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Exploring How Advanced Cancer Patients Experience High or Low Existential Well-being: A Mixed-Methods Study

Antoine Beauchemin

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Canadian Institutes of Health Research (CIHR)
Early cutaneous melanoma (CM) detection and removal has been established as the most effective way of reducing CM-related mortality. A method called skin self-examinations (SSE) has been shown to improve early CM detection and thus reduce CM mortality by 63%. However, 85% of CM survivors do not engage in SSE. Research has demonstrated that treatment adherence and medical outcomes are improved when patients' perceive greater support from medical staff4. Additionally, self-determination theory proposes that patients' motivation to maintain healthy habits depends on feeling they can make autonomous decisions, confidence to perform the health behaviour competently, and relating to others regarding their illness. However, no research has examined how doctor-patient interactions influence SSE adherence. The goal of this research project is to examine the impact of doctor's support of such factors through their interactions with patients on long-term SSE adherence. I hypothesize that CM patients who feel their physician supports SSE will demonstrate better SSE adherence 3 and 12 months following SSE education. I also hypothesize that patients whose physician fosters their self-determination will enhance the effect of perceived physician SSE support on SSE adherence. Given that CM patients' prioritize building a relationship with their physician and following their physician's advice, this study will generate greatly needed data about the impact of physician support of SSE the doctor-patient relationship and on short- and long-term SSE adherence. Results will inform follow-up care practices and SSE education to increase SSE behaviour. This will improve early detection of CM in high-risk patients and lower CM-related mortality.

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