A double whammy: health promotion among cancer survivors with preexisting functional limitations.

PURPOSE/OBJECTIVES To explore the experience of living with a preexisting functional disability and a cancer diagnosis and to identify strategies that promote health in the growing population of cancer survivors. RESEARCH APPROACH Qualitative, descriptive. SETTING Four sites in the United States. PARTICIPANTS 19 female cancer survivors with preexisting disabling conditions. METHODOLOGIC APPROACH Four focus groups were conducted. The group discussions were audio recorded and transcribed and analyzed using content analysis techniques. FINDINGS Analytic categories included living with a cancer diagnosis, health-promotion strategies, and wellness program development for survivors with preexisting functional limitations. Participants described many challenges associated with managing a cancer diagnosis on top of living with a chronic disabling functional limitation. They identified strategies to maintain health and topics in health-promotion programs tailored for this unique group of cancer survivors. CONCLUSIONS The "double whammy" of a cancer diagnosis for people with preexisting functional limitations requires modification of health-promotion strategies and programs to promote wellness in this group of cancer survivors. INTERPRETATION Nurses and other healthcare providers must attend to patients' preexisting conditions as well as the challenges of the physical, emotional, social, and economic sequelae of a cancer diagnosis. KNOWLEDGE TRANSLATION Cancer survivors with preexisting functional disabilities had difficulties finding cancer care providers who could manage their unique needs. That may be because some cancer-care providers are inadequately prepared to care for patients with cancer who have complex preexisting conditions. Cancer survivors with preexisting conditions may benefit from health-promotion programs that emphasize self-advocacy strategies, management of the economic impact of multiple diagnoses, and wellness activities adapted to their unique functional limitations.