Mar 16, 2020
This episode features Kim de Nooijer and Sophie van
Dongen (Erasmus University Medical Center,
Rotterdam, Netherlands). Self-management
has predominantly been studied in the context of chronic
diseases, where it has been defined as ‘the ability to manage the
symptoms, treatment, physical and psychosocial consequences,
and lifestyle changes inherent in living with the
condition’. Patients with advanced cancer experience severe,
multidimensional symptoms and challenges and are increasingly
expected to actively manage their health and care. There still
is a lack of insight into the full range of self-management
experiences of patients with advanced cancer and the attitudes of
relatives and healthcare professionals towards self-management of
these patients. This study demonstrates that
self-management strategies of patients with advanced cancer span
many domains: medicine and pharmacology, lifestyle,
psychology, social support, knowledge and information, navigation
and coordination and medical decision-making. Patients’
self-management strategies and experiences are highly
individual and divergent and may be substitutional, additional and
distinctive or conflicting compared to care provided by
healthcare professionals. Healthcare professionals perceive
self-management as both desirable and achievable if based on
sufficient skills and knowledge and solid patient–professional
partnerships. Self-management support programmes for patients
with advanced cancer can benefit from an individualised
approach that re-evaluates patients’ needs and wishes, is embedded
in solid partnerships with relatives and healthcare professionals,
and is incorporated into existing models of care. Future
studies on self-management of patients with advanced cancer need to
further examine attitudes of relatives and healthcare
professionals and investigate effectiveness and working mechanisms
at the levels of patients, communities and
healthcare organisations and policy.