Self-management Behaviors and Associated Factors in Adult Cancer Survivors: An Integrative Review.

Background: Despite numerous systematic reviews on self-management interventions for cancer survivors, little is known about survivors' daily self-management practices and the influencing factors.

Objective: To identify self-management behaviors and related factors among cancer survivors.

Methods: Six databases were searched for primary quantitative, qualitative, and mixed-methods studies on self-management behaviors in cancer survivors that were published in English-language, peer-reviewed journals between 2012 and July 2022. The methodological quality of the included studies was evaluated using the Mixed Methods Appraisal Tool. The data extracted using a predetermined form were analyzed using qualitative content analysis.

Results: A total of 22 articles were included in the review; the majority were qualitative research, and half had moderate to high quality of evidence. Nine domains of self-management behaviors were identified, namely, physical activity/exercise, diet, emotional management, complementary and alternative medicine, symptom management, religiosity/spirituality, attending regular follow-ups, adjustment of other lifestyles, and medication management. Four categories of factors were associated with self-management behaviors in cancer survivors: (1) personal factors (demographic and psychological), (2) health status, (3) family factors, and (4) healthcare system. However, the relationships between self-management behaviors and these factors were mainly identified from qualitative studies or addressed in single studies.

Conclusions: Self-management behaviors in cancer survivors are multifaceted. There is an urgent need for quantitative exploration of factors associated with self-management in cancer survivors.

Implications for practice: This review provides nurses with a comprehensive basis for designing self-management support interventions for cancer survivors.