Increasing outpatient demands and unmet patient needs necessitate personalized follow-up care for cancer survivors. This study investigated whether a self-management-focused follow-up model improves empowerment and quality of life (QoL) in gynecological cancer survivors compared to standard follow-up. Twelve Norwegian hospitals participated in this cohort study. Patients initiating routine follow-up after primary treatment were eligible and allocated to either intervention or standard care follow-up groups based on their treatment hospital. The intervention included nurse-led consultations using coaching techniques for education on symptom monitoring and healthy lifestyle, alternated with physician-led consultations and access to a mobile app. Standard follow-up consisted of physician-led consultations only. The primary outcome was change in patient empowerment over 12 months, measured with the self-monitoring and insight domain of the Health Education Impact Questionnaire (heiQ). Secondary outcomes included changes in remaining heiQ domains and QoL. Data were analyzed according to intention-to-treat principles using linear mixed effects models. Among 741 participants (intervention: 378, standard: 363), baseline characteristics were comparable. At 12 months, no significant differences were observed in self-monitoring and insight (Δ = 0.02 95% confidence interval (CI), -0.04 to 0.08; effect sizes ES = 0.29). However, health-directed activity (Δ = 0.15 95% CI, 0.04-0.25; ES = 0.15), emotional well-being (Δ = 0.12 95% CI, 0.02-0.20; ES = 0.15), social functioning (Δ = 5.2 95% CI, 1.1-9.3; ES = 0.41), and physical functioning (Δ = 2.5 95% CI, 0.0-5.0; ES = 0.20) were significantly more improved in the intervention group. Lifestyle and Empowerment Techniques in Survivorship of Gynaecologic Oncology follow-up did not significantly impact self-monitoring and insight, but positively influenced other survivorship domains, indicating its potential for enhancing self-management and QoL in gynecological cancer survivors.
Vistad et al. (Fri,) studied this question.