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Self-management, self-management support needs and interventions in advanced cancer: a scoping review
  1. Suman Budhwani1,2,
  2. Walter P Wodchis1,2,
  3. Camilla Zimmermann3,4,
  4. Rahim Moineddin5 and
  5. Doris Howell3,6
  1. 1 Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada
  2. 2 Health System Performance Research Network, University of Toronto, Toronto, ON, Canada
  3. 3 Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
  4. 4 Institute of Medical Science, University of Toronto, Toronto, ON, Canada
  5. 5 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  6. 6 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
  1. Correspondence to Suman Budhwani, Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor, 155 College Street, Toronto, ON, Canada M5T 1P8; suman.budhwani{at}


Patients with advanced cancer can experience illness trajectories similar to other progressive chronic disease conditions where undertaking self-management (SM) and provision of self-management support (SMS) becomes important. The main objectives of this study were to map the literature of SM strategies and SMS needs of patients with advanced cancer and to describe SMS interventions tested in this patient population. A scoping review of all literature published between 2002 and 2016 was conducted. A total of 11 094 articles were generated for screening from MEDLINE, Embase, PsychINFO, CINAHL and Cochrane Library databases. A final 55 articles were extracted for inclusion in the review. Included studies identified a wide variety of SM behaviours used by patients with advanced cancer including controlling and coping with the physical components of the disease and facilitating emotional and psychosocial adjustments to a life-limiting illness. Studies also described a wide range of SMS needs, SMS interventions and their effectiveness in this patient population. Findings suggest that SMS interventions addressing SMS needs should be based on a sound understanding of the core skills required for effective SM and theoretical and conceptual frameworks. Future research should examine how a patient-oriented SMS approach can be incorporated into existing models of care delivery and the effects of SMS on quality of life and health system utilisation in this population.

  • self-management
  • self-management support
  • advanced cancer
  • life-limiting illness
  • chronic disease management
  • palliative care

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  • Twitter Follow Suman Budhwani at @sumanbudhwani

  • Contributors All authors were involved in the design of the study. SB and DH conducted the scoping review. SB conducted the analysis and wrote the manuscript. All authors reviewed and revised the work for intellectual content.

  • Funding The primary author is supported by grants from the Ontario SPOR Support Unit and the Ontario Ministry of Health and Long-term Care to the Health System Performance Research Network, as well as funding from the School of Graduate Studies, University of Toronto.

  • Disclaimer The views expressed in this paper are the views of the authors and do not necessarily reflect those of the funders. The funders had no influence on the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at Components of this work were presented at the Canadian Association of Psychosocial Oncology Conference in May 2018.