title: Self-management for adult patients with cancer: an integrative review.
abstract: BACKGROUND
  Individuals with cancer are surviving long term, categorizing cancer as a chronic condition, and with it, numerous healthcare challenges. Symptoms, in particular, can be burdensome and occur from prediagnosis through many years after treatment. Symptom severity is inversely associated with functional status and quality of life.
  
  
  OBJECTIVE
  Management of these millions of survivors of cancer in a stressed healthcare system necessitates effective self-care strategies. The purpose of this integrative review is to evaluate intervention studies led by nurse principal investigators for self-care management in patients with cancer.
  
  
  METHODS
  PubMed, CINAHL (Cumulative Index to Nursing and Allied health Literature), and the Cochrane Database were searched from January 2000 through August 2012. Search terms included "symptom management and cancer," "self-management and cancer," and "self-care and cancer." All articles for consideration included intervention studies with a nurse as the primary principal investigator.
  
  
  RESULTS
  Forty-six articles were included yielding 3 intervention areas of educational and/or counseling sessions, exercise, and complementary and alternative therapies. Outcomes were predominately symptom focused and often included functional status and quality of life. Few studies had objective measures. Overarching themes were mitigation, but not prevention or elimination of symptoms, and improved quality of life related to functional status. No one intervention was superior to another for any given outcome.
  
  
  CONCLUSIONS
  Current interventions that direct patients in self-care management of symptoms and associated challenges with cancer/survivorship are helpful, but incomplete. No one intervention can be recommended over another.
  
  
  CONCLUSIONS
  Guiding patients with cancer in self-care management is important for overall functional status and quality of life. Further investigation and tailored interventions are warranted.
authors.affiliation: Author Affiliations: College of Nursing, New York University (Drs Hammer, Dickson, Chyun, and Melkus and Ms Wright); and Yale School of Nursing, New Haven, Connecticut (Dr Ercolano).
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Hammer
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Ercolano
authors.forename: Fay
authors.initials: F
authors.lastname: Wright
authors.forename: Victoria Vaughan
authors.initials: VV
authors.lastname: Dickson
authors.forename: Deborah
authors.initials: D
authors.lastname: Chyun
authors.forename: Gail D'Eramo
authors.initials: GD
authors.lastname: Melkus
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000534:rehabilitation*; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*