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Cancer survivors’ perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis

Journal of Cancer Survivorship volume 10, pages 1012–1034 (2016)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Implications for Cancer Survivors

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.

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Acknowledgments

This publication is independent research partly funded by the Irish Cancer Society and the Health Research Board (HRB) in Ireland under Grant No: SRP13GAL, MRCG/2013/11. AT is supported by a grant from the HRB (ICE/2012/9). Any opinions, findings, conclusions or recommendations expressed are those of the author(s) and not necessarily those of the Irish Cancer Society or the HRB.

Author information

Authors and Affiliations

  1. Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland

    Laura Coffey & Deirdre Desmond

  2. School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland

    Orla Mooney, Simon Dunne & Pamela Gallagher

  3. Institute of Health and Society, Newcastle University, Newcastle, UK

    Linda Sharp

  4. National Cancer Registry Ireland, Cork, Ireland

    Aileen Timmons

  5. Cork University Dental School and Hospital, Cork, Ireland

    Eleanor O’Sullivan

  6. Department of Otolaryngology/Head and Neck Surgery, St. James’s Hospital, Dublin, Ireland

    Conrad Timon

  7. School of Clinical Sciences, University of Bristol, Bristol, UK

    Rachael Gooberman-Hill

Authors
  1. Laura Coffey
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  2. Orla Mooney
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  3. Simon Dunne
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  4. Linda Sharp
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  7. Eleanor O’Sullivan
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Correspondence to Pamela Gallagher.

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Appendix. Example of a search strategy (Medline)

Appendix. Example of a search strategy (Medline)

Limiters:

  • English language

  • Humans

  • Publication date 1990–current

  1. 1.

    exp neoplasms/

  2. 2.

    (neoplas* or cancer* or tumo?r* or carcino* or malignan* or adenocarcinoma* or lymphoma* or leuk?emia* or onco* or metastat*).tw

  3. 3.

    1 or 2

  4. 4.

    exp Self Care/

  5. 5.

    (self adj (care or help or manag* or direct* or monitor* or efficacy)).tw

  6. 6.

    (selfcare or selfhelp or selfmanag* or selfdirect* or selfmonitor* or selfefficacy).tw

  7. 7.

    ((symptom or stress) adj1 manag*).tw

  8. 8.

    Patient Education as Topic/

  9. 9.

    exp Consumer Participation/

  10. 10.

    ((health or patient*) adj2 (educat* or information)).tw

  11. 11.

    ((patient* or consumer*) adj (focus* or cent* or part*)).tw

  12. 12.

    exp Behavior Therapy/

  13. 13.

    exp Cognitive Therapy/

  14. 14.

    (cbt).tw

  15. 15.

    exp Adaptation, Psychological/

  16. 16.

    ((psychologic* or behavio?r*) adj1 (adjust* or adapt*)).tw

  17. 17.

    Social Support/

  18. 18.

    Self-Help Groups/

  19. 19.

    (peer or patient or emotional or social or psychosocial) adj1 (support or group*).tw

  20. 20.

    (cope* or coping or psychoeducation*).tw

  21. 21.

    Holistic Health/

  22. 22.

    (holistic or wholistic).tw

  23. 23.

    Self Efficacy/

  24. 24.

    “Power (Psychology)”/

  25. 25.

    (empower*).tw

  26. 26.

    ((behavio?r* or cognitive or psychological or psychosocial or interpersonal or relaxation) adj3 (therap* or program* or train* or instruct* or workshop)).tw

  27. 27.

    4–26

  28. 28.

    Interviews as topic/ or interview/ or focus groups/ or narration/ or exp qualitative research/

  29. 29.

    (qualitative or ethnograph* or phenomenol* or ethnonurs* or grounded theor* or purposive sample or hermeneutic* or heuristic* or semiotics or lived experience* or narrative* or life experience* or cluster sample or action research or observational method or content analysis or thematic analysis or constant comparative method or field stud* or fieldwork or field work or key informant or theoretical sample or discourse analysis or focus group* or interview* or discussion* or ethnological research or ethnomethodolog* or mixed model* or mixed design* or multiple method* or multimethod* or triangulat*).tw

  30. 30.

    28 or 29

  31. 31.

    Intervention Studies/ or evaluation studies/ or evaluation studies as topic/ or program evaluation/ or validation studies as topic/ or pilot projects/ or feasibility studies/

  32. 32.

    (pre- adj5 post-).tw

  33. 33.

    (pretest adj5 posttest).tw

  34. 34.

    (program* adj6 evaluat*).tw

  35. 35.

    (effectiveness or intervention or pilot or feasibility or process evaluation).tw

  36. 36.

    31–35

  37. 37.

    3 and 27 and 30 and 36

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Coffey, L., Mooney, O., Dunne, S. et al. Cancer survivors’ perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis. J Cancer Surviv 10, 1012–1034 (2016). https://doi.org/10.1007/s11764-016-0546-3

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