TY - JOUR
T1 - Self-management of patients with advanced cancer
T2 - A systematic review of experiences and attitudes
AU - van Dongen, Sophie I.
AU - de Nooijer, Kim
AU - Cramm, Jane M.
AU - Francke, Anneke L.
AU - Oldenmenger, Wendy H.
AU - Korfage, Ida J.
AU - Witkamp, Frederika E.
AU - Stoevelaar, Rik
AU - van der Heide, Agnes
AU - Rietjens, Judith Ac
N1 - Funding Information: The authors would like to thank Gerdien de Jonge and Wichor Bramer, biomedical information specialists, at the Erasmus University Medical Centre Rotterdam, for assisting in developing and conducting the search strategy for this systematic review. The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was funded by the Innovational Research Incentives Scheme Vidi of the Netherlands Organisation for Scientific Research (grant number: 91717386, Dr. Rietjens) and by an EUR Fellowship of the Erasmus University Rotterdam (Dr. Rietjens). Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was funded by the Innovational Research Incentives Scheme Vidi of the Netherlands Organisation for Scientific Research (grant number: 91717386, Dr. Rietjens) and by an EUR Fellowship of the Erasmus University Rotterdam (Dr. Rietjens). Publisher Copyright: © The Author(s) 2020. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - BACKGROUND: Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. AIM: To summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management. DESIGN: A systematic review including non-experimental quantitative and qualitative studies. Data were analysed using critical interpretive synthesis. Included studies were appraised on methodological quality and quality of reporting. DATA SOURCES: MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019). RESULTS: Of 1742 identified articles, 31 moderate-quality articles describing 8 quantitative and 23 qualitative studies were included. Patients with advanced cancer used self-management strategies in seven domains: medicine and pharmacology, lifestyle, mental health, social support, knowledge and information, navigation and coordination and medical decision-making (29 articles). Strategies were highly individual, sometimes ambivalent and dependent on social interactions. Older patients and patients with more depressive symptoms and lower levels of physical functioning, education and self-efficacy might have more difficulties with certain self-management strategies (six articles). Healthcare professionals perceived self-management as desirable and achievable if based on sufficient skills and knowledge and solid patient-professional partnerships (three articles). CONCLUSION: Self-management of patients with advanced cancer is highly personal and multifaceted. Strategies may be substitutional, additional or even conflicting compared to care provided by healthcare professionals. Self-management support can benefit from an individualised approach embedded in solid partnerships with relatives and healthcare professionals.
AB - BACKGROUND: Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. AIM: To summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management. DESIGN: A systematic review including non-experimental quantitative and qualitative studies. Data were analysed using critical interpretive synthesis. Included studies were appraised on methodological quality and quality of reporting. DATA SOURCES: MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019). RESULTS: Of 1742 identified articles, 31 moderate-quality articles describing 8 quantitative and 23 qualitative studies were included. Patients with advanced cancer used self-management strategies in seven domains: medicine and pharmacology, lifestyle, mental health, social support, knowledge and information, navigation and coordination and medical decision-making (29 articles). Strategies were highly individual, sometimes ambivalent and dependent on social interactions. Older patients and patients with more depressive symptoms and lower levels of physical functioning, education and self-efficacy might have more difficulties with certain self-management strategies (six articles). Healthcare professionals perceived self-management as desirable and achievable if based on sufficient skills and knowledge and solid patient-professional partnerships (three articles). CONCLUSION: Self-management of patients with advanced cancer is highly personal and multifaceted. Strategies may be substitutional, additional or even conflicting compared to care provided by healthcare professionals. Self-management support can benefit from an individualised approach embedded in solid partnerships with relatives and healthcare professionals.
KW - Cancer
KW - integrative oncology
KW - nursing
KW - palliative care
KW - quality of life
KW - self-care
KW - self-management
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85078862560&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/0269216319883976
DO - https://doi.org/10.1177/0269216319883976
M3 - Review article
C2 - 32009565
SN - 0269-2163
VL - 34
SP - 160
EP - 178
JO - Palliative medicine
JF - Palliative medicine
IS - 2
ER -