Perspectives of patients with prostate cancer on self-management support through mHealth and health-coaching: an interpretive description (Preprint)

BACKGROUND Observational management, such as Active Surveillance and Watchful Waiting, is shown to be feasible for men with low-risk localized prostate cancer and a safe alternative to aggressive treatment. During observational management, treatment is postponed until the disease progresses, which often never happens. However, approximately 90% of patients with low-risk disease choose aggressive treatment, owing to anxiety. Strategies to address this are needed for optimal management of this population and to improve quality of life in men with low-risk localized prostate cancer. A review highlights that mHealth in combination with health-coaching can benefit from each other in order to enhance patients’ self-management and improve wellbeing. OBJECTIVE The objective of this study was to explore the patients’ experiences and perspectives of an intervention offering self-management support through different mHealth devices and health-coaching, in order to investigate what supported them in making sustainable changes for improving well-being. METHODS We used an interpretive description approach, combining semi-structured interviews with 13 purposively selected prostate cancer patients and participant observations of patient-coach interactions in coaching sessions. The interviews were transcribed and analyzed. Self-determination theory were used as a theoretical lens. Field notes and the coaching notes from each session were used to orient data generation and confirm or challenge the analysis. RESULTS In general, our analysis revealed that the men’s identity seemed to influence their experience and perspective of the self-management support through mHealth and health-coaching in clinical practice. The men´s individual experiences and perspectives indicated that they placed themselves in a dynamic continuum of sustaining and/or repressing own identity. Our analysis revealed four interacting themes all related to the identity of the men. CONCLUSIONS In order for the men with prostate cancer to achieve wellbeing, we found it important for the men to be able to sustain own identity, when offered a self-management intervention. Motivation and autonomy were important aspects in order for the men to sustain own identity throughout the intervention. In contrast, demotivation and paternalism could result in an experience of having to repress own identity.