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Zubair HM, Khan MA, Gulzar F, Alkholief M, Malik A, Akhtar S, Sharif A, Akhtar MF, Abbas M. Patient Perspectives and Side-Effects Experience on Chemotherapy of Non-Small Cell Lung Cancer: A Qualitative Study. Cancer Manag Res 2023; 15:449-460. [PMID: 37255669 PMCID: PMC10226488 DOI: 10.2147/cmar.s396751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/03/2023] [Indexed: 06/01/2023] Open
Abstract
Purpose This study aimed to explore patients' experiences of palliative chemotherapy for non-small cell lung cancer (NSCLC), how patients adapt to their new and challenging life after chemotherapy, their beliefs, and their quality of life. Patients and Methods The study used an exploratory descriptive qualitative approach that was designed to explore the experiences and side effects of NSCLC patients on chemotherapy in Pakistan. The study was designed to obtain a deeper understanding of 22 NSCLC patients' experiences, using a face-to-face approach and interviews were conducted. Patients who have completed chemotherapy agreed to participate in semi-structured interviews. Results The data were arranged into five themes: hospital facilities and environment, patient's beliefs in alternative treatments, presenting a positive/negative face, life is for living, and health insurance coverage. The major complaints related to bad experiences of chemotherapy-induced side effects, but these patients still managed to complete the full course of their respective chemotherapy. Additionally, the current study revealed the real experience of patients with NSCLC which had been less studied. The patient's experience was summarized into four themes and several subthemes. Conclusion This study aid healthcare providers when deciding on treatment options that will improve shared decision-making between clinicians and treatment outcomes.
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Affiliation(s)
| | - Muhammad Arslan Khan
- Department of Pharmacy Services, The University of Lahore Teaching Hospital, Lahore, Pakistan
| | - Faisal Gulzar
- Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Musaed Alkholief
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdul Malik
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Akhtar
- Department of Biochemistry, A.T. Still University of Health Sciences, Kirksville, MO, USA
| | - Ali Sharif
- Department of Pharmacology, Institute of Pharmacy, Lahore College for Women University, Lahore, Pakistan
| | - Muhammad Furqan Akhtar
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Campus, Lahore, Pakistan
| | - Muhammad Abbas
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Islamabad, Pakistan
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Yan T, Chan CWH, Chow KM, Li M. Experiences and perception of character strengths among patients with breast cancer in China: a qualitative study. BMJ Open 2022; 12:e061994. [PMID: 36307158 PMCID: PMC9621164 DOI: 10.1136/bmjopen-2022-061994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/06/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To explore the patients' experiences on character strengths that Chinese patients experience after the diagnosis of breast cancer. DESIGN A qualitative, exploratory study using semistructured interviews based on the patients' lived experience after being diagnosed with breast cancer. Ethics approval was granted. Interviews were audiorecorded and transcribed verbatim. Values in Action Classification of Strengths provided conceptual framework for analysing strengths. Directed content analysis based on the classification of strengths and framework analysis were used to analyse transcribed data. The Standards for Reporting Qualitative Research guideline was followed. SETTING The Second Affiliated Hospital of Zhengzhou University and Henan Provincial Cancer Hospital in China. PARTICIPANTS Adult patients over 18 years, diagnosed with breast cancer between October 2019 and December 2020 were recruited. We used purposive sample method to collected data from 24 participants diagnosed with breast cancer. RESULTS Six themes (virtues) emerged from our analysis. In addition, two new subthemes (character strengths) emerged in this study, selflessness and pragmatism, respectively. Patients with breast cancer described a large repertoire of character strengths they used or wished for during survivorship, including gratitude, hope, humility, kindness, humour, honesty and forgiveness. Cultural values (eg, collectivism, familyism, Confucianism and Buddhist beliefs) helped structure the experiences of Chinese patients' character strengths. Patients wanted their character strengths to be more noticed, appreciated and encouraged by others and reported their psychological trajectory of using personal strengths. CONCLUSION The findings indicated that patients with breast cancer believing character strengths are important to them. Medical staff should pay more attention to motivating and cultivating character strengths of patients with breast cancer. Attention to make strength-based practices workable in clinical health promotion programmes is necessary. The healthcare system should develop tailored individualised psychological services that specifically address patients' needs for the application of personalised character strengths. TRIAL REGISTRATION NUMBER NCT04219267, Pre-results.
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Affiliation(s)
- Tingting Yan
- School of Nursing, Peking University, Beijing, Beijing, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, Beijing, China
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Jessen S, Mirkovic J, Halvorsen Brendmo E, Solberg Nes L. Evaluating a Strengths-Based mHealth Tool (MyStrengths): Explorative Feasibility Trial. JMIR Form Res 2021; 5:e30572. [PMID: 34787580 PMCID: PMC8663534 DOI: 10.2196/30572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/03/2021] [Accepted: 10/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As the number of people living with chronic illnesses increases, providing wide-reaching and easy-to-use support tools is becoming increasingly important. Supporting people in this group to recognize and use more of their personal strengths has the potential to improve their quality of life. With this in mind, we have developed the MyStrengths app prototype, a gamefully designed app aimed at aiding users in both identifying their strengths and using these strengths more actively in their daily life. OBJECTIVE The goal of this study was to evaluate the user-reported feasibility and usefulness of the MyStrengths app. The study additionally aimed to explore whether the use of MyStrengths could be associated with selected psychosocial outcomes. METHODS A 31-day explorative feasibility trial with a pretest-posttest design and an optional end of study interview was conducted. Data collection included system-use log data, demographic information, pre- and post-psychosocial measures (ie, strengths use, self-efficacy, health-related quality of life, depression), user experience measures (ie, usability, engagement, flow), and interview data. RESULTS In total, 34 people with at least 1 chronic condition were enrolled in the study, with 26 participants (mean age 48 years, range 29-62 years; 1 male) completing the trial. Among these individuals, 18 were also interviewed posttrial. Participants used the MyStrengths app an average of 6 days during the trial period, with 54% (14/26) using the app over a period of at least 19 days. In total, 8738 unique app actions were registered. Of the psychosocial outcome measures, only 1 subscale, general health in the RAND 36-Item Health Survey, yielded significant pre- and posttest changes. Posttrial interviews showed that the number of participants who considered the MyStrengths app to be useful, somewhat useful, or not useful was evenly distributed across 3 groups. However, every participant did voice support for the strengths approach. All participants were able to identify a multitude of personal strengths using the MyStrengths app. Most participants that reported it to be useful had little or no previous experience with the personal strengths approach. A multitude of users welcomed the gameful design choices, particularly the rolling die feature, suggesting strengths exercises, activities that use a specific strength, were well received. CONCLUSIONS Although the reported usefulness and feedback from use varied, most participants were favorable to the strengths-focused approach to care and support. Consequently, low-threshold and wide-reaching mobile health tools that use a strengths-focused approach, such as MyStrengths, hold the potential to support people living with chronic illness in performing self-management and achieving mastery of their life.
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Affiliation(s)
- Stian Jessen
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jelena Mirkovic
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Elanor Halvorsen Brendmo
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
- Department of Psychiatry and Psychology, Mayo Clinic, College of Medicine and Science, Rochester, MN, United States
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Singh S, Orlando JM, Alghamdi ZS, Franklin KA, Lobo MA. Reframing Clinical Paradigms: Strategies for Improving Patient Care Relationships. Phys Ther 2021; 101:6178887. [PMID: 33742681 DOI: 10.1093/ptj/pzab095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/17/2020] [Accepted: 02/11/2021] [Indexed: 12/21/2022]
Abstract
This article presents strategies for reframing clinical paradigms to build better therapeutic relationships with patients and the members of their support network from the unique and important lens of a parent and disability researcher. First, a brief history of the evolution of models of care is presented, and implementation of the current biopsychosocial model is discussed. Then, evidence-based practice and the role of the patient perspective is considered. Next, specific examples, tools, techniques, guidelines, and resources to foster the demonstration of patient-informed respect and patient-centered communication in clinical practice are provided. Examples and resources are presented that can be accessed and implemented immediately, without cost to the practitioner and with the vast potential to improve care, therapeutic relationships, and patient outcomes. It is important for health care providers and researchers in all practice areas and across all experience levels to regularly evaluate their psychosocial skills. It is critical that the voices of patients and the members of their support network are central in this process. This can enable health care providers to acknowledge areas for growth and to implement changes effectively and efficiently at the individual level to facilitate changes across the broader spectrum of health care practice.
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Affiliation(s)
- Shailen Singh
- Department of Organization, Workforce, and Leadership Studies, Texas State University, Round Rock, Texas, USA
| | - Julie M Orlando
- Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| | - Zainab S Alghamdi
- Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| | | | - Michele A Lobo
- Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
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Cuthbert CA, Farragher JF, Farrer CL, Cheung WY. Living with paradox: A qualitative study of colorectal cancer patients' experiences in managing their health after cancer treatment. Eur J Cancer Care (Engl) 2021; 30:e13416. [PMID: 33506569 DOI: 10.1111/ecc.13416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/09/2020] [Accepted: 01/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Managing one's health after colorectal cancer may present specific challenges given long-term impacts to biopsychosocial functioning. Understanding experiences of managing one's health post-treatment is important to informing patient-centred supportive care. METHODS A qualitative study with 19 patients who had completed treatment for colorectal cancer to explore the experience of managing one's health. Following Thorne's Interpretive Description, we conducted interviews using either focus groups or individual interviews. Transcribed data were analysed following Thorne's approach. Sociodemographic and clinical characteristics were also collected. RESULTS The metaphor of living with paradox was the main theme characterising the experiences of managing one's health in the post-treatment period. Participants described the ambiguity of health, their need to accept the new normal, losing control and taking back control, experiencing positive and negative life changes, and the need to continually reframe their perspectives to focus on the positives. CONCLUSION Our findings suggest that providing patient-centred care to colorectal cancer survivors post-treatment involves recognising their changing and sometimes conflicting experiences. Their ability to manage their health may fluctuate and their supportive care needs may not fit with a particular trajectory. Cancer care systems should strive for flexibility in the structure and timing of support available.
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Affiliation(s)
- Colleen A Cuthbert
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.,Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Janine F Farragher
- Department of Occupational Science and Occupational Therapy, University of Toronto, Calgary, Alberta, Canada
| | - Christie L Farrer
- Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Winson Y Cheung
- Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,CancerControl, Alberta Health Services, Calgary, Alberta, Canada
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Holland DE, Vanderboom CE, Mandrekar J, Borah BJ, Dose AM, Ingram CJ, Griffin JM. A technology-enhanced model of care for transitional palliative care versus attention control for adult family caregivers in rural or medically underserved areas: study protocol for a randomized controlled trial. Trials 2020; 21:895. [PMID: 33115524 PMCID: PMC7594268 DOI: 10.1186/s13063-020-04806-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Transitioning care from hospital to home is associated with risks of adverse events and poor continuity of care. These transitions are even more challenging when new approaches to care, such as palliative care, are introduced before discharge. Family caregivers (FCGs) are expected to navigate these transitions while also managing care. In addition to extensive caregiving responsibilities, FCGs often have their own health needs that can inhibit their ability to provide care. Those living in rural areas have even fewer resources to meet their self-care and caregiving needs. The purpose of this study is to test the efficacy and cost-effectiveness of an intervention to improve FCGs’ health and well-being. The intervention uses video visits to teach, guide, and counsel FCGs in rural areas during hospital-to-home transitions. The intervention is based on evidence of transitional and palliative care principles, which are individualized to improve continuity of care, provide caregiver support, enhance knowledge and skills, and attend to caregivers’ health needs. It aims to test whether usual care practices are similar to this technology-enhanced intervention in (1) caregiving skills (e.g., caregiving preparedness, communication with clinicians, and satisfaction with care), (2) FCG health outcomes (e.g., quality of life, burden, coping skills, depression), and (3) cost. We describe the rationale for targeting rural caregivers, the methods for the study and intervention, and the analysis plan to test the intervention’s effect. Methods The study uses a randomized controlled trial design, with FCGs assigned to the control condition or the caregiver intervention by computer-generated lists. The intervention period continues for 8 weeks after care recipients are discharged from the hospital. Data are collected at baseline, 2 weeks, 8 weeks, and 6 months. Time and monetary costs from a societal perspective are captured monthly. Discussion This study addresses 2 independent yet interrelated health care foci—transitional care and palliative care—by testing an intervention to extend palliative care practice and improve transition management for caregivers of seriously ill patients in rural areas. The comprehensive cost assessment will quantify the commitment and financial burden of FCGs. Trial registration ClinicalTrials.gov NCT03339271. Registered on 13 November 2017. Protocol version: 11. Supplementary information Supplementary information accompanies this paper at 10.1186/s13063-020-04806-0.
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Affiliation(s)
- Diane E Holland
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Catherine E Vanderboom
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jay Mandrekar
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Bijan J Borah
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.,The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Ann Marie Dose
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Cory J Ingram
- Center for Palliative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joan M Griffin
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA. .,The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
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Jessen S, Mirkovic J, Nes LS. MyStrengths, a Strengths-Focused Mobile Health Tool: Participatory Design and Development. JMIR Form Res 2020; 4:e18049. [PMID: 32706651 PMCID: PMC7414410 DOI: 10.2196/18049] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/06/2020] [Accepted: 06/13/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND People living with chronic illnesses are an increasingly large group. Research indicates that care and self-management should not only focus on the illness and problem-oriented aspects of these individuals' lives but also support them in recognizing and leveraging their personal strengths in daily life. OBJECTIVE This paper presents the design and developmental process of MyStrengths, a mobile health (mHealth) app designed to help its users (people with chronic conditions) both find and make use of their personal strengths in their daily lives. Through 4 consecutive phases, this paper presents participant- and researcher-driven activities, discussions regarding design, and development of both the MyStrengths app and its content. METHODS During the 4 phases, we used a range of methods and activities, including (1) an idea-generating workshop aimed at creating ideas for strengths-supporting features with different stakeholders, including patients, caregivers, relatives, and designers (N=35); (2) research seminars with an international group of experts (N=6), in which the concept, theoretical background, and design ideas for the app were discussed; (3) a series of co-design workshops with people in the user group (N=22) aiming to create ideas for how to, in an engaging manner, design the app; and (4) in 4 developmental iterations, the app was evaluated by people in the user group (N=13). Content and strengths exercises were worked on and honed by the research team, the expert groups, and our internal editorial team during the entire developmental process. RESULTS The first phase found a wide range of stakeholder requirements to, and ideas for, strengths-focused mHealth apps. From reviewing literature during the second phase, we found a dearth of research on personal strengths with respect to people living with chronic illnesses. Activities during the third phase creatively provided numerous ideas and suggestions for engaging and gameful ways to develop and design the MyStrengths app. The final phase saw the output from all the earlier phases come together. Through multiple increasingly complete iterations of user evaluations testing and developing, the final prototype of the MyStrengths app was created. CONCLUSIONS Although research supports the use of strengths-focused mHealth tools to support people living with chronic illnesses, there is little guidance as to how these tools and their content should be designed. Through all activities, we found great support among participating users for strengths-focused apps, and we can consider such apps to be both appropriate and valuable. This paper illustrates how combining a range of user-, researcher-, literature-, and designer-based methods can contribute to creating mHealth tools to support people with chronic illnesses to find and use more of their own personal strengths.
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Affiliation(s)
- Stian Jessen
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jelena Mirkovic
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Hanghøj S, Pappot H, Hjalgrim LL, Hjerming M, Visler CL, Boisen KA. Experiences of involvement processes during participation in cancer service user initiatives from an adolescent and young adult perspective. Int J Adolesc Med Health 2020; 34:67-75. [PMID: 32543451 DOI: 10.1515/ijamh-2019-0253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 01/30/2020] [Indexed: 11/15/2022]
Abstract
Background Service user participation contributes to the improvement of health care services for the betterment of conditions experienced by patients. However, there is a lack of knowledge about how adolescents and young adults (AYAs) experience involvement processes in practice and what it would take to achieve a high degree of involvement according to AYAs. Objectives To explore: (1) how AYAs with cancer experienced involvement processes during participation in three different service user involvement initiatives (development of an app, development of a book and youth panel meetings), and (2) AYAs' perceptions of determination and collaborative areas between AYAs and professionals. Methods Individual semi-structured interviews were conducted with 12 AYAs with cancer aged 16-29 who had participated in at least one of the service user initiatives in Kræftværket, a youth cancer support centre and social organisation located at Copenhagen University Hospital, Denmark. We analysed data with thematic analysis. Results We identified three main themes with matching sub-themes: Working procedures (Agenda setting, Workflow, Dialogue), Knowledge sharing (AYAs' needs and ideas, Areas of expertise), Influence (Decisions, Ownership). Generally, the participants experienced an equal dialogue with professionals and felt they had the final say on decisions. Conclusions This study produced specific suggestions on how to involve AYAs to a high extent. Based on AYAs' own perceptions of involvement, AYAs', professionals' and shared determination areas were illuminated. Additionally, the AYAs highlighted how the professionals gave feedback during co-creation processes, which may inspire future service user involvement projects.
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Affiliation(s)
- Signe Hanghøj
- Center of Adolescent Medicine, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lisa Lyngsie Hjalgrim
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Hematology, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Camilla Louise Visler
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten A Boisen
- Center of Adolescent Medicine, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Kristjansdottir OB, Stenberg U, Mirkovic J, Krogseth T, Ljoså TM, Stange KC, Ruland CM. Personal strengths reported by people with chronic illness: A qualitative study. Health Expect 2018; 21:787-795. [PMID: 29478260 PMCID: PMC6117496 DOI: 10.1111/hex.12674] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Self-management of chronic illness can be highly demanding and people need to mobilize their personal strengths to live well with their condition. More knowledge is needed about how people with chronic illness perceive and use their personal strengths as a basis for better integrating empowering person-centred approaches into health care. OBJECTIVE To explore what people with chronic illness describe as their strengths relevant to their health and well-being. SETTING AND PARTICIPANTS Thirty-nine participants (11 men) from 4 outpatient self-management programmes were recruited to individual or group interviews. Participants included patients with chronic respiratory disease (n = 7), chronic pain (n = 18) and morbid obesity (n = 14). Interviews were analysed using content analysis. RESULTS A number of personal strengths were reported and categorized into 3 domains: (i) Internal strengths, (ii) External strengths and (iii) Self-management strategies. Internal strengths included being persistent, having a positive outlook, being kind and caring, experiencing positive emotions, being kind towards oneself, reconciling oneself with the situation, having courage and having knowledge and insight. External strengths included support from family, friends, peers and health-care providers. Self-management strategies included being active, planning and prioritizing, reducing stress, goal setting and seeking knowledge and help. DISCUSSION AND CONCLUSION The study provides insights into personal strengths as reported by people with chronic illness. The results complement prior findings on strengths in people with health challenges and can aid in incorporating person-centred approaches into health care.
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Affiliation(s)
- Olöf Birna Kristjansdottir
- Center for Shared Decision Making and Collaborative Care ResearchDivision of MedicineOslo University HospitalOsloNorway
| | - Una Stenberg
- Center for Shared Decision Making and Collaborative Care ResearchDivision of MedicineOslo University HospitalOsloNorway
- Norwegian National Advisory Unit on Learning and Mastery in HealthOslo University HospitalOsloNorway
| | - Jelena Mirkovic
- Center for Shared Decision Making and Collaborative Care ResearchDivision of MedicineOslo University HospitalOsloNorway
| | - Tonje Krogseth
- Center for Shared Decision Making and Collaborative Care ResearchDivision of MedicineOslo University HospitalOsloNorway
| | - Tone Marte Ljoså
- Department of Pain Management and ResearchOslo University HospitalOsloNorway
| | - Kurt C. Stange
- Center for Community Health IntegrationCase Western Reserve UniversityClevelandOHUSA
| | - Cornelia M. Ruland
- Center for Shared Decision Making and Collaborative Care ResearchDivision of MedicineOslo University HospitalOsloNorway
- Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
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Tanaka K. Strengths promoting the recovery process in older adults with depression. J Clin Nurs 2018; 27:3032-3043. [DOI: 10.1111/jocn.14359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Koji Tanaka
- Department of Nursing; School of Nursing; Kanazawa Medical University; Kahoku-gun Japan
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11
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Mirkovic J, Jessen S, Kristjansdottir OB, Krogseth T, Koricho AT, Ruland CM. Developing Technology to Mobilize Personal Strengths in People with Chronic Illness: Positive Codesign Approach. JMIR Form Res 2018; 2:e10774. [PMID: 30684404 PMCID: PMC6334702 DOI: 10.2196/10774] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 12/11/2022] Open
Abstract
Background Emerging research from psychology and the bio-behavioral sciences recognizes the importance of supporting patients to mobilize their personal strengths to live well with chronic illness. Positive technology and positive computing could be used as underlying design approaches to guide design and development of new technology-based interventions for this user group that support mobilizing their personal strengths. Objective A codesigning workshop was organized with the aim to explore user requirements and ideas for how technology can be used to help people with chronic illness activate their personal strengths in managing their everyday challenges. Methods Thirty-five participants from diverse backgrounds (patients, health care providers, designers, software developers, and researchers) participated. The workshop combined principles of (1) participatory and service design to enable meaningful participation and collaboration of different stakeholders and (2) an appreciative inquiry methodology to shift participants’ attention to positive traits, values, and aspects that are meaningful and life-giving and stimulate participants’ creativity, engagement, and collaboration. Utilizing these principles, participants were engaged in group activities to develop ideas for strengths-supportive tools. Each group consisted of 3-8 participants with different backgrounds. All group work was analysed using thematic analyses. Results Participants were highly engaged in all activities and reported a wide variety of requirements and ideas, including more than 150 personal strength examples, more than 100 everyday challenges that could be addressed by using personal strengths, and a wide range of functionality requirements (eg, social support, strength awareness and reflection, and coping strategies). 6 concepts for strength-supportive tools were created. These included the following: a mobile app to support a person to store, reflect on, and mobilize one’s strengths (Strengths treasure chest app); “empathy glasses” enabling a person to see a situation from another person’s perspective (Empathy Simulator); and a mobile app allowing a person to receive supportive messages from close people in a safe user-controlled environment (Cheering squad app). Suggested design elements for making the tools engaging included: metaphors (eg, trees, treasure island), visualization techniques (eg, dashboards, color coding), and multimedia (eg, graphics). Maintaining a positive focus throughout the tool was an important requirement, especially for feedback and framing of content. Conclusions Combining participatory, service design, and appreciative inquiry methods were highly useful to engage participants in creating innovative ideas. Building on peoples’ core values and positive experiences empowered the participants to expand their horizons from addressing problems and symptoms, which is a very common approach in health care today, to focusing on their capacities and that which is possible, despite their chronic illness. The ideas and user requirements, combined with insights from relevant theories (eg, positive technology, self-management) and evidence from the related literature, are critical to guide the development of future more personalized and strengths-focused self-management tools.
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Affiliation(s)
- Jelena Mirkovic
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway
| | - Stian Jessen
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway
| | - Tonje Krogseth
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Center for Learning and Mastery for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Absera Teshome Koricho
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Center for Learning and Mastery for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cornelia M Ruland
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Jørgensen CR, Thomsen TG, Ross L, Dietz SM, Therkildsen S, Groenvold M, Rasmussen CL, Johnsen AT. What Facilitates "Patient Empowerment" in Cancer Patients During Follow-Up: A Qualitative Systematic Review of the Literature. QUALITATIVE HEALTH RESEARCH 2018; 28:292-304. [PMID: 28758544 DOI: 10.1177/1049732317721477] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Empowerment is a concept of growing importance in cancer care, but little is known about cancer patients' experiences of empowerment during follow-up. To explore this area, a qualitative systematic literature review was conducted in PubMed, CINAHL, and PsycINFO. A total of 2,292 papers were identified and 38 articles selected and included in the review. The thematic synthesis of the papers resulted in seven analytical themes being identified: empowerment as an ongoing process, knowledge is power, having an active role, communication and interaction between patients and health care professionals, support from being in a group, religion and spirituality, and gender. Very few articles explicitly explored the empowerment of cancer patients during follow-up, and the review identified a lack of attention to patients' own understandings of empowerment, a lack of specific focus on empowerment during follow-up, and insufficient attention to collective empowerment, as well as ethnic, social, and gender differences.
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Affiliation(s)
- Clara R Jørgensen
- 1 University of Warwick, Coventry, United Kingdom
- 2 University of Birmingham, Birmingham, United Kingdom
| | - Thora G Thomsen
- 3 Zealand University Hospital, Roskilde, Denmark
- 4 University of Southern Denmark, Odense, Denmark
| | - Lone Ross
- 5 Bispebjerg Hospital, Copenhagen, Denmark
| | - Susanne M Dietz
- 6 Patient and Public (PPI) Representative, Copenhagen, Denmark
| | | | - Mogens Groenvold
- 5 Bispebjerg Hospital, Copenhagen, Denmark
- 7 University of Copenhagen, Copenhagen, Denmark
| | | | - Anna T Johnsen
- 4 University of Southern Denmark, Odense, Denmark
- 5 Bispebjerg Hospital, Copenhagen, Denmark
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13
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Mirkovic J, Kristjansdottir OB, Stenberg U, Krogseth T, Stange KC, Ruland CM. Patient Insights Into the Design of Technology to Support a Strengths-Based Approach to Health Care. JMIR Res Protoc 2016; 5:e175. [PMID: 27558951 PMCID: PMC5014985 DOI: 10.2196/resprot.5906] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/04/2016] [Accepted: 08/08/2016] [Indexed: 01/07/2023] Open
Abstract
Background An increasing number of research studies in the psychological and biobehavioral sciences support incorporating patients’ personal strengths into illness management as a way to empower and activate the patients, thus improving their health and well-being. However, lack of attention to patients’ personal strengths is still reported in patient–provider communication. Information technology (IT) has great potential to support strengths-based patient–provider communication and collaboration, but knowledge about the users’ requirements and preferences is inadequate. Objective This study explored the aspirations and requirements of patients with chronic conditions concerning IT tools that could help increase their awareness of their own personal strengths and resources, and support discussion of these assets in consultations with health care providers. Methods We included patients with different chronic conditions (chronic pain, morbid obesity, and chronic obstructive pulmonary disease) and used various participatory research methods to gain insight into the participants’ needs, values, and opinions, and the contexts in which they felt strengths-based IT tools could be used. Results Participants were positive toward using technology to support them in identifying and discussing their personal strengths in clinical consultation, but also underlined the importance of fitting it to their specific requirements and the right contexts of use. Participants recommended that technology be designed for use in preconsultation settings (eg, at home) and felt that it should support them in both identifying strengths and in finding out new ways how strengths can be used to attain personal health-related goals. Participants advocated use of technology to support advance preparation for consultations and empower them to take a more active role. IT tools were suggested to be potentially useful in specific contexts, including individual or group consultations with health care providers (physician, nurse, specialist, care team) in clinical consultations but also outside health care settings (eg, as a part of a self-management program). Participants’ requirements for functionality and design include, among others: providing examples of strengths reported by other patients with chronic conditions, along with an option to extend the list with personal examples; giving an option to briefly summarize health-related history; using intuitive, easy-to-use but also engaging user interface design. Additionally, the findings are exemplified with a description of a low-fidelity paper prototype of a strengths-based tool, developed with participants in this study. Conclusions Users requirements for IT support of a strengths-based approach to health care appear feasible. The presented findings reflect patients’ values and lists potential contexts where they feel that technology could facilitate meaningful patient–provider communication that focuses not just on symptoms and problems, but also takes into account patients’ strengths and resources. The findings can be used to inform further development of IT tools for use in clinical consultations.
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Affiliation(s)
- Jelena Mirkovic
- Centre for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway.
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14
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“I just have to move on”: Women's coping experiences and reflections following their first year after primary breast cancer surgery. Eur J Oncol Nurs 2016; 21:205-11. [DOI: 10.1016/j.ejon.2015.10.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 10/14/2015] [Accepted: 10/15/2015] [Indexed: 12/20/2022]
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15
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Monsen KA, Holland DE, Fung-Houger PW, Vanderboom CE. Seeing the whole person: feasibility of using the Omaha System to describe strengths of older adults with chronic illness. Res Theory Nurs Pract 2015; 28:299-315. [PMID: 25577860 DOI: 10.1891/1541-6577.28.4.299] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A promising strategy for enhancing care and self-management of chronic illness is an integrative, whole-person approach that recognizes and values well-being. Assessment tools are needed that will enable health care professionals to perceive patients as whole persons, with strengths as well as problems. The purpose of this study was to examine the feasibility of using a standardized terminology (the Omaha System) to describe strengths of older adults with chronic illness. The Omaha System assessment currently consists of identifying signs/symptoms for 42 health concepts. Researchers mapped self-reported strengths phrases to Omaha System concepts using existing narratives of 32 older adults with 12-15 comorbid conditions. Results demonstrated the feasibility of describing strengths of patients with chronic illness. Exploratory analysis showed that there were 0-9 strengths per patient, with unique strengths profiles for 30 of 32 patients. Given that older adults with multiple chronic illnesses also have strengths that can be classified and quantified using the Omaha System, there is potential to use the Omaha System as a whole-person assessment tool that enables perception of both problems and strengths. Further research is needed to enhance the Omaha System to formally represent strengths-based as well as a problem-focused perspectives.
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Affiliation(s)
- Karen A Monsen
- University of Minnesota, School of Nursing, Minneapolis, MN 55455, USA.
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Dwarswaard J, Bakker EJM, van Staa A, Boeije HR. Self-management support from the perspective of patients with a chronic condition: a thematic synthesis of qualitative studies. Health Expect 2015; 19:194-208. [PMID: 25619975 DOI: 10.1111/hex.12346] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Receiving adequate support seems to be crucial to the success of self-management. Although different empirical studies separately examined patients' preferences for self-management support (SMS), an overview is lacking. OBJECTIVE The aim of this qualitative review was to identify patients' needs with respect to SMS and to explore by whom this support is preferably provided. SEARCH STRATEGY Qualitative studies were identified from Embase, MEDLINE OvidSP, Web of science, PubMed publisher, Cochrane central, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO. INCLUSION CRITERIA Articles needed to meet all of the following criteria: (i) focuses on self-management, (ii) concerns adult patients with rheumatic diseases (rheumatoid arthritis and fibromyalgia), a variant of cancer or chronic kidney disease, (iii) explores support needs from the patients' perspective, (iv) uses qualitative methods and (v) published in English. DATA EXTRACTION AND SYNTHESIS A thematic synthesis, developed by Thomas and Harden, was conducted of the 37 included studies. MAIN RESULTS Chronic patients need instrumental support, psychosocial support and relational support from health-care professionals, family/friends and fellow patients to manage the chronic condition. Relational support is at the centre of the support needs and fuels all other types of support. DISCUSSION AND CONCLUSIONS Patients do not self-manage on their own. Patients expect health-care professionals to fulfil a comprehensive role. Support needs can be knitted together only when patients and professionals work together on the basis of collaborative partnership. Dynamics in support needs make it important to regularly assess patient needs.
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Affiliation(s)
- Jolanda Dwarswaard
- Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Ellen J M Bakker
- Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations of Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hennie R Boeije
- Department of Methodology and Statistics, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
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Melin-Johansson C, Öhlén J, Koinberg I, Berg L, Nolbris MJ. The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden. Glob Qual Nurs Res 2015; 2:2333393615595965. [PMID: 28462312 PMCID: PMC5342296 DOI: 10.1177/2333393615595965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/03/2015] [Accepted: 06/23/2015] [Indexed: 11/18/2022] Open
Abstract
The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences. Interpretation proceeded through three phases: naïve reading, structural analysis, and comprehensive understanding. Three themes were disclosed: receiving support for recovery when being most vulnerable, recapturing capabilities through supportive activities, and searching to find stability and well-being in a changed life situation. Participating in the programs was an existential transition from living in an unpredictable situation that was turned into something meaningful. Recovery did not mean the return to a state of normality; rather, it meant a continuing recovery from cancer treatments and symptoms involving recapturing capabilities and searching for a balance in a forever changed life. This study provides new insights about the experiences of participating in cancer support and rehabilitation programs.
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Affiliation(s)
| | - Joakim Öhlén
- University of Gothenburg, Göteborg, Sweden
- Ersta Sköndal University College, Stockholm, Sweden
| | - Ingalill Koinberg
- University of Gothenburg, Göteborg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linda Berg
- University of Gothenburg, Göteborg, Sweden
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Andersen LS, Larsen BH, Birkelund R. A companionship between strangers - learning from fellow people with cancer in oncology wards. J Adv Nurs 2014; 71:271-80. [DOI: 10.1111/jan.12490] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2014] [Indexed: 11/28/2022]
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Olsson F, Berterö C. Living with faecal incontinence: trying to control the daily life that is out of control. J Clin Nurs 2014; 24:141-50. [PMID: 24894099 DOI: 10.1111/jocn.12617] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 12/20/2022]
Abstract
AIMS AND OBJECTIVES To identify and describe the lived experience of persons living with faecal incontinence and show how it affects daily life. BACKGROUND Faecal incontinence is a relatively common condition, with a prevalence ranging from 3-24%, not differing between men and women. There is an under-reporting due to patients' reluctance to talk about their symptoms and consult healthcare professionals about their problems, which means that problems related to faecal incontinence are often underestimated. Living with faecal incontinence affects the quality of life negatively and has a negative impact on family situations, social interaction, etc. DESIGN A qualitative interpretative study based on interviews. METHODS In-depth interviews were conducted with five informants, all women, living with faecal incontinence. The interviews were transcribed verbatim and analysed using interpretive phenomenological analysis. RESULTS The analysis identified four themes: self-affirmation, guilt and shame, limitations in life and personal approach. The themes differ from each other, but are related and have similarities. The results show different aspects of living with faecal incontinence and how they affected daily life. CONCLUSIONS Living with faecal incontinence is a complex problem affecting everyday life in a number of different ways. It is a highly distressing and socially incapacitating problem. Living with faecal incontinence is about trying to control the daily life which is out of control. Living with faecal incontinence cannot be generalised as individuals experience the situation in unique ways. RELEVANCE TO CLINICAL PRACTICE By gaining insight into the experience of living with faecal incontinence, healthcare professionals can deepen their understanding of this complex problem and thereby better address it and provide more individually based care.
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Affiliation(s)
- Frida Olsson
- Department of Surgery, Uppsala University Hospital, Uppsala, Sweden
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Larsen LS, Larsen BH, Birkelund R. A companionship between strangers - the hospital environment as a challenge in patient-patient interaction in oncology wards. J Adv Nurs 2013; 70:395-404. [PMID: 23829553 DOI: 10.1111/jan.12204] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2013] [Indexed: 11/28/2022]
Abstract
AIM To present an identification and discussion of the impact of the hospital environment on interaction among people with cancer. BACKGROUND In recent years, researchers have focused on identifying and describing features of the hospital environment that promote healing, recovery and well-being. It has been discovered that architectural features affect hospitalized patients both positively and negatively. But the research has failed to include fellow patients as part of the hospital environment. DESIGN A qualitative approach influenced by ethnography. METHOD Participant observation and individual qualitative interviews were used to collect data. From a total of 85 observed people with cancer 10 men and 10 women were interviewed. Data were collected over 6 months in 2010-2011 and analysed using inductive thematic analysis. FINDINGS Patients had ambiguous views regarding their fellow patients and the hospital environment. The hospital environment imposed conditions that caused stress factors such as the loss of personal privacy and control, but it also offered the possibility of good company and support from fellow patients. Refuge from fellow patients was hard to achieve and the fact that personal conversations might be overheard by fellow patients caused patients to withhold important information from healthcare professionals. Nevertheless, patients accepted the hospital environment uncritically, with resignation or with silent rebellion. Despite the challenges, 18 of 20 patients preferred multiple-bed rooms with the company of fellow patients. CONCLUSION The influence of the hospital environment on hospitalized people with cancer and their interpersonal interaction needs to be acknowledged by healthcare professionals. In addition, evidence-based hospital design must include research into patient preferences and arguments. Further investigation is needed.
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Charlier C, Van Hoof E, Pauwels E, Lechner L, Spittaels H, Bourgois J, De Bourdeaudhuij I. Treatment-related and psychosocial variables in explaining physical activity in women three weeks to six months post-treatment of breast cancer. PATIENT EDUCATION AND COUNSELING 2012; 89:171-177. [PMID: 22841589 DOI: 10.1016/j.pec.2012.06.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 06/15/2012] [Accepted: 06/29/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study examined treatment-related and psychosocial variables in explaining total and leisure time physical activity in breast cancer survivors three weeks to six months post-treatment. METHODS A questionnaire was used to measure total and leisure time physical activity and relevant determinants among 464 breast cancer survivors (aged 18-65 years). RESULTS Personal control was an important overall determinant in explaining physical activity in breast cancer survivors. The impact of treatment-related variables and psychological functioning depended on the working status of the women. Fatigue and poor body image prevented non-working women from being sufficiently physically active. In working women, chemotherapy and arm problems negatively influenced physical activity, whereas therapy side-effects (headaches, hot flashes, feeling unwell) and poor body image positively influenced physical activity. Social support and coping strategies could not explain post-treatment physical activity levels. CONCLUSION Personal control, treatment-related variables and psychological functioning influenced physical activity after cancer treatment. Relations depended on the working status of the women. PRACTICE IMPLICATIONS Incorporating self-control methods in physical activity interventions after breast cancer could be helpful. Furthermore, interventions should be tailored to the experienced symptoms (fatigue, arm-problems, body image) and working status of women.
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Affiliation(s)
- Caroline Charlier
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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