Promotion of self-management for post treatment cancer survivors: evaluation of a risk-adapted visit

J Cancer Surviv. 2016 Feb;10(1):206-19. doi: 10.1007/s11764-015-0467-6. Epub 2015 Jul 16.

Abstract

Purpose: The LIFE Cancer Survivorship Program at NorthShore University HealthSystem provides risk-adapted visits (RAV) facilitated by an oncology nurse during which a survivorship care plan (SCP) is provided and discussed. In this report, we describe and evaluate RAV in promoting individualized health care and self-management during survivorship transition.

Methods: Patients complete a post-RAV questionnaire at their RAV and another ≥1 year after their RAV.

Results: One thousand seven hundred thirteen (1713) RAVs, majority for breast cancer, occurred from January 2007 to March 2014. One thousand six hundred fifteen (1615) "day-of" post-RAV questionnaires were completed. Respondents scaled statements as strongly agree/agree/disagree/strongly disagree. Combined strongly agree/agree ratings are 94 % felt more confident in communicating information about their treatments to other health care providers, 90 % felt more comfortable recognizing signs/symptoms to report to providers, and 98 % had a better appreciation for community programs/services. Of 488 respondents (RAV January 2007 to December 2012 n = 1366) to a questionnaire at least 1 year after the RAV, nearly 100 % found SCP useful to summarize medical information, 97 % to reinforce follow-up, 85 % to recognize symptoms of recurrence, 93 % to identify healthy lifestyle practices, 91 % to assist in identifying resources for support, 72 % discussed their SCP with their healthcare provider, and 97 % made at least one positive lifestyle change.

Conclusions: Participation in LIFE RAV following treatment helps survivors to guide future self-care behavior. Data suggest that benefits may persist 1 year after the visit and support the feasibility of a nurse-led RAV to establish a SCP in cancer survivors.

Implications for cancer survivors: Combined provision and discussion of SCPs help survivors construct a useful understanding of their cancer experience and may promote long-term self-management.

Keywords: Aftercare; Cancer survivorship program; Patient education; Self-management; Survivorship care plan; Survivorship transitions in care.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Continuity of Patient Care
  • Female
  • Health Promotion* / methods
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasms / mortality
  • Neoplasms / nursing
  • Neoplasms / therapy*
  • Patient Care Planning*
  • Patient Education as Topic* / methods
  • Patient-Centered Care* / methods
  • Risk Factors
  • Self Care*
  • Surveys and Questionnaires
  • Survivors / statistics & numerical data
  • Transitional Care
  • Young Adult