Self-management engagement in adults with hematologic cancers: a meta-synthesis of qualitative studies

To systematically evaluate and synthesize qualitative evidence on the lived experiences of self-management engagement among adult patients with hematologic malignancies to inform the development of targeted interventions.

A systematic literature search was conducted across eight databases (including PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CNKI, WanFang, and CBM) from inception to July 2025, with an updated search performed in January 2026. Sixteen qualitative studies involving adults (≥ 18 years) with hematologic malignancies were included. The methodological quality of the included studies was appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist (2020). Data were synthesized using the thematic synthesis method.

This meta-synthesis integrated findings from 16 studies involving adults with diverse hematologic malignancies across 11 countries, covering trajectories from active treatment to long-term survivorship. Using NVivo 15.0 for inductive thematic analysis, the synthesis established four overarching analytical themes reflecting the unique demands of this population: (1) The Hidden Work: Vigilance and Risk Management, which details the hyper-vigilance required for infection prevention, bleeding risks, and continuous physiological monitoring; 2) Psychological Labor and Emotional Adaptation, encompassing the cognitive burden of dyadic coping, protective buffering, and managing the pervasive fear of relapse; 3) Engagement Capacity: Drivers and Resources, which bridges intrinsic drivers with the essential knowledge and skills required for self-management; and 4) The Context of Care Continuum, highlighting the systemic barriers and information gaps encountered during critical disease transitions.

This meta-synthesis indicates that self-management engagement in hematologic malignancies extends beyond task adherence to involve continuous "risk work" and significant emotional labor within the family unit. Findings suggest that nursing interventions should prioritize targeted strategies, such as sepsis-prevention education and dyadic coping support, over generic approaches. Addressing these specific, high-stakes demands is critical for optimizing patient safety and quality of life throughout complex treatment transitions.