Facilitating practitioners to deliver self-management support to cancer survivors: development and co-design of a theory-based intervention informed by contexts and mechanisms

Kantilal, Kumud (2021) Facilitating practitioners to deliver self-management support to cancer survivors: development and co-design of a theory-based intervention informed by contexts and mechanisms. Doctoral thesis, University of East Anglia.

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Abstract

Background
Older cancer survivors have physical and psychosocial problems after completing cancer treatment which are not adequately addressed by secondary care teams. Enabling older cancer survivors to self-manage problems after cancer treatment is essential for optimising their health and wellbeing. This thesis aimed to design an intervention to facilitate primary care teams to provide self-management support to older cancer survivors.

Methods
Underpinned by scientific realism and behavioural science, this research involved three empirical studies: a cross-sectional study to estimate the prevalence of cancer treatment-related problems in older cancer survivors and overall care satisfaction, a realist review, and a co-design study to understand and address the barriers and enablers for facilitating primary care practitioners to provide self-management support.

Results
Half of older cancer survivors experienced physical and psychosocial problems after cancer treatment. Of these, 82% experienced physical, 69% psychological and 51% social problems. Perceived support from secondary care teams to manage physical, psychological and social problems was rated as adequate by 64%, 50% and 28%, respectively.

Key enablers for facilitating practitioners to provide self-management support were knowledge and communication skills to engage cancer survivors in discussions about self-management, practitioners feeling that their role and responsibilities included self-management support, the organisation prioritising self-management support, and health system configuration to integrate self-management support into routine care.

A structured pathway was co-designed to facilitate primary care teams to provide self-management support. This will involve using the knowledge and skills of existing team members to identify patients with unmet needs who may benefit from additional support, identifying local self-management resources and signposting patients to existing provision of information and care, and a mechanism for annual patient follow-up.

Conclusion
The intervention developed maximises the role of existing primary care teams and optimises current processes. The next step is to operationalise the intervention and evaluate efficacy at facilitating delivery of self-management support.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Science > School of Pharmacy
Depositing User:	Chris White
Date Deposited:	15 Aug 2022 08:24
Last Modified:	15 Aug 2022 08:24
URI:	https://ueaeprints.uea.ac.uk/id/eprint/87226
DOI:

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