Which self-management strategies do health care professionals recommend to their cancer patients? An experimental investigation of patient age and treatment phase
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This vignette based study aimed to examine recommendations of health care professionals (HCPs) in promoting self-management strategies to cancer patients. Nine-hundred-forty-two physicians and nurses were asked to (1) indicate if they would recommend self-management strategies to a vignette cancer patient, and (2) to specify those in an open format. Vignettes included a manipulation of patient age (60 vs. 75 years) and treatment phase (currently treated versus treatment completed). Six categories emerged through coding a total of 2303 recommendations: physical activity (71.8%), nutrition (64.3%), psychological support (36.7%), medical support (29.2%), conscious living (17.2%) and naturopathy (12.3%). While psychological support was particularly recommended during treatment, physical activity was more frequently recommended after completion of treatment. Results suggest that HCPs recommend a variety of self-management strategies besides standard medical treatment. Patient’s treatment phase and age seem to partly influence recommendation behavior, potentially indicating insecurities regarding acute treatment situations and age-related stereotypes.
KeywordsCancer Health care professionals Perceived control Physical activity Self-management Vignette study
This study was part of the Momentum Project Heidelberg and was supported by a Grant from the German Cancer Aid (Grant Nos. 110512, 110551 and 111223). We thank Anastasia Penner, Fiona Rupprecht, Sophie Scherer and Kim Alice Schouten for their help in the recruitment, coding procedure and data-management.
Compliance with ethical standards
Conflict of interest
Nadine Ungar, Laura Schmidt, Martina Gabrian, Alexander Haussmann, Angeliki Tsiouris, Monika Sieverding, Karen Steindorf, and Joachim Wiskemann declares that they have no conflict of interest.
Human and animal rights and Informed consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- Arat, S., Van den Zegel, A., Van Rillaer, M., Moons, P., Vandenberghe, J., De Langhe, E., et al. (2016). Development and preliminary evaluation of the validity and reliability of a revised illness perception questionnaire for healthcare professionals. BMC Nursing, 15, 34. https://doi.org/10.1186/s12912-016-0156-4 CrossRefGoogle Scholar
- Bandura, A. (2000). Self-efficacy. In Encyclopedia of psychology (Vol. 7, pp. 537–538). Washington, DC: American Psychological Association.Google Scholar
- Boger, E., Ellis, J., Latter, S., Foster, C., Kennedy, A., Jones, F., et al. (2015). Self-management and self-management support outcomes: A systematic review and mixed research synthesis of stakeholder views. PLoS ONE, 10, e0130990. https://doi.org/10.1371/journal.pone.0130990 CrossRefGoogle Scholar
- Brearley, S. G., Stamataki, Z., Addington-Hall, J., Foster, C., Hodges, L., Jarrett, N., et al. (2011). The physical and practical problems experienced by cancer survivors: A rapid review and synthesis of the literature. European Journal of Oncology Nursing, 15, 204–212. https://doi.org/10.1016/j.ejon.2011.02.005 CrossRefGoogle Scholar
- Charlier, C., Van Hoof, E., Pauwels, E., Lechner, L., Spittaels, H., Bourgois, J., et al. (2012). Treatment-related and psychosocial variables in explaining physical activity in women three weeks to six months post-treatment of breast cancer. Patient Education and Counseling, 89, 171–177. https://doi.org/10.1016/j.pec.2012.06.029 CrossRefGoogle Scholar
- Council of the European Union. (2008) Council conclusions on reducing the burden of cancer. In 2876th Employment, social policy, health and consumer affairs council meeting, Luxembourg.Google Scholar
- Crocker, J., & Quinn, D. M. (2000). Social stigma and the self: Meanings, situations, and self-esteem. In T. F. Heatherton, E. R. Kleck, M. R. Hebl, & J. G. Hull (Eds.), The social psychology of stigma (pp. 153–183). New York, London: The Guilford Press.Google Scholar
- de Melo Ghisi, G. L., Abdallah, F., Grace, S. L., Thomas, S., & Oh, P. (2014). A systematic review of patient education in cardiac patients: Do they increase knowledge and promote health behavior change? Patient Education and Counseling, 95, 160–174. https://doi.org/10.1016/j.pec.2014.01.012 CrossRefGoogle Scholar
- Dimeo, F. C. (2010). Körperliche Aktivität und Sport bei Tumorerkrankungen - Bewegung im eigenen Takt [Physical activity and exercise in tumor diseases: Movement in the own rythm]. Im Focus Onkologie, 5, 60–66.Google Scholar
- Haussmann, A., Gabrian, M., Ungar, N., Jooß, S., Wiskemann, J., Sieverding, M., et al. (2018). What hinders health care professionals in promoting physical activity towards cancer patients? The influencing role of health care professionals’ concerns, perceived patient characteristics, and perceived structural factors. European Journal of Cancer Care. https://doi.org/10.1111/ecc.12853 Google Scholar
- Jones, L. W., Courneya, K. S., Fairey, A. S., & Mackey, J. R. (2004). Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: A single-blind, randomized controlled trial. Annals of Behavioral Medicine, 28, 105–113. https://doi.org/10.1207/s15324796abm2802_5 CrossRefGoogle Scholar
- Karvinen, K., DuBose, K., Carney, B., & Allison, R. (2010). Promotion of physical activity among oncologists in the United States. The Journal of Supportive Oncology, 8, 35–41.Google Scholar
- Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. In S. Rachman (Ed.), Contributions to medical psychology (Vol. 2, pp. 7–30). New York: Pergamon.Google Scholar
- McGowan, E. L., Speed-Andrews, A. E., Blanchard, C. M., Rhodes, R. E., Friedenreich, C. M., Cubs-Reed, S. N., et al. (2013). Physical activity preferences among a population-based sample of colorectal cancer survivors. Oncology Nursing Forum, 40, 44–52. https://doi.org/10.1188/13.onf.44-52 CrossRefGoogle Scholar
- Nyrop, K. A., Deal, A. M., Williams, G. R., Guerard, E. J., Pergolotti, M., & Muss, H. B. (2016). Physical activity communication between oncology providers and patients with early-stage breast, colon, or prostate cancer. Cancer, 122, 470–476. https://doi.org/10.1002/cncr.29786 CrossRefGoogle Scholar
- Schmitz, K. H., Courneya, K. S., Matthews, C., Demark-Wahnefried, W., Galvao, D. A., Pinto, B. M., et al. (2010). American college of sports medicine roundtable on exercise guidelines for cancer survivors. Medicine and Science in Sports and Exercise, 42, 1409–1426. https://doi.org/10.1249/MSS.0b013e3181e0c112 CrossRefGoogle Scholar
- Shneerson, C., Taskila, T., Holder, R., Greenfield, S., Tolosa, I., Damery, S., et al. (2014). Patterns of self-management practices undertaken by cancer survivors: Variations in demographic factors. European Journal of Cancer Care, 24, 683–694. https://doi.org/10.1111/ecc.12252 CrossRefGoogle Scholar
- Tamagawa, R., Garland, S., Vaska, M., & Carlson, L. E. (2012). Who benefits from psychosocial interventions in oncology? A systematic review of psychological moderators of treatment outcome. Journal of Behavioral Medicine, 35, 658–673. https://doi.org/10.1007/s10865-012-9398-0 CrossRefGoogle Scholar
- Ungar, N., Tsiouris, A., Haussmann, A., Herbolsheimer, F., Wiskemann, J., Steindorf, K., & Sieverding, M. (under revision). To rest or not to rest - health care professionals’ attitude toward recommending physical activity to their cancer patients. Psycho-Oncology.Google Scholar