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. Author manuscript; available in PMC: 2021 Feb 19.
Published in final edited form as: ANS Adv Nurs Sci. 2021 Jan-Mar;44(1):E1–E13. doi: 10.1097/ANS.0000000000000342

Table.

Progression of Studies Leading to the Self-advocacy Conceptual Framework

Order of Studies Study Methodology and Citation Study Purpose (as Stated in Each Article) Main Results Related to Conceptual Framework
1. Concept analysis of self-advocacy in cancer survivorship10 “To report an analysis of the concept of
self-advocacy among individuals with cancer to clarify its meaning, to differentiate this meaning with related concepts, and to unify understanding of the concept in cancer research and practice.”
  1. Precursors to self-advocacy:
    • Personal characteristics
    • Learned skills
    • Attainable support
  2. Defining characteristics of self-advocacy with examples:
    • Thoughts and cognitions
      • Creation of “new normal”
      • Prioritization of needs and wants
      • Sense of empowerment
    • Actions for self
      • Navigation through the health care system
      • Teamwork with health care providers
      • Making informed decisions
    • Utilization of resources
      • Seeking and providing support
      • Membership in cancer-related groups
  3. Proximal outcomes of self-advocacy:
    • Symptom management
    • Adherence
    • Quality of life
    • Health care utilization
2. Focus groups of self-advocacy in women with ovarian cancer11 “To explore ovarian cancer survivors’ experiences of self-advocacy in symptom management.”
  1. Themes and subthemes of self-advocacy:
    • Theme 1: Knowing who I am and keeping my psyche intact
      • Having a strong will
      • Keeping a positive attitude
      • Being on the tipping point
    • Theme 2: Knowing what I need and fighting for it
      • Knowing how and when to seek out information
      • Being proactive to manage the health care providers
      • Taking advantage of support networks
3. Creation of a self-advocacy scale for women with a history of cancer12 To report “the development of the Female Self-Advocacy in Cancer Survivorship Scale’s conceptual underpinnings and item development” including “evaluations of the measure’s content validity and reliability. ”

  1. The creation of an initial measure of self-advocacy

  2. The initial measure has face validity (eg, experts recognized the measure as relevant to and representative of self-advocacy)

  3. The initial measure can consistently capture self-advocacy (eg, individuals’ scores did not significantly vary over 2-week period)
4. Validation of the Female Self-Advocacy in Cancer Survivorship Scale13 “To develop and psychometrically test the validity of the Female Self-Advocacy in Cancer Survivorship Scale.”

  1. The validation of a 20-item measure of self-advocacy

  2. Three subdimensions of self-advocacy:
    • Informed decision-making
    • Effective communication with health care providers
    • Connected strength
  3. Relationships between self-advocacy and other variables:
    • Precursors/moderators
      • Sociodemographic characteristics
      • Personality characteristics
      • Information engagement
      • Social support availability
    • Outcomes
      • Symptom burden
      • Health care utilization