kort H, de Wit N, et al. Self-management: one size does not fit all. Patient Educ Couns. 2013;92(1):134–7.CrossRefPubMed
11.
Taylor D, Bury M. Chronic illness, expert patients and care transition. Sociol Health Illn. 2007;29(1):27–45.CrossRefPubMed
12.
Department of Health, Macmillan Cancer Support and National Health Service Improvement. The National Cancer Survivorship Initiative Vision. London: Department of Health; 2010.
13.
14.
15.
Noblit GW, Hare RD. Meta-ethnography: synthesizing qualitative studies. Newbury Park: Sage; 1988.CrossRef
16.
Britten N, Campbell R, Pope C, Donovan J, Morgan M, Pill R. Using meta ethnography to synthesise qualitative research: a worked example. J Health Serv Res Policy. 2002;7(4):209–15.CrossRefPubMed
17.
Atkins S, Lewin S, Smith H, Engel M, Fretheim A, Volmink J. Conducting a meta-ethnography of qualitative literature: lessons learnt. BMC Med Res Methodol. 2008;8:21.CrossRefPubMedPubMedCentral
18.
Tong A, Flemming K, McInnes E, Oliver S, Craig J. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med Res Methodol. 2012;12:181.CrossRefPubMedPubMedCentral
19.
Kroon FPB, van der Burg LRA, Buchbinder R, Osborne RH, Johnston RV, Pitt V. Self-management education programmes for osteoarthritis. Cochrane Database Syst Rev. 2014;1:CD008963.
20.
Davies N, Batehup L. Self-management support for cancer survivors: guidance for developing interventions. An update of the evidence. Macmillan Cancer Support; 2010.
21.
Critical Appraisal Skills Programme (CASP). CASP Checklists. Oxford: CASP; 2014.
22.
Duggleby W, Holtslander L, Kylma J, Duncan V, Hammond C, Williams A. Metasynthesis of the hope experience of family caregivers of persons with chronic illness. Qual Health Res. 2010;20(2):148–58.CrossRefPubMed
23.
Malpass A, Shaw A, Sharp D, Walter F, Feder G, Ridd M, et al. “Medication career” or “Moral career”? The two sides of managing antidepressants: a meta-ethnography of patients’ experience of antidepressants. Soc Sci Med. 2009;68(1):154–68.CrossRefPubMed
24.
Jackson LJ, Roberts TE. Conceptualising quality of life outcomes for women participating in testing for sexually transmitted infections: a systematic review and meta-synthesis of qualitative research. Soc Sci Med. 2015;143:162–70.CrossRefPubMed
25.
Beckmann K, Strassnick K, Abell L, Hermann J, Oakley B. Is a chronic disease self-management program beneficial to people affected by cancer? Aust J Prim Health. 2007;13(1):36–44.
26.
Bottomley A. Group cognitive behavioural therapy with cancer patients: the views of women participants on a short-term intervention. Eur J Cancer Care. 1998;7(1):23–30.CrossRef
27.
Chambers SK, Morris BA, Clutton S, Foley E, Giles L, Schofield P, et al. Psychological wellness and health-related stigma: a pilot study of an acceptance-focused cognitive behavioural intervention for people with lung cancer. Eur J Cancer Care. 2015;24(1):60–70.CrossRef
28.
Chow KM, Chan CW, Chan JC, Choi KK, Siu KY. A feasibility study of a psychoeducational intervention program for gynecological cancer patients. Eur J Oncol Nurs. 2014;18(4):385–92.CrossRefPubMed
29.
Cimprich B, Janz NK, Northouse L, Wren PA, Given B, Given CW. Taking CHARGE: a self‐management program for women following breast cancer treatment. Psychooncology. 2005;14(9):704–17.CrossRefPubMed
30.
Watts S, Edgar L. Nucare, a coping skills training intervention for oncology patients and families: participants’ motivations and expectations. Can Oncol Nurs J. 2004;14(2):84–95.CrossRefPubMed
31.
Fitch M, McAndrew A, Magee S, Turner F, Ross E. Evaluation of a workshop for survivors: picking up the pieces. Can Oncol Nurs J. 2011;21(3):140–4.CrossRefPubMed
32.
Gray NM, Allan JL, Murchie P, Browne S, Hall S, Hubbard G, et al. Developing a community-based intervention to improve quality of life in people with colorectal cancer: a complex intervention development study. BMJ Open. 2013;3(4):e002596.CrossRefPubMedPubMedCentral
33.
Kilbourn KM, Anderson D, Costenaro A, Lusczakoski K, Borrayo E, Raben D. Feasibility of EASE: a psychosocial program to improve symptom management in head and neck cancer patients. Support Care Cancer. 2013;21(1):191–200.CrossRefPubMed
34.
Loh SY, Ong L, Ng LL, Chew SL, Lee SY, Boniface G. Qualitative experiences of breast cancer survivors on a self-management intervention: 2-year post-intervention. Asian Pac J Cancer Prev. 2011;12(6):1489–95.PubMed
35.
Martin F, Turner A, Bourne C, Batehup L. Development and qualitative evaluation of a self-management workshop for testicular cancer survivor-initiated follow-up. Oncol Nurs Forum. 2013;40(1):E14–23.CrossRefPubMed
36.
Risendal B, Dwyer A, Seidel R, Lorig K, Katzenmeyer C, Coombs L, et al. Adaptation of the Chronic Disease Self-Management Program for cancer survivors: feasibility, acceptability, and lessons for implementation. J Cancer Educ. 2014;29(4):762–71.CrossRefPubMed
37.
Thompson J, Coleman R, Colwell B, Freeman J, Greenfield D, Holmes K, et al. Preparing breast cancer patients for survivorship (PREP)—a pilot study of a patient-centred supportive group visit intervention. Eur J Oncol Nurs. 2014;18(1):10–6.CrossRefPubMed
38.
Lorig KR, Sobel DS, Stewart AL, Brown Jr BW, Bandura A, Ritter P, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999;37(1):5–14.CrossRefPubMed
39.
Wilson PM. The UK expert patients program: lessons learned and implications for cancer survivors’ self-care support programs. J Cancer Surviv. 2008;2(1):45–52.CrossRefPubMed
40.
Salander P. Why doesn’t mind matter when we are to find out what is helpful? Psychooncology. 2011;20(4):441–2.CrossRefPubMed
41.
Taylor SJC, Pinnock H, Epiphaniou E, Pearce G, Parke HL, Schwappach A, et al. A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS – practical systematic review of self-management support for long-term conditions. NIHR HS & DR 2014;2(53).
42.
Campbell HS, Phaneuf MR, Deane K. Cancer peer support programs—do they work? Patient Educ Couns. 2004;55(1):3–15.CrossRefPubMed
43.
Ussher J, Kirsten L, Butow P, Sandoval M. What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer. Soc Sci Med. 2006;62(10):2565–76.CrossRefPubMed
44.
Embuldeniya G, Veinot P, Bell E, Bell M, Nyhof-Young J, Sale JEM, et al. The experience and impact of chronic disease peer support interventions: a qualitative synthesis. Patient Educ Couns. 2013;92(1):3–12.CrossRefPubMed
45.
Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer. 2009;17(8):1117–28.CrossRefPubMed
46.
Ross J, Stevenson F, Lau R, Murray E. Exploring the challenges of implementing e-health: a protocol for an update of a systematic review of reviews. BMJ Open. 2015;5(4):e006773.CrossRefPubMedPubMedCentral
47.
Jansen F, van Uden-Kraan CF, van Zwieten V, Witte BI, Verdonck-de Leeuw IM. Cancer survivors’ perceived need for supportive care and their attitude towards self-management and eHealth. Support Care Cancer. 2015;23(6):1679–88.CrossRefPubMed
48.
Kendall E, Rogers A. Extinguishing the social?: state sponsored self‐care policy and the chronic disease self‐management programme. Disabil Soc. 2007;22(2):129–43.CrossRef
49.
Lawn S, McMillan J, Pulvirenti M. Chronic condition self-management: expectations of responsibility. Patient Ed Couns. 2011;84(2):e5–8.CrossRef
50.
Kendall PR. Investing in prevention: improving health and creating sustainability: the Provincial Officer’s special report. Victoria: Office of the Provincial Health Officer; 2010.
51.
Milkie MA, Raley SB, Bianchi SM. Taking on the second shift: time allocations and time pressures of US parents with preschoolers. Soc Forces. 2009;88(2):487–517.CrossRef
52.
Thirsk LM, Clark AM. What is the ‘self’ in chronic disease self-management? Int J Nurs Studies. 2014;51(5):691–3.CrossRef
53.
Shaw RL, Booth A, Sutton AJ, Miller T, Smith JA, Young B, et al. Finding qualitative research: an evaluation of search strategies. BMC Med Res Methodol. 2004;4:5.CrossRefPubMedPubMedCentral
54.
Swerissen H, Belfrage J, Weeks A, Jordan L, Walker C, Furler J, et al. A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Patient Educ Couns. 2006;64(1):360–8.CrossRefPubMed
55.
Bosma H, Lamers F, Jonkers CC, van Eijk JT. Disparities by education level in outcomes of a self-management intervention: the DELTA trial in The Netherlands. Psychiatr Serv. 2011;62(7):793–5.CrossRefPubMed
56.
Schofield P, Chambers S. Effective, clinically feasible and sustainable: key design features of psycho-educational and supportive care interventions to promote individualised self-management in cancer care. Acta Oncol. 2015;54(5):805–12.CrossRefPubMed
57.
Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: medical research council guidance. BMJ. 2015;350:h1258.CrossRefPubMedPubMedCentral
58.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, et al. Developing and evaluating complex interventions: the new medical research council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
Metadata
Title
Cancer survivors’ perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis
Authors
Laura Coffey
Orla Mooney
Simon Dunne
Linda Sharp
Aileen Timmons
Deirdre Desmond
Eleanor O’Sullivan
Conrad Timon
Rachael Gooberman-Hill
Pamela Gallagher
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 6/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-016-0546-3

Other articles of this Issue 6/2016

Journal of Cancer Survivorship 6/2016 Go to the issue

OriginalPaper

The “Big C”—stigma, cancer, and workplace discrimination

OriginalPaper

Negative information-seeking experiences of long-term prostate cancer survivors

OriginalPaper

Survivorship care plans and adherence to lifestyle recommendations among breast cancer survivors

OriginalPaper

Cancer survivors’ experiences with insurance, finances, and employment: results from a multisite study

OriginalPaper

Understanding strength exercise intentions and behavior in hematologic cancer survivors: an analysis of the intention-behavior gap

OriginalPaper

Trends in cancer survivors’ experience of patient-centered communication: results from the Health Information National Trends Survey (HINTS)
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits