Barriers and facilitators to self-management in people living with a lower-grade glioma

Ben Rimmer*, Michelle Balla, Lizzie Dutton, Sophie Williams, Vera Araújo-Soares, Pamela Gallagher, Tracy Finch, Joanne Lewis, Richéal Burns, Fiona Menger, Linda Sharp

*Corresponding author for this work

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Self-management can have clinical and quality-of-life benefits. However, people with lower-grade gliomas (LGG) may face chronic tumour- and/or treatment-related symptoms and impairments (e.g. cognitive deficits, seizures), which could influence their ability to self-manage. Our study aimed to identify and understand the barriers and facilitators to self-management in people with LGG.


We conducted semi-structured interviews with 28 people with LGG across the United Kingdom, who had completed primary treatment. Sixteen participants were male, mean age was 50.4 years, and mean time since diagnosis was 8.7 years. Interviews were audio-recorded and transcribed. Following inductive open coding, we deductively mapped codes to Schulman-Green et al.’s framework of factors influencing self-management, developed in chronic illness.


Data suggested extensive support for all five framework categories (‘Personal/lifestyle characteristics’, ‘Health status’, ‘Resources’, ‘Environmental characteristics’, ‘Healthcare system’), encompassing all 18 factors influencing self-management. How people with LGG experience many of these factors appears somewhat distinct from other cancers; participants described multiple, often co-occurring, challenges, primarily with knowledge and acceptance of their incurable condition, the impact of seizures and cognitive deficits, transport difficulties, and access to (in)formal support. Several factors were on a continuum, for example, sufficient knowledge was a facilitator, whereas lack thereof, was a barrier to self-management.


People with LGG described distinctive experiences with wide-ranging factors influencing their ability to self-manage.

Implications for cancer survivors

These findings will improve awareness of the potential challenges faced by people with LGG around self-management and inform development of self-management interventions for this population.

Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalJournal of Cancer Survivorship
Early online date21 Mar 2024
Publication statusE-pub ahead of print - 21 Mar 2024

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