title: Self-management and transitions in women with advanced breast cancer.
abstract: BACKGROUND
  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: Yale School of Nursing, New Haven, Connecticut, USA. dena.schulman-green@yale.edu
authors: Dena
authors: D
authors: Schulman-Green
authors: Elizabeth H
authors: EH
authors: Bradley
authors: M Tish
authors: MT
authors: Knobf
authors: Holly
authors: H
authors: Prigerson
authors: Michael P
authors: MP
authors: DiGiovanna
authors: Ruth
authors: R
authors: McCorkle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003142:Communication; D032882:Comprehension; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D012648:Self Care