The process of self-management: a qualitative case study reporting on cancer survivors’ and program staff’s experiences within one self-management support intervention

Abstract

Background: Cancer survivors are responsible for managing a range of adverse physical, psychological, and social effects post-diagnosis. These negative effects often co-occur with pre-existing co-morbid conditions. Recognizing the complex chronicity of the disease, self-management support (SMS) interventions have been developed to promote cancer survivors’ knowledge, skills, and confidence to self-manage their own health. Though beneficial, the processes underlying self-management have yet to be explicated. Aim: To explore how a community-based SMS intervention (i.e., cancer coaching) fosters cancer survivors’ knowledge, confidence, and skills. Method: A qualitative case study adopting multiple viewpoints was utilized. Seventeen cancer survivors were interviewed and six program staff participated in a focus group. The interviews and the focus group were analyzed using a hybrid inductive-deductive approach guided by principles of qualitative description. Results: Cancer survivors and staff offered complimentary perspectives that enhanced understanding of how the SMS intervention fosters cancer survivors’ knowledge, confidence, and skills to self-manage their health. Four themes captured strategies necessary to promote self-management: (1) looking beyond the disease: the importance of person-centered care, (2) co-creation: the key to effective and meaningful SMS, (3) fostering activation via tailored, targeted, and expertly sourced information and resources, and (4) the necessity of dependable and impartial emotional support. Within each theme, pertinent SMS strategies were described from the viewpoint of cancer survivors and staff. Discussion and Conclusion: Findings offer a deeper understanding of how one community-based SMS intervention promotes self-management and highlight valuable SMS strategies that could be incorporated into future interventions and existing programs.