Facilitating healthcare practitioners to deliver self-management support in adult cancer survivors: A realist review

Kantilal, Kumud; Hardeman, Wendy; Whiteside, Hattie; Karapanagioutou, Eleni; Small, Matthew; Bhattacharya, Debi

doi:10.1016/j.sapharm.2022.05.011

Cited by 12 publications

(5 citation statements)

References 63 publications

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“…However, our result differs from a meta-analysis of eight studies that compared the effects of care plans for cancer survivors, which found no significant differences in self-efficacy between groups over time [22]. This difference can be explained by the fact that increased self-efficacy is associated with support strategies for self-management, such as increased knowledge and skill development, which in turn impact patient confidence, in managing the physical and psychosocial effects [26]. Therefore, structured and individualized tools based on cognitive, affective, and social components can facilitate behavior change [27].…”

Section: Discussioncontrasting

confidence: 99%

Effectiveness of the socioecological informed contextual treatment summary and care plan (TSSCP-P, Brazil) for breast cancer survivors: a randomized, controlled study

das Graças Silva Matsubara,

Bergerot,

Ashing

et al. 2024

Support Care Cancer

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Objective This study aimed to evaluate the impact of an intervention using the Treatment Summary and Survivorship Care Plan (TSSCP-P) on self-efficacy and quality of life (QoL) in breast cancer survivors. Method A clinical study, randomized and controlled, conducted to assess self-efficacy and QOL in breast cancer survivors. The participants were randomly assigned to either an intervention group or a control group. The intervention group received individualized nursing consultations guided by the TSSCP-P, while the control group received standard care. Self-efficacy and QoL were assessed at three evaluation moments using validated scales: Functional Assessment of Cancer Therapy-Breast Plus Anm Morbidity (FACT B + 4) and Perceived General Self-Efficacy Scale. Statistical analyses, including regression analysis and hypothesis tests, were conducted to examine the effects of the intervention on self-efficacy and QoL. Results Female breast cancer survivors (N = 101) were recruited. The intervention group demonstrated a significant improvement in self-efficacy over time compared to the control group (p = 0.01). However, no significant differences were observed in the overall QoL scores between the two groups. Subscale analysis revealed a significant improvement in physical well-being for the intervention group (p = 0.04), while emotional well-being showed a non-significant improvement (p = 0.07). The study suggests that individualized care plans and support strategies, such as the TSSCP-P, can positively influence breast cancer survivors’ self-efficacy and certain aspects of their QoL. Conclusion These findings highlight the potential benefits of the TSSCP-P intervention in enhancing self-efficacy among breast cancer survivors. However, further research is needed to explore its impact on overall QoL and its effectiveness across different stages of breast cancer, as well as with longer follow-up periods. Clinical trial registration number Brazilian Registry of Clinical Trials (ReBEC- RBR-2m7qkjy; UTN code: U1111-1257–3560), registered in April 19th, 2022.

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Section: Discussioncontrasting

confidence: 99%

Effectiveness of the socioecological informed contextual treatment summary and care plan (TSSCP-P, Brazil) for breast cancer survivors: a randomized, controlled study

das Graças Silva Matsubara,

Bergerot,

Ashing

et al. 2024

Support Care Cancer

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“…In line with critiques of the cancer trajectory (Bell, 2012;Bluethmann et al, 2015) as a series of "teachable moments" that should provoke agency (Ganz, 2005;McBride et al, 2003), this study suggests the benefits of shifting our attention to consider how social and environmental factors might impact recovery. Participants felt released into a liminal state at discharge, with an absence of discussion around self-management, reflecting other recent literature (Kantilal et al, 2022). With urgent calls to redesign services (Cinar et al, 2021), increase individuals' ability to selfmanage (Howell et al, 2021), and increase guidance around self-care in the next generation of oncology nurses (Chan et al, 2020), it is imperative that the recovery process is carefully characterized.…”

Section: Implications For Cancer Carementioning

confidence: 72%

Turning a Curve: How People Use Everyday Resources to Negotiate Recovery From Cancer Treatment With Curative Intent

Bravington,

Johnson,

Macleod

2024

Qual Health Res

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Many more cancers are treated with intent to cure now than in previous decades, but for most, this involves significant effects from which people need to recover psychologically and socially, as well as physically. This longitudinal photo-elicitation interview study uses grounded theory to explain how people discharged from specialist care made use of everyday social and material resources to manage this process at home. Recovery is presented as a curve in life’s pathway requiring gradual reorientation, drawing on social worlds and domestic resources to calibrate this process. Findings are described in three stages: (1) responding to diagnosis and treatment, (2) using social resources for meaning-making, and (3) developing assets for recovery. During treatment, participants drew on past identities to reinforce their sense of self, and personalized health care communication supported this process. In the weeks after treatment, new frameworks of understanding were constructed from perspectives on cancer encountered in the family, workplace, and outpatient clinics. Recovery processes included the negotiation of personal change, the renegotiation of close relationships, and the use of everyday resources to regain three sensations: control, comfort, and continuity. Supportive care would benefit from an individualized exploration of the assets that can help people to negotiate this challenging phase as treatment comes to a close. Possibilities for self-care (the maintenance of health and well-being in the context of everyday life) can be explored and assessed through personalized discussion around the identities, social worlds, and everyday resources available to each individual.

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“…Furthermore, for SMS to be successful, the barriers to implementation at the organisational and HCP level also need to be understood and overcome. 18 In other cancers, the few available studies indicate that key HCP barriers to implementation of SMS included time, communication between HCPs and appropriate knowledge and training 19,20 ; in addition, lack of HCP confidence in providing SMS led to reduced motivation. 21 A competency framework has been developed to inform SMS training for cancer nurses 22 ; however, healthcare organisations need to be ready and willing to implement SMS, which requires a process of change.…”

Section: People Withmentioning

confidence: 99%

Understanding supported self‐management for people living with a lower‐grade glioma: Implementation considerations through the lens of normalisation process theory

Rimmer,

Finch,

Balla

et al. 2024

Health Expectations

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BackgroundSupported self‐management can improve clinical and psychosocial outcomes in people with cancer; the considerations required to implement self‐management support (SMS) for people living with a lower‐grade glioma (LGG)—who often have complex support needs—are not known. We aimed to identify and understand these implementation considerations through the lens of normalisation process theory (NPT), from the perspectives of healthcare professionals (HCP) and people with LGG.MethodsWe conducted semistructured interviews with HCPs who support adults with brain tumours (n = 25; 12 different healthcare professions), and people with LGG who had completed primary treatment (n = 28; male n = 16, mean age 54.6 years, mean time since diagnosis 8.7 years), from across the United Kingdom. Interviews were transcribed and inductive open coding conducted, before deductively mapping to constructs of NPT. We first mapped HCP data, then integrated data from people with LGG to explore alignment in experiences and perspectives.ResultsWe generated supporting evidence for all four NPT constructs and related subconstructs, namely: ‘Coherence’, ‘Cognitive participation’, ‘Collective action’ and ‘Reflexive monitoring’. Data from HCPs and people with LGG clearly demonstrated that effective SMS constitutes a collective activity. Key implementation considerations included: ensuring awareness of, and access to, support; building strong HCP‐support recipient relationships; and careful inclusion of close family and friends. We identified pertinent challenges, such as identifying support needs (influenced by the extent to which those with LGG engage in help‐seeking), resistance to support (e.g., technology literacy), training for HCPs and HCP cooperation.ConclusionsThis study demonstrates the collective nature of, and provides insight into the individual roles within, supported self‐management. We outline considerations to operationalise, sustain and appraise the implementation of SMS for people with LGG.Patient or Public ContributionPeople with brain tumours, and informal caregivers, were involved in the development of information materials and topic guides to ensure accessibility and pertinence. They also had opportunities to comment on interview findings.

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Facilitating healthcare practitioners to deliver self-management support in adult cancer survivors: A realist review

Cited by 12 publications

References 63 publications

Effectiveness of the socioecological informed contextual treatment summary and care plan (TSSCP-P, Brazil) for breast cancer survivors: a randomized, controlled study

Effectiveness of the socioecological informed contextual treatment summary and care plan (TSSCP-P, Brazil) for breast cancer survivors: a randomized, controlled study

Turning a Curve: How People Use Everyday Resources to Negotiate Recovery From Cancer Treatment With Curative Intent

Understanding supported self‐management for people living with a lower‐grade glioma: Implementation considerations through the lens of normalisation process theory

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