Coffey Laura, Mooney Orla, Dunne Simon, Sharp Linda, Timmons Aileen, Desmond Deirdre, O'Sullivan Eleanor, Timon Conrad, Gooberman-Hill Rachael, Gallagher Pamela
Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
J Cancer Surviv. 2016 Dec;10(6):1012-1034. doi: 10.1007/s11764-016-0546-3. Epub 2016 May 5.
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.
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.
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.
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.
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.
自我管理干预措施可改善多种长期疾病患者的预后,但往往因接受率和完成率低而受到限制。本文旨在对定性研究进行元综合分析,探讨癌症幸存者对参与以调整为重点的自我管理干预措施的看法和体验,以便为今后针对这一人群的干预措施的制定提供参考。
系统检索了四个电子数据库。纳入使用定性方法探讨癌症幸存者对参与以调整为重点的自我管理干预措施的看法和体验的研究。采用元民族志方法对研究结果进行综合分析。
13项研究符合纳入标准。参与以调整为重点的自我管理干预措施,使癌症幸存者能够在开放、无评判的环境中从同伴和/或促进者那里获得情感和信息支持,通过增强知识和技能以及重新获得信心和控制感而获得力量,并通过接受疾病经历、重新确定目标和采取积极的态度超越癌症。然而,他们参与此类干预措施的程度以及从中获得的益处,因对干预措施的设计、内容和实施方式的不同偏好而受到影响。参与的个人障碍包括认知需求低、不愿讨论与癌症相关的经历以及各种实际问题。
癌症幸存者从参与以调整为重点的自我管理干预措施中获得了一系列益处;在干预措施的推广、设计和实施过程中,应更全面地解决潜在的参与障碍。
研究结果为未来以调整为重点的自我管理干预措施的开发和实施提供了一些关键考虑因素,可能有助于优化这些干预措施在癌症幸存者中的吸引力和有效性。