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TMR Integrative Nursing  2018, Vol. 2 Issue (1): 4-11    DOI: 10.12032/TMRIN20180308
Concept Analysis     
Self-management A concept analysis of self-management for cancer patients’ home-basedrehabilitation
Ling Dong-Lan1, Yu Hong-Jing2,*()
1Urology Surgical Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
2Department of Nursing, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Objective: To explore and clarify the concept of self-management in the context of cancer patients’ home-based rehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to develop self-management strategies and enables them to improve their ability in symptom self-management of home-based rehabilitation. Method: Walker and Avant’s framework (2011) was used to analyse the concept of self-management. Results: Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation, problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge and social support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes and quality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Management scale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether this instrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thus further research is needed. Conclusion: According to the concept analysis, nurses should encourage cancer patients to involve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management of home-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Highlights  This study identified four attributes of self-management as follows from reviewing vast literature: perception of one’s needs, resource utilisation, problem solving and active participation. The presentation of a model case and a contrary case has shown the differences related to attributes between effective or invalid self-management. Editor’s Summary Self-management is regarded as an essential concept relevant to behavioural interventions and healthy behaviour; it is a pivotal skill that can help individuals throughout their lives. This study analyses the concept of self-management in the context of cancer patients' rehabilitation and introduced the attributes of self-management in detail.
Key wordsSelf-management      Concept analysis      Cancer patients’ rehabilitation;      Home-based rehabilitation     
Received: 09 January 2018      Published: 24 March 2018
Corresponding Authors: Yu Hong-Jing     E-mail:
Cite this article:

Ling Dong-Lan, Yu Hong-Jing. Self-management A concept analysis of self-management for cancer patients’ home-basedrehabilitation. TMR Integrative Nursing, 2018, 2(1): 4-11.

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Figure 1 Self-management
Figure 2 Theory lens
1   Lorig KR, Holman H.Self-management education: history, definition, outcomes, and mechanisms. Ann Ann Behav Med 2003, 26:1-7.
doi: 10.1207/S15324796ABM2601_01 pmid: 12867348
2   Creer TL, Renne CM, Christian WP.Behavioral contributions to rehabilitation and childhood asthma. Rehabil Lit 1976, 37: 226-232,247.
pmid: 959645
3   Ryan P, Sawin KJ.The Individual and Family Self-management Theory: Background and Perspectives on Context, Process, and Outcomes. Nurs Outlook 2009, 57:217-225.
doi: 10.1016/j.outlook.2008.10.004 pmid: 2908991
4   Miller WR, Lasiter S, Ellis RB, et al. Chronic Disease Self-Management: A Hybrid Concept Analysis. Nurs Outlook 2015, 63:154-161.
doi: 10.1016/j.outlook.2014.07.005 pmid: 4326608
5   Jansen F, van UdenKraan CF, Van ZV, et al. Cancer survivors' perceived need for supportive care and their attitude towards self-management and eHealth. Support Care Cancer 2015, 23:1679-1688.
doi: 10.1007/s00520-014-2514-7 pmid: 25424520
6   National Cancer Registry of Ireland. Cancer incidence statistics.2014 online.
7   Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015.CA Cancer J Clin 2016, 66:115-132.
doi: 10.3322/caac.21338 pmid: 26808342
8   Haward RA, Morris E, Monson JR, et al. The long term survival of rectal cancer patients following abdominoperineal and anterior resection: results of a population-based observational study. Eur J Surg Oncol 2005, 31:22-28.
doi: 10.1016/j.ejso.2004.08.002 pmid: 15642422
9   Dodd M, Janson S, Facione N, et al. Advancing the science of symptom management. J Adv Nues 2001, 33:668.
doi: 10.1046/j.1365-2648.2001.01697.x pmid: 11298204
10   National Cancer Survivorship Initiative. Living with & Beyond Cancer: Taking Action to Improve Outcomes.2010, London: NCSI.
11   Hsiao CP, Moore IM, Insel KC, et al. Symptom self-management strategies in patients with non-metastatic prostate cancer. J Clin Nurs 2014, 23:440-449.
doi: 10.1111/jocn.12178 pmid: 23551614
12   Loh SY, Packer T, Chinna K, et al. Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial. J Cancer Surviv 2013, 7:331-342.
doi: 10.1007/s11764-013-0274-x pmid: 23519654
13   Risendal B, Dwyer A, Seidel R, et al. Adaptation of the Chronic Disease Self-Management Program for Cancer Survivors: Feasibility, Acceptability, and Lessons for Implementation. J Cancer Educ 2014, 29:762-771.
doi: 10.1007/s13187-014-0652-8 pmid: 24903138
14   Udlis K A.Self-management in chronic illness: concept and dimensional analysis. J Nurs Healthc Chronic Illn 2011, 3:130-139.
doi: 10.1111/j.1752-9824.2011.01085.x
15   Kidd L A.Consequences, control and appraisal: cues and barriers to engaging in self-management among people affected by colorectal cancer - a secondary analysis of qualitative data. Health Expect 2014, 17:565-578.
doi: 10.1111/j.1369-7625.2012.00785.x pmid: 22574759
16   Corbin J M, Strauss A.Unending work and care: Managing chronic illness at home. San Francisco: Jossey-Bass. 1988.
doi: 10.2307/2074227
17   Walker LO, Avant KC.Strategies for theory construct in nursing (5th ed). New Jersey: Prentice-Hall, 2011.
doi: 10.1097/00002800-200611000-00014
18   Schulman-Green D, Jaser S, Martin F, et al. Processes of self-management in chronic illness. J Nurs Scholarsh 2012, 44:136-144.
doi: 10.1111/j.1547-5069.2012.01444.x pmid: 22551013
19   Landers M G. Symptom Management Theory.In: J. J. Fitzpatrick and G. Mccarthy, eds. 2014. Theories guiding nursing research and practice: making knowledge development explicit. New York: Springer publishing company.Ch.3.
20   Kralik D, Koch T, Price K, et al. Chronic illness self-management: taking action to create order. J Clin Nurs 2004, 13:259-267.
doi: 10.1046/j.1365-2702.2003.00826.x pmid: 14723679
21   Mccorkle R, Ercolano E, Lazenby M, et al. Self-management: Enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin 2011, 61:50-62.
doi: 10.3322/caac.20093 pmid: 21205833
22   Bright M A, Fleisher L, Thomsen C, et al. Exploring e-Health usage and interest among cancer information service users: the need for personalized interactions and multiple channels remains. J Health Commun 2005, 10:35-52.
doi: 10.1080/10810730500265609 pmid: 16377599
23   Huffman M H.Compliance, health outcomes, and partnering in PPS: acknowledging the patient’s agenda. Home Healthcare Nurse 2005, 23:23-28.
pmid: 15632503
24   Faithfull S, Cockle-Hearne J, Khoo V.Self-management after prostate cancer treatment: evaluating the feasibility of providing a cognitive and behavioural programme for lower urinary tract symptoms. BJU Int 2011, 107:783-790.
doi: 10.1111/j.1464-410X.2010.09588.x pmid: 20942826
25   Chambers SK, Ferguson M, Gardiner RA, et al. Intervening to improve psychological outcomes for men with prostate cancer. Psychooncology 2013, 22:1025-1034.
doi: 10.1002/pon.3095 pmid: 22549800
26   Prior K N, Bond M J.The roles of self-efficacy and abnormal illness behaviour in osteoarthritis self-management. PHealth Psychol Behav Med 2004, 9:177-192.
doi: 10.1080/13548500410001670708
27   Butz AM, Syron L, Johnson B, et al. Home-based asthma self-management education for inner city children. Public Health Nurs 2005, 22:189-199.
doi: 10.1111/j.0737-1209.2005.220302.x pmid: 15982192
28   Fitzner K, Greenwood D, Payne H, et al. An assessment of patient education and self-management in diabetes disease management--two case studies. Popul Health Manag 2008, 11:329-340.
doi: 10.1089/pop.2008.0012 pmid: 19108648
29   Paterson C, Robertson A, Nabi G.Exploring prostate cancer survivors’ self-management behaviours and examining the mechanism effect that links coping and social support to health-related quality of life, anxiety and depression: A prospective longitudinal study. Eur J Oncol Nurs 2015, 19:120-128.
30   Mccaughan E, Prue G, Mcsorley O, et al. A randomized controlled trial of a self-management psychosocial intervention for men with prostate cancer and their partners: a study protocol. J Adv Nurs 2013, 69:2572-83.
doi: 10.1111/jan.12132 pmid: 23528148
31   Shneerson C, Taskila T, Greenfield S, et al. A survey investigating the associations between self-management practices and quality of life in cancer survivors. Supportive Care in Cancer 2015, 23:2655-2662.
doi: 10.1007/s00520-015-2626-8 pmid: 25669966
32   Gately C, Rogers A, Sanders C.Re-thinking the relationship between long-term condition self-management education and the utilisation of health services. Social Sci & Med 2007, 65:934-945.
33   Zhang C, Wang W, LiJ, et al. Development and validation of a COPD self-management scale. Care Respir 2013, 58:1931-1936.
doi: 10.4187/respcare.02269 pmid: 23592786
34   Wallston KA, Rothman RL, Cherrington A.Psychometric properties of the Perceived Diabetes Self-Management Scale (PDSMS). J Behav Med 2007, 30:395-401.
doi: 10.1007/s10865-007-9110-y pmid: 17522972
35   Northouse L L, Mood D, Kershaw T, et al. Quality of life of women with recurrent breast cancer and their family members. J Clin Oncol 2002, 20:4050-4064.
doi: 10.1200/JCO.2002.02.054 pmid: 12351603
36   Liang SY, Wu WW, Kuo CY, et al. Development and Preliminary Evaluation of Psychometric Properties of Symptom-Management Self-Efficacy Scale for Breast Cancer Related to Chemotherapy. Asian Nurs Res 2015, 9:312.
doi: 10.1016/j.anr.2015.09.001 pmid: 26724240
37   Hsiao CP.Stress, symptoms, symptom distress, and symptom self-management in localized prostate cancer. Oncol Nurs Forum 2008, 34:216-216.
doi: 10.1188/07.ONF.142-147
38   Froelicher ES, Gortner SR, Halliburton P.A Model for Symptom Management. J Nurs Scholarsh 1994, 26:272-276.
doi: 10.1111/j.1547-5069.1994.tb00333.x
39   Humphreys J, Lee KA, Carrieri-Kohlman V, et al.Theory of symptom management. In: M J Smith and P R Liehr, eds.2008. Middle range theory for nursing, 2nd ed. New York: Springer Publishing Company. Ch. 8.
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