Post-treatment head and neck cancer survivors' approaches to self-management: A qualitative study

Eur J Oncol Nurs. 2021 Jun:52:101944. doi: 10.1016/j.ejon.2021.101944. Epub 2021 Mar 21.

Abstract

Purpose: Post-treatment head and neck cancer (HNC) survivors contend with distinct, long-term challenges related to cancer treatments that impact their day-to-day lives. Alongside follow-up cancer care, they also must be responsible for the daily management of often intrusive physical and psychological symptoms, as well as maintaining their health and a lifestyle to promote their well-being. The purpose of this study was to identify HNC survivors' approaches toward engagement in self-management activities.

Methods: Post-treatment HNC survivors (N=22) participated in the study through purposeful sampling. Participants were eligible if they 1) had a history of upper aerodigestive tract cancer; 2) completed their most recent primary treatment (i.e. chemotherapy, radiation, and surgery) more than eighteen months prior and had no evidence of HNC, and 3) could speak in English. A semi-structured interview was used. Data was analyzed using content analysis.

Results: We identified three approaches that survivors took towards self-management activities: taking charge, living with it, and engaging as needed. Our results showed that taking charge is when survivors take an active role in evaluating their health and taking action subsequently; as needed represents engaging in self-management as necessary; and living with it reflects adapting to the symptoms and side effects without managing them.

Conclusions: We propose self-management approaches as a novel mechanism to understand the relationship between survivors' characteristics and health preferences and their self-management. It is important for clinicians to highlight the variation in individuals 'self-management approaches as they work to identify tailored patient-centered strategies that compliment specific patient needs.

Keywords: Cancer survivorship; Head and neck cancer; Self-management; Symptom management.

MeSH terms

  • Academic Medical Centers
  • Activities of Daily Living / psychology
  • Adaptation, Psychological
  • Adult
  • Aged
  • Aged, 80 and over
  • Cancer Survivors / psychology*
  • Female
  • Head and Neck Neoplasms / psychology*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Psycho-Oncology
  • Qualitative Research
  • Quality of Life
  • Self-Management / methods*
  • Self-Management / psychology*