Self management intervention for Malaysian women with breast cancer : enabling quality of life and participation

Abstract

Study on self-management intervention has shown enhanced quality of life in the chronic 'non-oncology‘ population, but has yet to make an impact in the field of oncology. The aim of this study was to explore, develop and evaluate the 4-week self-management intervention for women with breast cancer. The study, based on robust phased-model of a complex intervention, demonstrated an increasing research evidence from a qualitative need-assessment to a pilot study and finally to a definitive Clinical Controlled Trial. Insights and findings from the preclinical phase aided the development of the 4-week “Staying Abreast, Moving Ahead” (SAMA) program which was piloted, refined and tested using a CCT on Malaysian women (n=147) with breast cancer. The results from the robust intent-to-treat multivariate analyses of co-variances and the univariate repeated measure analyses of variances supported the efficacy of the 4-week self-management intervention. There were significant between-group differences on Quality of life (p=0.005), Social Relationship (0.015), Psychological symptoms (p=0.001) at post test, and self-efficacy and proactive coping for both Post-test and Follow-up (p<0.001).There were significant differences over time within the experimental group for Quality of life (p<0.001), Participation, (p=0.04), Psychological outcomes (p<0.001), as well as the Cancer self-efficacy scales (p<0.001 to p=0.02) and Proactive coping (p<0.001). A key implication of this study is that the theory-led SAMA program (which was developed based on the perspectives from the fields of Psychosocial oncology and Patient self-management for chronic conditions) can be disseminated to enable better Quality of life. SAMA is a potential blueprint for a feasible, timely and effective self management program for women diagnosed with breast cancer.