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COMMENTARY
Commentary on Kidd L, Hubbard G, OCarroll R & Kearney N
(2009)
Perceived control and involvement in self-care in patients
with
colorectal cancer. Journal of Clinical Nursing 18, 22922300
Berna Dizer, Ayla Yava and Fatma S Hatipoglu
The paper by Kidd et al. (2009) demonstrates changes in
perceived control and the relationship between levels of
perceived control and self-care behaviours in patients with
colorectal cancer undergoing chemotherapy. The patients
with control perceived as high were defined as those who
were significantly engaged in self-care and who showed poor
participation or let health staff organise their care were
defined as having a low perception of control.
Chemotherapy is an important treatment in cancer care
and is associated with numerous side effects the severity
and
frequency of which differ between patients (Akin et al.
2008).
Complications may vary from the minor to significant such
as bone marrow suppression, increased susceptibility to
infection, oral mycosis, nephrotoxicity, anorexia, alopecia,
diarrhoea, nausea and vomiting (Bergkvist & Wengstro m
2006, Vincent et al. 2001). However, it is not clear how
frequently and consistently the patients in Kidd et al.s
(2009)study, who participated in their self-care more easily,
experienced side effects. This poses questions, such as, did
the high perceived control levels in these patients result
from facing less intense and less frequent side effects
compared with other patients with low perceived control?
Furthermore, did the experience of minor and inconsistent
side effects of chemotherapy actually result in a perception
of
high perceived control?
Certainly, participation in ones own care can contribute to
raised levels of perceived control and lessen side effects
(Brody et al. 1989). It can also enhance feelings of
well-being(Scharloo & Kaptein 1997). The severity of the
illness
appears to be an important factor in patients perceived
control and adaptation to their illness (Endler et al.
2001).
That is why patients experiencing severe and more frequent
symptoms and complications may be expected to lessen their
participation in care.
The definition of self-care by Kidd et al. (2009) is clearly
defined in their paper, but it is less evident what roles a
cancer
patient may play to be seen as participating in self-care.
For
instance, can participation in decisions related to
treatment
alternatives be considered as participation in self-care? Or
does participation in self-care mean performing procedures
to
protect from oral infections, avoid nausea, vomiting, etc.?
As
stated, chemotherapy-related complications have different
effects and may vary from one to another. This is another
important aspect that must be taken into account within the
evaluation of participation in self-care and levels of
perceived
control.Research has shown that an increase in the level of
self-
efficacy has a positive effect on health conditions, eases
symptom control in chemotherapy, and helps the patient to
reconcile with the challenges of cancer treatment (Cunning-
ham et al. 1991, Lev et al. 2001). Lev and Owen (1996)
found a significant negative correlation between psycholog-
ical distress and symptom distress in cancer patients and
self-
care/self-efficacy and a significantly positive correlation
was
found between quality of life and the perception of self-
efficacy (Lev & Owen 1996). Self-efficacy is actually an
individuals self-judgment ability on his or her capacity
toorganise the necessary activities to successfully undertake a
Authors: Berna Dizer, RN, PhD, Assistant Professor, Izmir
University, Doganata Education and Culture Foundation, School
of
Nursing, Izmir; Ayla Yava, RN, PhD, Assistant Professor,
Gulhane
Military Medical Academy, School of Nursing; Fatma S
Hatipoglu,
RN, PhD, Professor, Gulhane Military Medical Academy, School
of
Nursing, Ankara, Turkey
Correspondence: Berna Dizer, Assistant Professor, Izmir
University,
Doganata Education and Culture Foundation, School of
Nursing,
Izmir, Turkey. Telephone: +90 232 246 33 11.
E-mail: [email protected]
2372 2010 Blackwell Publishing Ltd, Journal of Clinical Nursing,
19, 23722373doi: 10.1111/j.1365-2702.2010.03338.x
