Toward the Patient Participation Pathway: A Mixed Methods Study of Patients With Cancer and Other Chronic Diseases

Abstract

Introduction: Chronic diseases such as breast cancer, colon cancer, chronic obstructive pulmonary disease (COPD), stroke, diabetes, depression, and myocardial infarction remain leading causes of death worldwide, contributing significantly to premature mortality. Understanding psychosocial impact is essential for comprehensive care. This study aimed to explore how patients with different chronic disease profiles experience participation during the chronic phase, using a mixed-methods approach. Materials and Methods: A convergent parallel mixed-methods design was used to integrate qualitative data from focus group discussions and quantitative data from physical performance tests. A total of 117 patients were recruited through clinical referrals and patient associations, using purposive and snowball sampling. Thematic analysis was performed collaboratively to ensure consistency. Statistical analysis (R v4.1.3) examined the coding and sentiment differences across disease profiles. Results: The sample included 117 patients (mean age = 58.66 years; majority were female). Significant differences in qualitative coding were found between pathologies (p < 0.001), particularly regarding quality of life and emotional experience in COPD and stroke patients compared to others (p < 0.05). Topic modeling identified seven relevant topics, and two main coding clusters emerged: one focused on pain and basic activities, and the other on environment and advanced activities. Positive emotions were predominant (p < 0.001). The thematic analysis revealed three main themes: quality of life, emotional experience, and empowerment. Conclusion: Patients with different chronic conditions experienced disease and unique participation. Patients with breast cancer prioritized pain and daily function, while patients with COPD focused on autonomy in self-management. These findings support the need for individualized disease-specific approaches to promote meaningful patient participation.