title: Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. syloh@ummc.edu.my
authors.forename: Siew Yim
authors.initials: SY
authors.lastname: Loh
authors.forename: Tanya
authors.initials: T
authors.lastname: Packer
authors.forename: Karuthan
authors.initials: K
authors.lastname: Chinna
authors.forename: Kia Fatt
authors.initials: KF
authors.lastname: Quek
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D002908:Chronic Disease; D019058:Community Networks; D003266:Continuity of Patient Care; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010358:Patient Participation; D015397:Program Evaluation; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D012944:Social Support; D016896:Treatment Outcome; D055815:Young Adult