title: Cancer survivors' perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis.
abstract: Self-management interventions improve patient outcomes across a range of long-term conditions but are often limited by low uptake and completion rates. The aim of this paper was to conduct a meta-synthesis of qualitative studies exploring cancer survivors' views and experiences of engaging with adjustment-focused self-management interventions in order to inform the development of future interventions targeting this population.
  
  
  
  Four electronic databases were systematically searched. Studies that used qualitative methods to explore cancer survivors' views and experiences of engaging with adjustment-focused self-management interventions were included. A meta-ethnographic approach was used to synthesize the findings.
  
  
  
  Thirteen studies met the inclusion criteria. Engaging with adjustment-focused self-management interventions enabled cancer survivors to gain emotional and informational support from peers and/or facilitators in an open, non-judgemental environment, become empowered through enhancing knowledge and skills and regaining confidence and control, and move beyond cancer by accepting illness experiences, reprioritising goals and adopting a positive outlook. However, the extent to which they engaged with, and benefited from, such interventions was mitigated by diverse preferences regarding intervention design, content and delivery. Personal obstacles to engagement included low perceived need, reticence to discuss cancer-related experiences and various practical issues.
  
  
  
  Cancer survivors derive a range of benefits from participating in adjustment-focused self-management interventions; potential barriers to engagement should be addressed more comprehensively in intervention marketing, design and delivery.
  
  
  
  The findings suggest some key considerations for the development and implementation of future adjustment-focused self-management interventions that may help to optimize their appeal and effectiveness among cancer survivors.
authors.affiliation: Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
authors.forename: Laura
authors.initials: L
authors.lastname: Coffey
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Orla
authors.initials: O
authors.lastname: Mooney
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors.forename: Simon
authors.initials: S
authors.lastname: Dunne
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland.
authors.forename: Aileen
authors.initials: A
authors.lastname: Timmons
authors.affiliation: Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
authors.forename: Deirdre
authors.initials: D
authors.lastname: Desmond
authors.affiliation: Cork University Dental School and Hospital, Cork, Ireland.
authors.forename: Eleanor
authors.initials: E
authors.lastname: O'Sullivan
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, St. James's Hospital, Dublin, Ireland.
authors.forename: Conrad
authors.initials: C
authors.lastname: Timon
authors.affiliation: School of Clinical Sciences, University of Bristol, Bristol, UK.
authors.forename: Rachael
authors.initials: R
authors.lastname: Gooberman-Hill
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland. pamela.gallagher@dcu.ie.
authors.forename: Pamela
authors.initials: P
authors.lastname: Gallagher
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D010465:Perception; D036301:Qualitative Research; D012648:Self Care; D015996:Survival Rate; D017741:Survivors
keywords: Cancer; Meta-synthesis; Qualitative research; Self-management; Survivorship