eQuiPe Study

The study was embedded in the Dutch nationwide eQuiPe prospective observational cohort, which investigates quality of care and quality of life in advanced cancer patients and their relatives. This study is among the first large studies to assess associations between self-management skills and outcomes across multiple advanced cancer types. The cross-sectional design of the analysis prevents causal interpretation, making it impossible to determine the direction of associations between self-management and outcomes. The sample lacked ethnic diversity, skewed toward medium-to-high education, and excluded patients with severe psychiatric illness. Relatively high self-management scores may partly reflect selection effects, as patients who died between baseline and follow-up were excluded. Recruitment by treating physicians may have over-represented patients with positive healthcare interactions and better navigation skills.