title: A double whammy: health promotion among cancer survivors with preexisting functional limitations.
abstract: OBJECTIVE
  To explore the experience of living with a preexisting functional disability and a cancer diagnosis and to identify strategies that promote health in the growing population of cancer survivors.
  
  
  METHODS
  Qualitative, descriptive.
  
  
  METHODS
  Four sites in the United States.
  
  
  METHODS
  19 female cancer survivors with preexisting disabling conditions.
  
  
  METHODS
  Four focus groups were conducted. The group discussions were audio recorded and transcribed and analyzed using content analysis techniques.
  
  
  RESULTS
  Analytic categories included living with a cancer diagnosis, health-promotion strategies, and wellness program development for survivors with preexisting functional limitations. Participants described many challenges associated with managing a cancer diagnosis on top of living with a chronic disabling functional limitation. They identified strategies to maintain health and topics in health-promotion programs tailored for this unique group of cancer survivors.
  
  
  CONCLUSIONS
  The "double whammy" of a cancer diagnosis for people with preexisting functional limitations requires modification of health-promotion strategies and programs to promote wellness in this group of cancer survivors.
  
  
  CONCLUSIONS
  Nurses and other healthcare providers must attend to patients' preexisting conditions as well as the challenges of the physical, emotional, social, and economic sequelae of a cancer diagnosis.
  
  
  CONCLUSIONS
  Cancer survivors with preexisting functional disabilities had difficulties finding cancer care providers who could manage their unique needs. That may be because some cancer-care providers are inadequately prepared to care for patients with cancer who have complex preexisting conditions. Cancer survivors with preexisting conditions may benefit from health-promotion programs that emphasize self-advocacy strategies, management of the economic impact of multiple diagnoses, and wellness activities adapted to their unique functional limitations.
authors.affiliation: School of Nursing, University of Texas, Austin, TX, USA. dvolker@mail.nur.utexas.edu
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Volker
authors.forename: Heather
authors.initials: H
authors.lastname: Becker
authors.forename: Sook Jung
authors.initials: SJ
authors.lastname: Kang
authors.forename: Vicki
authors.initials: V
authors.lastname: Kullberg
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001294:Attitude to Health; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D020446:Fitness Centers / Q000379:methods / Q000458:organization & administration; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology*; D009859:Oncology Nursing; D016730:Program Development; D036301:Qualitative Research; D017741:Survivors / Q000523:psychology*; D014481:United States