Evaluate the effectiveness and sustainability of OptiMal as a self-management intervention for cancer survivors

Abstract

Introduction: There are over 150,000 cancer survivors in Ireland and survival rates are continuing to increase. Cancer survivors experience continuing symptoms such as pain, fatigue, cognitive difficulties, anxiety and depression post-treatment resulting in social isolation and decreased activity participation. Self-management interventions are recommended for cancer survivors as they can help individuals identify and manage these continuing symptoms. OptiMal is a six-week, self-management intervention originally designed for individuals with multimorbidity. The aim of this research is to evaluate OptiMal's effectiveness and sustainability as a self-management intervention for cancer survivors. Methodology: Three studies were undertaken as part of this research. Study I included a systematic review undertaken to examine the type, content and the impact of self-management interventions for cancer survivors. Study II included a mixed methods study to determine the effectiveness and sustainability of OptiMal as a self-management intervention for cancer survivors. The primary outcome measure was frequency of activity participation. Secondary measures included health-related quality of life, self-efficacy, perception of occupational performance, anxiety, depression, cognitive difficulties and fatigue. Finally, Study III included a qualitative study exploring cancer survivors' reasons for non-participation in self-management interventions. Results: Findings from the systematic review highlighted the diversity of self-management interventions that have been provided to cancer survivors and their lack of sustainability. In Study II, no statistically significant differences were observed in the primary outcome measure. However, statistically significant improvements were observed in quality of life (p<0.001, p=0.035) and anxiety (p=0.04) from baseline to three months follow-up between the control and intervention group. OptiMal was considered to be an acceptable intervention by cancer survivors. However, many survivors stated that they would have benefited from it earlier post-treatment. In Study III, cancer survivors declined participation in the mixed methods study as they had already developed effective self-management strategies or reported a lack of perceived need for self-management. Conclusion: Cancer survivors experience physical and psychosocial symptoms post-treatment which can impact on their quality of life and participation in daily activities. OptiMal, an occupation-based, self-management intervention was considered an acceptable intervention by cancer survivors. Participants identified benefits of the programme including group support and goal-setting, which may have helped address psychosocial issues. However, many would have preferred OptiMal earlier post-treatment. Further research is required to explore the effectiveness and sustainability of OptiMal, with a larger number of cancer survivors, earlier post-treatment. Some survivors reported a lack of perceived need for self-management. Further research is required to identify those in need of self-management.