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“Being a Part of Treatment”: The Meaning of Self-monitoring for Rural Cancer Patients

Purtzer, Mary Anne PhD, RN; Hermansen-Kobulnicky, Carol J. PhD, RPh

doi: 10.1097/NCC.0b013e318263f385

Background: The diagnosis and treatment of cancer entail managing vast amounts of information in order for patients to participate effectively in disease self-management. Information management includes patients’ responses to acquire, manage, and use external and internal information, such as through self-monitoring practices.

Objective: The study objective was to examine the meaning of self-monitoring practices within the context of rural patients’ responses to internal and external information.

Methods: An empirical phenomenological approach was used. Participants were adults 18 years or older, who were once diagnosed with cancer, who agreed to discuss health monitoring behavior in relation to their cancer experience, and who used services at a small, rural cancer center. Data were collected using semistructured interviews.

Results: Findings revealed a self-directed pursuit of self-monitoring that was shaped by 4 factors, that is, cognitive, affective, interpersonal, and symptomatic. Quotations from participants illustrate these factors. “I’d ask the questions …” represents the cognitive factor. “Are the horse stories about cancer treatments true?” represents the affective factor. The interpersonal factor is represented as “My nurse was there for me!” The symptomatic factor is represented as “Chemotherapy blocks out your memory.” Informed by these factors, participants’ self-monitoring practices fostered participants’ sense of control and self-advocacy efforts.

Conclusion: Nurses are in a strategic position to engage in supportive care practices through the facilitation of self-monitoring.

Implications for Practice: Assessment questions grounded in study findings are suggested for use by nurses to develop patient-centered education that facilitates self-monitoring practices.

Author Affiliations: Fay W. Whitney School of Nursing (Dr Purtzer) and School of Pharmacy (Dr Hermansen-Kobulnicky), University of Wyoming, Laramie.

This study was funded by an American Association of Colleges of Pharmacy New Investigator Program Grant.

The authors have no conflicts of interest to disclose.

Correspondence: Mary Anne Purtzer, PhD, RN, Fay W. Whitney School of Nursing, University of Wyoming, Dept 3065, 1000 E University Ave, Laramie, WY 82071-2000 (

Accepted for publication June 8, 2012.

© 2013 Lippincott Williams & Wilkins, Inc.