Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Palliat Med. 2020 Feb;34(2):160-178. doi: 10.1177/0269216319883976.
Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention.
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.
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.
MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019).
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).
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.
患有晚期癌症的患者越来越需要自我管理。到目前为止，这个话题还没有得到系统的关注。
总结描述晚期癌症患者自我管理策略以及相关经验和个人特征的研究。总结亲属和医疗保健专业人员对患者自我管理的态度。
一项系统综述，包括非实验性定量和定性研究。使用批判性解释合成法分析数据。对纳入的研究进行方法学质量和报告质量评估。
MEDLINE、Embase、Cochrane 中心、PsycINFO、CINAHL、Web of Science 和 Google Scholar（截至 2019 年 6 月 11 日）。
在 1742 篇已确定的文章中，纳入了 31 篇中等质量的文章，这些文章描述了 8 项定量研究和 23 项定性研究。晚期癌症患者在七个领域使用自我管理策略：药物和药理学、生活方式、心理健康、社会支持、知识和信息、导航和协调以及医疗决策（29 篇文章）。策略高度个体化，有时存在矛盾，取决于社会互动。年龄较大的患者和抑郁症状较多、身体功能、教育和自我效能较低的患者在某些自我管理策略上可能会遇到更多困难（6 篇文章）。医疗保健专业人员认为，如果基于足够的技能和知识以及牢固的医患伙伴关系，自我管理是可取且可行的（3 篇文章）。
晚期癌症患者的自我管理是高度个性化和多方面的。与医疗保健专业人员提供的护理相比，策略可能是替代、附加甚至冲突的。自我管理支持可以从嵌入与亲属和医疗保健专业人员牢固伙伴关系的个性化方法中受益。
