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Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial

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Abstract

Purpose

Patient self-management enables living with a chronic disease effectively. This study examines the effectiveness of a 4-week self-management programme to enable self-management of the numerous after-effects and with breast cancer as a chronic disease.

Methods

Upon ethical approval, 147 multiethnic survivors (stages I–III breast cancer) received either a 4-week self-management intervention (n = 68) or usual care (n = 78) on a controlled clinical trial in a medical centre. The facilitator-led group intervention provides self-management support and skills for managing the medical, emotional and role tasks. Survivors completed the pre- and post-intervention measures on quality of life, distress and participation inventory.

Results

Multiple analyses of covariance (adjusted for baseline measures) showed significant differences between groups [F(6, 129) = 2.26, p = 0.04 at post-test and F(6, 129) = 4.090, p < 0.001 at follow-up]. Post hoc analysis indicated significantly better outcome on all measures. At follow-up, the experimental group had a mean quality of life (QOL) score of 3.39 [CI = 1.37–5.42; p = 0.001] greater than the control.

Conclusions

There is preliminary evidence that the 4-week self-management intervention enhance the QOL of women with breast cancer, by enabling them to better self-manage the numerous medical, emotional and role tasks. Further randomised trials are warranted.

Implication for Cancer Survivors

Survivors receiving self-management programme report improved HRQL compared with those on usual care. Although time can attenuate the participation limitation and distress of survivors, self-management programmes could help to increase patients’ self-efficacy for better self-management.

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Acknowledgments

SY Loh received a Research Scholarship, Australia; and cancer research grant from the Malaysian National Cancer Council (MAKNA, Malaysia) and from University Malaya’s Fundamental Research grant. We thank the women with breast cancer who participated in the trial; A Passmore, CH Yip, S Dhaliwal, and R Parson; Dr Patricia Gomez, RN Clarice Ong Tamil Selvi; and OTR FL Tan, OTR M Xavier, and Dr Elizabeth Helsintine for editorial assistance.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50630, Kuala Lumpur, Malaysia

    Siew Yim Loh

  2. Centre for Research into Disability and Society, within the Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Australia

    Tanya Packer

  3. Department of Social Preventive Medicine, University of Malaya, 50630, Kuala Lumpur, Malaysia

    Karuthan Chinna

  4. School of Health and Medicine and Health Sciences, Monash University, Sunway Campus, Bandar Sunway, Malaysia

    Kia Fatt Quek

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  1. Siew Yim Loh
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Correspondence to Siew Yim Loh.

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Loh, S.Y., Packer, T., Chinna, K. et al. Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial. J Cancer Surviv 7, 331–342 (2013). https://doi.org/10.1007/s11764-013-0274-x

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  • DOI: https://doi.org/10.1007/s11764-013-0274-x

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