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Self‐management in older people living with cancer and multi‐morbidity: A systematic review and synthesis of qualitative studies

Self‐management in older people living with cancer and multi‐morbidity: A systematic review and synthesis of qualitative studies
Self‐management in older people living with cancer and multi‐morbidity: A systematic review and synthesis of qualitative studies
Objective
Many older people with cancer live with multimorbidity. Little is understood about the cumulative impact of old age, cancer and multimorbidity on self‐management. This qualitative systematic review and synthesis aimed to identify what influences self‐management from the perspective of older adults living with cancer and multimorbidity.

Methods
Six databases were systematically searched for primary qualitative research reporting older adults' experiences of living with cancer and multimorbidity (eg, Medline, Embase, and CINAHL). A thematic synthesis was guided by Shippee's model of cumulative complexity. Text labelled as results in the included papers was treated as data.

Results
Twenty‐eight studies were included. While the included studies varied in their focus, our analysis highlighted a number of important themes consistent across the studies. Health conditions with the greatest negative impact on independent living assumed the greatest importance, sometimes meaning their cancer was a low priority. Self‐management practices seen as likely to interfere with quality of life were deprioritized unless viewed as necessary to maintain independence. When burden outweighed capacity, people were reluctant to ask for help from others in their social network. The contribution of formal healthcare services to supporting self‐management was relatively peripheral.

Conclusions
Old age and multimorbidity together may complicate self‐management after cancer, threatening health and well‐being, creating burden and diminishing capacity. Older adults prioritized self‐management practices they considered most likely to enable them to continue to live independently.

The protocol was registered with Prospero (CRD42018107272).
Psycho-Oncology, burden of treatment, cumulative complexity, multimorbidity, patient capacity, qualitative, quality of life, review, self-management, synthesis
1057-9249
1452-1463
Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Cummings, Amanda
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Calman, Lynn
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Farrington, Naomi
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Fenerty, Vicky
5edbe55b-e185-4e44-a81d-34065cc28df7
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Richardson, Alison
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Wiseman, Theresa
e3ff42ae-97ef-4640-af3d-40eeae830df9
Bridges, Jackie
57e80ebe-ee5f-4219-9bbc-43215e8363cd
Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Cummings, Amanda
7c5f6bd2-979b-456d-9368-8edd13c06691
Calman, Lynn
9ae254eb-74a7-4906-9eb4-62ad99f058c1
Farrington, Naomi
ba8e905c-862b-4609-b0cc-9e27218de542
Fenerty, Vicky
5edbe55b-e185-4e44-a81d-34065cc28df7
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Wiseman, Theresa
e3ff42ae-97ef-4640-af3d-40eeae830df9
Bridges, Jackie
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Corbett, Teresa, Cummings, Amanda, Calman, Lynn, Farrington, Naomi, Fenerty, Vicky, Foster, Claire, Richardson, Alison, Wiseman, Theresa and Bridges, Jackie (2020) Self‐management in older people living with cancer and multi‐morbidity: A systematic review and synthesis of qualitative studies. Psycho-Oncology, 29 (10), 1452-1463. (doi:10.1002/pon.5453).

Record type: Review

Abstract

Objective
Many older people with cancer live with multimorbidity. Little is understood about the cumulative impact of old age, cancer and multimorbidity on self‐management. This qualitative systematic review and synthesis aimed to identify what influences self‐management from the perspective of older adults living with cancer and multimorbidity.

Methods
Six databases were systematically searched for primary qualitative research reporting older adults' experiences of living with cancer and multimorbidity (eg, Medline, Embase, and CINAHL). A thematic synthesis was guided by Shippee's model of cumulative complexity. Text labelled as results in the included papers was treated as data.

Results
Twenty‐eight studies were included. While the included studies varied in their focus, our analysis highlighted a number of important themes consistent across the studies. Health conditions with the greatest negative impact on independent living assumed the greatest importance, sometimes meaning their cancer was a low priority. Self‐management practices seen as likely to interfere with quality of life were deprioritized unless viewed as necessary to maintain independence. When burden outweighed capacity, people were reluctant to ask for help from others in their social network. The contribution of formal healthcare services to supporting self‐management was relatively peripheral.

Conclusions
Old age and multimorbidity together may complicate self‐management after cancer, threatening health and well‐being, creating burden and diminishing capacity. Older adults prioritized self‐management practices they considered most likely to enable them to continue to live independently.

The protocol was registered with Prospero (CRD42018107272).

Text
Self‐management in older people living with cancer and multi‐morbidity A systematic review and synthesis of qualitative studies - Accepted Manuscript
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More information

Accepted/In Press date: 18 June 2020
e-pub ahead of print date: 28 June 2020
Published date: October 2020
Keywords: Psycho-Oncology, burden of treatment, cumulative complexity, multimorbidity, patient capacity, qualitative, quality of life, review, self-management, synthesis

Identifiers

Local EPrints ID: 443103
URI: http://eprints.soton.ac.uk/id/eprint/443103
ISSN: 1057-9249
PURE UUID: 835519ef-adfa-42ad-ae6e-02ab4a9dace2
ORCID for Teresa Corbett: ORCID iD orcid.org/0000-0002-5620-5377
ORCID for Lynn Calman: ORCID iD orcid.org/0000-0002-9964-6017
ORCID for Vicky Fenerty: ORCID iD orcid.org/0000-0002-1712-5614
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Theresa Wiseman: ORCID iD orcid.org/0000-0002-3355-1269
ORCID for Jackie Bridges: ORCID iD orcid.org/0000-0001-6776-736X

Catalogue record

Date deposited: 11 Aug 2020 16:30
Last modified: 26 Nov 2021 05:19

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Contributors

Author: Teresa Corbett ORCID iD
Author: Amanda Cummings
Author: Lynn Calman ORCID iD
Author: Vicky Fenerty ORCID iD
Author: Claire Foster ORCID iD
Author: Theresa Wiseman ORCID iD
Author: Jackie Bridges ORCID iD

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