Self-management Interventions for Cancer Survivors: A Systematic Review and Evaluation of Intervention Content and Theories.

Self-management has been proposed as a strategy to help cancer patients optimize their health and wellbeing during survivorship. Previous reviews have shown variable effects of self-management on outcomes. The theoretical basis and psycho-educational components of these interventions has not been evaluated in detail. We aimed to evaluate the evidence for self-management and provide a description of the components of these interventions.We conducted a systematic review of self-management interventions for adults who had completed primary cancer treatment by searching MEDLINE, EMBASE, PsychINFO, CINAHL, Scopus, Cochrane database of systematic reviews, National Institutes of Health clinical trials registry, and Cochrane CENTRAL registry of controlled trials. We included experimental and quasi-experimental designs. Data synthesis included narrative and tabular summary of results; heterogeneity of interventions and outcomes precluded meta-analysis. Study quality was evaluated using the Cochrane Risk of Bias tool or the Risk of Bias of Non-Randomized studies tool.41 studies published between 1994 and March 29, 2018 were included. Studies were predominantly randomized controlled trials and targeted to breast cancer survivors. A variety of intervention designs, psychoeducational components, and outcomes were identified. Less than 50% of the studies included a theoretical framework. There was variability of effects across most outcomes. Risk of bias could not be fully assessed.There are limitations in the design and research on self-management interventions for cancer survivors which hinders their translation into clinical practice. Further research is needed to understand if these interventions are an important type of support for cancer survivors.