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

J Cancer Surviv. 2013 Sep;7(3):331-42. doi: 10.1007/s11764-013-0274-x. Epub 2013 Mar 22.

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.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / complications
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / therapy*
  • Chronic Disease
  • Community Networks
  • Continuity of Patient Care*
  • Depression / epidemiology
  • Depression / etiology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Middle Aged
  • Patient Participation
  • Program Evaluation
  • Quality of Life
  • Self Care / methods*
  • Social Support
  • Treatment Outcome
  • Young Adult