One step at a time: self-management and transitions among women with ovarian cancer.

PURPOSE/OBJECTIVES To describe experiences of self-management and transitioning among women with ovarian cancer. RESEARCH APPROACH Interpretive description. SETTING Participants' homes. PARTICIPANTS Purposive sample of 10 women with ovarian cancer. METHODOLOGIC APPROACH Individual interviews about women's self-management and transition experiences. MAIN RESEARCH VARIABLES Self-management, transitions, and ovarian cancer. FINDINGS Participants self-managed to increase their sense of control and to self-advocate. They managed their care one step at a time to prevent becoming overwhelmed. Common transitions were diagnosis, surgery and recovery, starting chemotherapy, managing symptoms, and recurrence. Transitions were challenging, even if previously experienced, and influenced the ability and willingness of women to self-manage. Barriers and facilitators to self-management were identified. CONCLUSIONS The approach to self-management of one step at a time is somewhat illusory, as women face multiple transitions simultaneously. The short trajectory of ovarian cancer leaves little time between transitions and an awareness of mortality. Women are forced to confront goals of care quickly, which may affect their ability to self-manage. INTERPRETATION Women with ovarian cancer need clinical and social support to prioritize and manage transitions. Introducing palliative care shortly after diagnosis could facilitate women's anticipation of and adjustment to transitions.