What factors contribute to cancer survivors’ self-management skills? A cross-sectional observational study

• Published in: European journal of oncology nursing : the official journal of European Oncology Nursing Society 2024-04, Vol.69, p.102539-102539, Article 102539
• Main Authors: Been-Dahmen, Janet M.J., van der Stege, Heleen, Oldenmenger, Wendy H., Braat, Cora, van der Lans, Mariska C.M., Scheper, Mark, van Staa, AnneLoes, Ista, Erwin
• Format: Article
• Language: English
• Subjects: Cancer survivors; Holistic support; Nurses; Patient-centered care; Self-management skills
• ISSN: 1462-3889; 1532-2122
• DOI: 10.1016/j.ejon.2024.102539

Many cancer survivors, facing the consequences of their disease and its treatment, have medical and supportive aftercare needs. However, limited knowledge exists regarding the relationship between support needs and survivors' self-management skills. The study aim is to explore factors contributing to cancer survivors’ self-management skills. A cross-sectional study was conducted among cancer survivors (n = 277) of two outpatient oncology clinics at a university hospital in the Netherlands. Patients with head and neck cancer (n = 55) who had received radiotherapy and cisplatin or cetuximab were included, as well as patients who had undergone hematopoietic stem cell transplantation (n = 222). The primary outcome was self-management skills, assessed using the Partners in Health Scale (PIH), which comprises two subscales: knowledge and coping (PIH-KC), and recognition and management of symptoms, and adherence to treatment (PIH-MSA). Secondary outcomes were quality of life (EORTC QLQ-C30), self-efficacy (SECD6), patient-centered care (CAPHS), and social support (HEIQ). Machine learning-based Random Forest models were employed to construct associative models. Feature Importance (FI) was used to express the contribution to the model. High emotional quality of life (FI = 33.1%), increased self-efficacy (FI = 22.2%), and greater social support (FI = 18.2%) were identified as key factors contributing to cancer survivors' self-management knowledge (PIH-KC). Furthermore, greater support from professionals (FI = 36.1%) and higher self-efficacy (FI = 18.2%) were found to benefit participants’ recognition and management, and therapy adherence (PIH-MSA). A patient-centered relationship between nurses and cancer survivors is essential for therapy adherence and the management of aftercare needs. Training to provide this holistic self-management support is required. •Patient-centeredness is the cornerstone of self-management support (68).•Support should focus on survivors' self-efficacy and emotional quality of life (80).•Receiving social support increases cancer survivors' abilities to cope well (78).•Nurses need adequate tools and training to provide holistic aftercare (72).