title: Is self-management feasible and acceptable for addressing nutrition and physical activity needs of cancer survivors?
abstract: BACKGROUND
  Self-management is recommended for patients with chronic conditions, but its use with cancer survivors is underexplored. Optimal strategies for achieving lifestyle changes in cancer survivors are not known.
  
  
  OBJECTIVE
  We aimed to determine feasibility, acceptability and preliminary efficacy of self-management-based nutrition and physical activity interventions for cancer survivors.
  
  
  METHODS
  Adult survivors (n = 25) during (Group 1 , n = 11) or post (Group 2, n = 14)-curative chemotherapy for solid tumours, most (n = 20, 80%) with breast cancer, were recruited prospectively from a single clinical centre.
  
  
  METHODS
  The Flinders Living Well Self-Management Program, a generic self-management care planning programme, was utilized to establish patient-led nutrition and exercise goals within a tailored 12-week intervention. Fortnightly progress reviews occurred with assessments at baseline, 6 and 12 weeks.
  
  
  RESULTS
  Most participants (84%) found the intervention acceptable/very acceptable. Both groups showed a trend towards significant improvement in the self-management capability 'knowledge about changing risk factors' (P = 0.047); Group 2 showed a trend towards significantly improved 'psychological impacts' (P = 0.007). Goal ratings improved for both groups (P = 0.001). Quality of life improved for both groups for emotional functioning (P = 0.03). Physical functioning improved for Group 2 (P = 0.05); however, most symptom domains worsened for Group 1, as expected given their treatment stage.
  
  
  CONCLUSIONS
  Self-management interventions are feasible for this population. In particular, building self-management capacity during the active phase of patients' cancer treatment provides health and psychosocial benefits. Larger randomized controlled trials are required to further determine efficacy. Further translational research is also needed to determine acceptability,feasibility, enablers and barriers for clinicians embedding this approach into routine cancer survivorship care.
authors.affiliation: Flinders Human Behaviour & Health Research Unit, Margaret Tobin Centre (Room 4T306), Flinders University, Adelaide, SA, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Lawn
authors.affiliation: Medical Oncology, Flinders University, Adelaide, SA, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Zrim
authors.affiliation: Department of Nutrition and Dietetics, Flinders University, Adelaide, SA, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Leggett
authors.affiliation: Department of Nutrition and Dietetics, Flinders University, Adelaide, SA, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Miller
authors.affiliation: Flinders Centre of Epidemiology and Biostatistics, Flinders University, Adelaide, SA, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Woodman
authors.affiliation: School of Physical Education, University of Otago, Dunedin, New Zealand.
authors.forename: Lynnette
authors.initials: L
authors.lastname: Jones
authors.affiliation: Medical Oncology, Flinders University, Adelaide, SA, Australia.
authors.forename: Ganessan
authors.initials: G
authors.lastname: Kichenadasse
authors.affiliation: Medical Oncology, Flinders University, Adelaide, SA, Australia.
authors.forename: Shawgi
authors.initials: S
authors.lastname: Sukumaran
authors.affiliation: Medical Oncology, Flinders University, Adelaide, SA, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Karapetis
authors.affiliation: Medical Oncology, Flinders University, Adelaide, SA, Australia.|Flinders Centre for Innovation in Cancer, Flinders Medical Centre/Flinders University, Adelaide, SA, Australia.
authors.forename: Bogda
authors.initials: B
authors.lastname: Koczwara
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000628:therapy*; D002908:Chronic Disease; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors; D016896:Treatment Outcome
keywords: cancer; exercise; nutrition; prevention (risk factors); self-management (self-care); survivor