Perceived control and involvement in self care in patients with colorectal cancer

Aim. This paper reports the qualitative findings from a mixed methods study which explored patients' understandings of perceived control in relation to their self care during chemotherapy for colorectal cancer. Background. A greater degree of patient involvement in self care is increasingly being encouraged; however, little is known about how factors such as perceived control influence patients' active involvement in self care. Design. Qualitative, longitudinal study. Methods. Semi structured interviews were conducted with 11 patients before and after six months of chemotherapy treatment for colorectal cancer in a Scottish cancer centre between March 2005-June 2006. The interviews, conducted as part of a larger study, explored patients' understandings of their perceived control over managing treatment-related side effects and how this influenced their attitudes toward, and role preferences in, self care. Results. Patients fell into one of two groups: 'high' or 'low' perceived controllers. High-perceived controllers were more likely to view their active involvement in self care positively, as being necessary in managing treatment-related effects and were less likely to rely on nurses to take overall responsibility for the management of treatment-related side effects. Low-perceived controllers were less likely to believe in the importance or necessity of their active involvement in self care and more likely to perceive nurses as being the ones responsible for the management of treatment-related side effects. Conclusions. Perceived control during treatment for cancer influences patients' perceptions toward, and role preferences in, self care. Relevance to clinical practice. Clinical interventions designed to enhance involvement in self care would benefit from focussing on enhancing patients' perceived control and understanding their role preferences in self care. Patients with different understandings of perceived control may require different help and support to encourage their involvement in self care.