Symptom Burden and Self-Advocacy: Exploring the Relationship Among Female Cancer Survivors.
Teresa L Hagan, Stephanie Gilbertson-White, Susan M Cohen and 3 others
PMID 29350706WHAT IT FOUND
Better communication with providers linked to less symptom interference, but stronger informed decision-making linked to higher symptom severity.
Nurses should assess patients' comfort discussing concerns and pay special attention to symptom management if they struggle.
Key findings
01Higher ability to communicate effectively with healthcare providers was associated with lower symptom severity and less interference with daily life.
02Higher ability to make informed decisions was associated with higher symptom severity, contradicting the hypothesis that self-advocacy skills reduce burden.
03The Connected Strength subscale showed no significant association with either symptom severity or interference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Cross-sectional design prevents determining cause and effect; high symptoms may drive self-advocacy, or self-advocacy may increase symptom awareness. Symptoms were self-reported for only the past 24 hours, and the study did not assess whether symptoms were cancer-related or due to other causes. The sample lacked diversity in cultural, social, and religious backgrounds, and did not include uninsured or underinsured populations. Participants' comorbidities were not assessed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that self-advocacy training reduces symptom burden. The study found that informed decision-making was associated with higher symptom severity, and the cross-sectional nature means we cannot tell if advocacy skills cause better outcomes or if patients with worse symptoms develop these skills.