Self management and cancer
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Self management and cancer. Claire Foster, PhD, CPsychol Jane Hopkinson, PhD, RN Heidi Hill, PhD David Wright, PhD Liz Roffe, BSc Macmillan Research Unit, University of Southampton. Background. Mortality associated with cancer remains high Advances in diagnostic techniques and treatment

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Self management and cancer

Self management and cancer

Claire Foster, PhD, CPsychol

Jane Hopkinson, PhD, RN

Heidi Hill, PhD

David Wright, PhD

Liz Roffe, BSc

Macmillan Research Unit, University of Southampton

School of Nursing and Midwifery


Background

Background

  • Mortality associated with cancer remains high

  • Advances in diagnostic techniques and treatment

  • Macmillan Listening Study [2005]

    #1 Impact on life; how to live with cancer

  • Many people want active role in managing problems

  • NHS Plan and NICE guidance

  • Workshops with Macmillan Stakeholders [2003]

    Supporting self management

Brennan, J. (2004).Cancer in context: A practical guide to supportive care. OUP.

Hopkinson, J & Corner, J. (2006). Helping patients with advanced cancer live with concerns about eating: A challenge for palliative care professionals. Journal of Pain and Symptom Management, 31 (4), 293-305.

School of Nursing and Midwifery


Focus of systematic review

Focus of systematic review

Supporting self management: Things people do to help themselves when living with cancer

How can people be helped to ‘live’ with cancer and its consequences?

School of Nursing and Midwifery


Self management and cancer

When you leave the clinic, you still have a long term condition. When the visiting nurse leaves your home, you still have a long term condition. In the middle of the night, you fight the pain alone. At the weekend, you manage without your home help. Living with a long term condition is a great deal more than medical or professional assistance [DoH, 2005]

Dept of Health (2005)Supporting people with long term conditions: An NHS and Social Care Model to support local innovation and integration. The Stationery Office: London.

School of Nursing and Midwifery


Self management

Self management

Self management of long term/chronic conditions

Monitor/manage signs and symptoms

Protect and promote health

Manage impact on functioning, emotions, interpersonal relationships

Adhere to treatment

Empower

Build confidence

Enhance QoL

Self management program

Barlow et al. (2005) Self-management training for people with chronic disease: A shared learning experience. Journal of Health Psychology, 10, 863-872

Lorig et al. (2001) Effect of a self-management programme on patients with chronic disease. Effective Clinical Practice, 4, 256-262.

School of Nursing and Midwifery


Approach

Approach

Systematic review of empirical evidence

Defining the search

  • Strategies used by adults living with cancer

  • Patient initiated

    Databases: BIDS, BNI, Cancer.gov, CINAHL, Medline, PsychINFO, Web of Science 1960-2004

    3 independent coders

School of Nursing and Midwifery


The evidence base

The evidence base

37

Papers included in review

97

Full papers retrieved

453

Titles and abstracts (where available) that appeared to meet criteria

8044

Initial scoping

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Self initiated strategies

Self initiated strategies

Self care& Self management

usual everyday behaviour to manage or prevent symptoms

medical management of cancer, symptoms or disease process by patient

Self help

additional activities engaged in to enhance physical and/or psychological well-being

School of Nursing and Midwifery


Key findings

Key findings

Focus of studies

Self care/management (symptoms)

Self help (CAM; support etc)

Lack of theoretical base

Few UK studies (N=3)

Heterogeneous groups

Site

Stage

Age

Gender

School of Nursing and Midwifery


Summary

Summary

  • Research evidence is limited

  • Need to build an understanding of what people do to help themselves and how this can be supported

  • Need to develop theoretical framework

  • Methodological difficulties

  • Self initiated action: term to encompass all activities that individuals engage in to help themselves when living with cancer

School of Nursing and Midwifery


Our research programme

Our research programme

  • Conceptualising self management/action

  • Building evidence base

    • Strategies people use to manage problems/change following treatment

    • Patients with advanced cancer living with weight loss and change in eating habits

  • Working in partnership with health care providers

  • Working in partnership with people affected by cancer

School of Nursing and Midwifery


Further information

Further information

[email protected]

www.mru.nursing.soton.ac.uk

School of Nursing and Midwifery


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