The Impact of Side Effects on Oral Anticancer Agent Self-Management: Patient Perception of Risks Matters

OBJECTIVES: To examine the relationship between side effect severity and self-management ability in patients taking capecitabine and investigate whether medication beliefs mediate this relationship. SAMPLE & SETTING: A secondary analysis was conducted using data from a descriptive study of 50 patients with gastrointestinal cancer receiving capecitabine at the University of Michigan Rogel Cancer Center. METHODS & VARIABLES: Self-management ability was assessed using the Measure of Drug Self-Management. The severity of capecitabine-related side effects was measured using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events. Patients' perceived necessity of and concerns about capecitabine were evaluated using the Beliefs about Medicines Questionnaire (adapted for capecitabine). Descriptive statistics, multiple linear regression, and PROCESS macro mediation analysis were employed. RESULTS: Self-management ability was significantly associated with total side effect severity (beta = -1.09, p = 0.003). This relationship was partially mediated by patients' overall beliefs about capecitabine (beta = -0.74, p = 0.04) and fully mediated by concerns about its potential harms (beta = -0.6, p = 0.11). IMPLICATIONS FOR NURSING: Oncology nurses should adopt a patient-centered approach that includes counseling about the benefits of capecitabine, addressing concerns about adverse effects, and reinforcing patients' self-efficacy and social support networks to enhance self-management during therapy.