Perceived Self-Efficacy in B-Cell Non-Hodgkin Lymphomas: Qualitative Outcomes in Patient-Directed Education

Objective: Perceived self-efficacy (PSE) is considered a foundation for effective self-care in the context of chronic disease and illness. In order to improve patient and caregiver knowledge about self-care in B-cell non-Hodgkin's lymphoma (NHL), we designed and delivered an online, patient-focused education activity. Educational impact on PSE was evaluated using a mixed quantitative/qualitative methodology. We report here on the qualitative characteristics of self-efficacy. Methods: We interviewed participants using open-ended questions based on a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim, and analysed using constant comparative method with software support (NVivo for Mac 11, QSR International). Results: In all, 12 people diagnosed with B-cell NHL were interviewed. Descriptive analysis showed that participants were able to summarise key education messages about B-cell NHL presented in the programme. Key themes linked to self-care knowledge and practice included normalisation of self-care, learning the hard way, everyone is different and being prepared. Participants described four key strategies linked to the notion of 'being prepared': (1) asking questions, (2) building relationships with oncologists, (3) developing/maintaining a philosophy of life, and (4) connecting with others. These themes provide context for the experience of PSE and may also reflect beliefs that have implications for self-efficacy education. Conclusions: Interview data affirm PSE as a foundation of self-care and identify beliefs underpinning PSE. A dominant belief of 'being prepared' was sustained by four strategies that education content reinforced. Educators can use these insights to strengthen self-efficacy education interventions for patients with B-cell NHL and other types of cancer.