Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA.
Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada.
Psychol Health. 2023 May;38(5):602-622. doi: 10.1080/08870446.2021.1979549. Epub 2021 Sep 27.
To evaluate feasibility of System Support Mapping (MAP), a systems thinking activity that involves creating a diagram of existing self-management activities (e.g. symptom management, health behaviors) to facilitate autonomous engagement in optimal self-management.
One-arm pilot study of MAP in colorectal cancer survivors (NCT03520283).
Feasibility of recruitment and retention (primary outcome), acceptability, and outcome variability over time.
We enrolled 24 of 66 cancer survivors approached (36%) and 20 completed follow-up (83%). Key reasons for declining participation included: not interested ( = 18), did not perceive a need ( = 9), and emotional distress/overwhelmed ( = 7). Most participants reported that MAP was acceptable (e.g. 80% liked MAP quite a bit/very much). Exploratory analyses revealed a -4.68 point reduction in fatigue from before to 2 weeks after MAP exceeding a minimally important difference ( = -0.68). There were also improvements in patient autonomy ( = 0.63), self-efficacy (for managing symptoms: = 0.56, for managing chronic disease: = 0.44), psychological stress ( = -0.45), anxiety ( = -0.34), sleep disturbance ( = -0.29) and pain ( = -0.32). Qualitative feedback enhanced interpretation of results.
MAP feasibility in colorectal cancer survivors was mixed, predominantly because many patients did not perceive a need for this approach. MAP was acceptable among participants and showed promise for improving health outcomes.
评估系统支持映射（MAP）的可行性，这是一种系统思维活动，涉及创建现有自我管理活动（例如症状管理、健康行为）的图表，以促进自主参与最佳自我管理。
一项针对结直肠癌幸存者的 MAP 单臂试点研究（NCT03520283）。
招募和保留的可行性（主要结局）、可接受性以及随时间的结果变异性。
我们招募了 66 名癌症幸存者中的 24 名（36%），其中 20 名完成了随访（83%）。拒绝参与的主要原因包括：不感兴趣（ = 18）、认为没有必要（ = 9）和情绪困扰/不知所措（ = 7）。大多数参与者报告 MAP 是可以接受的（例如，80%的人非常喜欢 MAP）。探索性分析显示，从 MAP 之前到 2 周后，疲劳感降低了 4.68 分，超过了最小有意义差异（ = -0.68）。患者自主性（ = 0.63）、自我效能（管理症状： = 0.56，管理慢性病： = 0.44）、心理压力（ = -0.45）、焦虑（ = -0.34）、睡眠障碍（ = -0.29）和疼痛（ = -0.32）也有所改善。定性反馈增强了对结果的解释。
MAP 在结直肠癌幸存者中的可行性喜忧参半，主要是因为许多患者认为不需要这种方法。参与者对 MAP 是可接受的，并且有望改善健康结果。
