Patterns of self-management practices undertaken

Article No 3
by cancer survivors: variations in demographic factors
Title: Patterns of self-management practices
undertaken by cancer survivors: variations in
demographic factors
Problem:
Cancer survivors experience secondary health problems (such as fatigue,
anxiety, depression, nausea and pain) after completion of treatment.
Financial, clinical and political pressures have been increased on healthcare
system to manage the health pathways of an increasing number of cancer
survivors.
Clinicians are short of adequate time, skills and resources to address peoples
requirements.
Pressure has increased on cancer survivors to self-manage the consequences of
their illness.
Cancer survivors lack support and advice on how to increase their Quality of Life
after completion of their treatment.

Variable: Age, gender, ethnicity, income, Self management (SM) practices, cancer
type, treatment type, health status, health behavior, Quality of life (QoL).

Hypothesis:
There is a significant difference in using Self management practice between low
and high income respondents.
There is a significant difference in using Self management practice between
male and female respondents.
There is a significant difference in using Self management practice between
respondents of different age groups.
There is a significant difference in using Self management practice between
respondents of different ethnicity.
There is a significant difference in using Self management practice between
respondents with different cancer types.
There is a significant difference in using Self management practice between
respondents who have undergone different treatments.

Sample: 957 eligible cancer survivors were selected from consultants clinic list,
with a SD of 13.3, power 90% and 5% significance. Eligible participants were
identified on the basis of inclusion and exclusion criteria.

Data collection Instrument:

A cross-sectional study was conducted using a patient questionnaire.
Questionnaire measured self-supported Self Management, which were classified
into six categories with similar SM practice type.
Questionnaire also collected data on QoL using the generic measure of health-
related QoL, the EuroQoL 5D-3L.
A pilot study was conducted with four patient representatives to assess
questionnaires comprehensibility and usability.

RESEARCH SURVEY METHODOLOGY ZARA KHAN 20026

Patterns of self-management practices undertaken
Article No 3
by cancer survivors: variations in demographic factors
Questionnaire and the patient information sheet were sent to eligible patients
through post.

Data Analysis:
Data analysis was carried out using SPSS v.19. Test applied were Chi-square and
independent t-test.

Results: 445 responses were received out of total 957 questionnaires sent. No
significant difference was found between the ages of respondents and non-
respondents. 51% of respondents were male with a median age of respondents 66
years and 53.6% were retired.
The median time since diagnosis of cancer was 3 years and the respondents were
significantly younger than average age at diagnosis of cancer in the study area by
3.1 years.
The most common cancer types among were breast (28.3%) and prostate (25.2%)
while stomach and lung cancer respondents were low.
91% of respondents had used some form of self-supported SM practice. The median
number of SM practices across the sample was 3.0. The most common SM type
exercise was undertaken by 84% of respondents. This was followed by diet (56%),
CAM (30%), spirituality/religion (30%), support groups (16%) and psychological
therapies (7%).
INCOME:
It was found that no significant differences exist between respondents on high
(25 000) and low (<25 000) incomes across the six SM categories. It was also
observed that only exercise is the category in which respondents with higher
incomes were more likely to undertake than those with lower incomes.
GENDER:
It was found that no significant differences were present in diet, exercise, support
group or psychological therapy uptake between genders. However, uptake of CAM
and spiritual/ religious practices were significantly higher in women than men.
AGE:
It was found that no significant differences occur in support group uptake or
spirituality/religion in relation to age. However, those undertaking exercise, diet,
psychological therapies and CAM was significantly younger than those who did not
use these SM practices.
ETHNICITY:
It was found that no significant differences were observed in support groups, diet,
exercise, psychological therapies and CAM between white and non-white
respondents. However, significantly greater numbers of non-white than white
respondents were engaged in spiritual/religious practices.
CANCER TYPES:
It was found that no significant differences were observed in diet, exercise, support
group or psychological therapy uptake between respondents with different cancer
types. However, uptake of CAM and spiritual/religious practices was highest in
breast cancer respondents.
TREATMENT TYPE:
No significant differences in spiritual/ religious practice uptake were found between
those who had undergone chemotherapy and those who had not. However exercise,
support group, psychological therapy, diet and CAM uptake were significantly higher

RESEARCH SURVEY METHODOLOGY ZARA KHAN 20026

Patterns of self-management practices undertaken
Article No 3
by cancer survivors: variations in demographic factors
in respondents who had undergone chemotherapy than those who had undergone
other forms of treatment.
CAM SUB GROUPS:
Within the four CAM subgroups uptake was highest in the manipulative and body-
based practices subgroup (9%), followed by mind and body medicine (9%).
Natural products and other CAM were each used by 6% of respondents.

Conclusion:
SM practices play an important role in elevating the cancer survivors health
conditions. Regardless of their level of income, cancer type, treatment type, age,
gender and ethnicity, cancer survivors are using different types of SM practices in
their daily life. The information obtained from this study can be utilized to form
policies that will help the healthcare system to reduce their burden of supporting
cancer survivors, as this study indicates the type of self-supported SM practices that
are greatly adopted by cancer survivors.

RESEARCH SURVEY METHODOLOGY ZARA KHAN 20026