BACKGROUND Self-management of symptoms related to cancer and its treatment is important for maintaining treatment regimens and improving outcomes. PURPOSE To determine factors associated with engagement in a symptom self-management intervention among patients initiating oral anticancer treatment. METHODS This secondary analysis included 127 patients randomized to the medication adherence reminder and symptom management intervention in a recently completed trial. Patients were recruited from six Comprehensive Cancer Centers, interviewed at intake, and mailed a Symptom Management Toolkit (Toolkit) with self-care management strategies for 18 symptoms. During eight automated telephone weekly calls, patients were asked to use the Toolkit to manage elevated symptoms. Toolkit use and symptoms were tracked weekly, and generalized linear mixed-effects models were used to determine factors predictive of Toolkit use. General linear modeling was used to relate the Toolkit use during intervention to postintervention symptom severity. RESULTS Better cognitive function at intake into the trial and higher symptom burden were predictive of the patients' initial decision to try the Toolkit during Week 1. In subsequent weeks, Toolkit use in the previous week and worsening of symptoms were associated with greater odds of Toolkit use. The extent of Toolkit use modified the relationship between intake and 8 week symptom severity: among patients with higher levels of severity at intake, use of the Toolkit conferred greater benefit at 8 weeks. CONCLUSIONS Patients make realistic decisions regarding when to use a self-directed approach to self-management and are likely to use strategies when their symptoms are higher and to forego use once symptoms subside. CLINICAL TRIAL REGISTRATION NCT02043184.

中文翻译：

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自动电话症状管理干预的患者参与：预测因素和结果。

背景与癌症及其治疗相关的症状的自我管理对于维持治疗方案和改善结果很重要。目的 确定与开始口服抗癌治疗的患者进行症状自我管理干预相关的因素。方法 这项二次分析包括在最近完成的一项试验中随机分配到药物依从性提醒和症状管理干预组的 127 名患者。从六个综合癌症中心招募患者，在入院时接受采访，并邮寄了症状管理工具包（工具包），其中包含针对 18 种症状的自我护理管理策略。在每周八次自动电话呼叫中，患者被要求使用工具包来管理升高的症状。每周跟踪工具包的使用和症状，和广义线性混合效应模型用于确定预测 Toolkit 使用的因素。一般线性模型用于将干预期间工具包的使用与干预后症状严重程度相关联。结果 进入试验时更好的认知功能和更高的症状负担预示着患者在第 1 周最初决定尝试使用 Toolkit。在随后的几周内，前一周使用 Toolkit 和症状恶化与 Toolkit 的几率更大有关采用。Toolkit 的使用范围改变了摄入量与 8 周症状严重程度之间的关系：在摄入严重程度较高的患者中，使用 Toolkit 在 8 周时带来更大的益处。结论 患者对何时使用自我指导的自我管理方法做出现实的决定，并且可能在症状更严重时使用策略，一旦症状消退就放弃使用。临床试验注册 NCT02043184。