Self-management of patients with advanced cancer: A systematic review of experiences and attitudes

Published: March 16, 2020, 12:04 p.m.

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This episode features\\xa0Kim de Nooijer and Sophie van Dongen\\xa0(Erasmus University Medical Center, Rotterdam,\\xa0Netherlands). \\xa0\\xa0Self-management has\\xa0predominantly been studied in the context of chronic diseases, where it has been defined as \\u2018the ability to manage the symptoms, treatment, physical and\\xa0psychosocial consequences, and lifestyle changes inherent in living with the condition\\u2019.\\xa0Patients with advanced cancer experience severe, multidimensional\\xa0symptoms and challenges and are increasingly expected to actively manage their health and care.\\xa0There still is a lack of insight into the full range of self-management experiences of patients with advanced cancer and the attitudes of relatives and healthcare professionals towards self-management of these\\xa0patients.\\xa0This study demonstrates that self-management strategies of patients with advanced cancer span many domains: medicine and pharmacology,\\xa0lifestyle, psychology, social support, knowledge and information, navigation and coordination and medical decision-making.\\xa0Patients\\u2019 self-management\\xa0strategies and experiences are highly individual and divergent and may be substitutional, additional and distinctive or conflicting compared to care\\xa0provided by healthcare professionals.\\xa0Healthcare professionals perceive self-management as both desirable and achievable if based on sufficient skills and\\xa0knowledge and solid patient\\u2013professional partnerships.\\xa0Self-management support programmes for patients with advanced cancer can benefit from an\\xa0individualised approach that re-evaluates patients\\u2019 needs and wishes, is embedded in solid partnerships with relatives and healthcare professionals, and is\\xa0incorporated into existing models of care.\\xa0Future studies on self-management of patients with advanced cancer need to further examine attitudes of\\xa0relatives and healthcare professionals and investigate effectiveness and working mechanisms at the levels of patients, communities and healthcare\\xa0organisations and policy.

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