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