title: One step at a time: self-management and transitions among women with ovarian cancer.
abstract: OBJECTIVE
  To describe experiences of self-management and transitioning among women with ovarian cancer.
  
  
  METHODS
  Interpretive description.
  
  
  METHODS
  Participants' homes.
  
  
  METHODS
  Purposive sample of 10 women with ovarian cancer.
  
  
  METHODS
  Individual interviews about women's self-management and transition experiences.
  
  
  METHODS
  Self-management, transitions, and ovarian cancer.
  
  
  RESULTS
  Participants self-managed to increase their sense of control and to self-advocate. They managed their care one step at a time to prevent becoming overwhelmed. Common transitions were diagnosis, surgery and recovery, starting chemotherapy, managing symptoms, and recurrence. Transitions were challenging, even if previously experienced, and influenced the ability and willingness of women to self-manage. Barriers and facilitators to self-management were identified.
  
  
  CONCLUSIONS
  The approach to self-management of one step at a time is somewhat illusory, as women face multiple transitions simultaneously. The short trajectory of ovarian cancer leaves little time between transitions and an awareness of mortality. Women are forced to confront goals of care quickly, which may affect their ability to self-manage.
  
  
  CONCLUSIONS
  Women with ovarian cancer need clinical and social support to prioritize and manage transitions. Introducing palliative care shortly after diagnosis could facilitate women's anticipation of and adjustment to transitions.
authors: School of Nursing, Yale University, New Haven, CT, USA. dena.schulman-green@yale.edu
authors: Dena
authors: D
authors: Schulman-Green
authors: Elizabeth H
authors: EH
authors: Bradley
authors: Nicholas R
authors: NR
authors: Nicholson
authors: Erin
authors: E
authors: George
authors: Allie
authors: A
authors: Indeck
authors: Ruth
authors: R
authors: McCorkle
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D015404:Nursing Methodology Research; D009742:Nursing Theory; D009859:Oncology Nursing / Q000379:methods*; D010051:Ovarian Neoplasms / Q000451:nursing* / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods; D036301:Qualitative Research; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012944:Social Support