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Self-Management and Transitions in Women with Advanced Breast Cancer.
MedLine Citation:
PMID:  21444183     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
CONTEXT: Self-management involves behaviors that individuals perform to handle health conditions. Self-management may be particularly challenging during transitions-shifts from one life phase or status to another, for example, from cure- to noncure-oriented care-because they can be disruptive and stressful. Little is known about individuals' experiences with self-management, especially during transitions. OBJECTIVE: Our purpose was to describe experiences of self-management in the context of transitions among women with advanced breast cancer. METHODS: We interviewed a purposive sample of 15 women with metastatic breast cancer about their self-management preferences, practices, and experiences, including how they managed transitions. Interviews were recorded and transcribed. The qualitative method of interpretive description was used to code and analyze the data. RESULTS: Participants' mean age was 52 years (range 37-91 years); most were White (80%), married (80%), and college educated (60%). Self-management practices related to womens' health and to communication with loved ones and providers. Participants expressed a range of preferences for participation in self-management. Self-management included developing skills, becoming empowered, and creating supportive networks. Barriers to self-management included symptom distress, difficulty obtaining information, and lack of knowledge about the cancer trajectory. Women identified transitions as shifts in physical, emotional, and social well-being, as when their cancer progressed and there was a need to change therapy. Transitions often prompted changes in how actively women self-managed and were experienced as positive, negative, and neutral. CONCLUSIONS: Self-management preferences can vary. Providers should explore and revisit patients' preferences and ability to self-manage over time, particularly during transitions.
Authors:
Dena Schulman-Green; Elizabeth H Bradley; M Tish Knobf; Holly Prigerson; Michael P Digiovanna; Ruth McCorkle
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-26
Journal Detail:
Title:  Journal of pain and symptom management     Volume:  -     ISSN:  1873-6513     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-3-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8605836     Medline TA:  J Pain Symptom Manage     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Affiliation:
Yale School of Nursing (D.S.-G., M.T.K., R.M.), Yale School of Public Health (E.H.B., R.M.), and Yale School of Medicine (M.P.D.), New Haven, Connecticut; and Dana Farber Cancer Institute (H.P.) and Harvard Medical School (H.P.), Boston, Massachusetts, USA.
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