Deconstruction of nurse-delivered patient self-management interventions for symptom management: Factors related to delivery enactment and response

Abstract

This research examines the processes by which patient self-management interventions are related to symptom responses among cancer patients. A total of 333 patients from two randomized clinical trials were combined. Each patient received a six-contact 8-week patient self-management intervention delivered by a nurse to address symptoms. Nurses' decisions to deliver the strategies, patient enactment of strategies, and their success were investigated using patient- and symptom-level characteristics. Generalized estimating equation modeling accounted for clustering of symptoms and strategies delivered for each symptom within patient. Patient self-management intervention strategies were classified into four classes. Strategies were delivered by nurses for symptoms with higher interference and longer duration. Patient and symptom factors were related to enactment strategies. Symptom responses were related to number of strategies tried by patients. Delivery and enactment of strategies were related to both patient and symptom characteristics. © 2010 The Society of Behavioral Medicine.