Researchers evaluated the instrument in 305 adults with metastatic solid tumors receiving first-line systemic therapy. Participants were primarily living with lung, gastrointestinal, or genitourinary cancers.
Self-Care Assessment Addresses More Than Treatment Adherence
Unlike many existing oncology tools that focus on specific symptoms or treatment regimens, the SC-CI measures three broad areas of self-care: maintaining healthy behaviors (maintenance), monitoring symptoms and health changes (monitoring), and responding appropriately when problems arise (management).
The study found that the tool demonstrated acceptable reliability (ICC=0.70-0.74, ω=0.74–0.85, P<0.001) and validity across these domains. The final version of the inventory included 40 questions and showed excellent content validity (maintenance = 0.97, monitoring = 0.98, management = 0.97). Patients participated in the development process, helping researchers refine questions to ensure they were understandable and relevant to the cancer experience.
The findings highlight the importance of evaluating self-care as a multidimensional process rather than focusing exclusively on medication adherence or symptom burden. Patients receiving systemic therapy must not only follow treatment recommendations, but also recognize changes in their condition, monitor treatment-related toxicities, and know when to seek clinical guidance.
Potential Applications for Symptom Management and Patient Education
Researchers reported that stronger self-care scores were associated with higher levels of health literacy (maintenance r=0.234, monitoring r=0.294, management r=0.361, P<0.001). Women also tended to report higher self-care scores than men across maintenance (M = 82.62 vs 78.72, P=0.001), monitoring (M=77.02 vs 71.63, P=0.016), and management (M = 81.40 vs. 76.98, P=0.007).
The tool may provide oncology nurses with a structured way to identify patients who need additional support in symptom monitoring, treatment-related decision-making, or day-to-day self-management. For example, patients who struggle to recognize worsening symptoms or are unsure when to contact the care team could benefit from targeted education and follow-up.
The inventory could also help nurses distinguish between different types of self-care needs. A patient may successfully attend appointments and complete treatment yet still require coaching on symptom surveillance or strategies for managing treatment-related side effects at home.
Supporting Personalized Oncology Care
As cancer increasingly is managed as a long-term condition, patients are expected to take a more active role in care between clinic visits. The authors suggest that tools such as the SC-CI may help clinicians better understand how patients manage their care outside the healthcare setting.
Although the study needs additional validation in more diverse oncology populations, it suggests that routinely assessing self-care behaviors could guide personalized education, symptom-management interventions, and supportive care planning for patients receiving systemic cancer treatment.