Transcript Survivorship Care Plans (SCP)

Survivorship Care Plans (SCP)
Survivorship Care Plans (SCP)
Cheryl MacDonald
Clinical Nurse Specialist Lead
Breast Care
Mid Central Health Ltd
Definition of survivorship
•
Cancer survivorship can be defined as starting from
the time of initial diagnosis and continuing through
the balance of life (National Coalition for Cancer
Survivorship, 2010; National Cancer Institute, 2010)
•
The NHS believes that survivorship in cancer
encompasses 3 elements;
1. those undergoing primary treatment,
2. those who are in remission following treatment, and
3. those who are cured or have active or advance
disease (NHS,2009).
When primary treatment
finishes….
• Some people can have
feelings of vulnerability and
abandonment. They can feel
like their safety net has gone
once primary treatment has
finished. This can be as
stressful as the initial
diagnosis.
• Its important that care
planning starts at the time of
diagnosis, thus reducing
anxiety and giving a clear
direction which will enable a
smooth transition from
treatment to follow-up
Rehabilitative support
• Rehabilitative support following cancer
treatment aims to maximise the ability of
those who have been treated for cancer
to function as normally as possible by
promoting independence, quality of life,
and adapting to living with cancer long
term (NZGG, 2010).
The evidence
• Research suggests that people have a much
better understanding of their health condition
when they are involved in the decision
making process with their health care
professional (Turton & Cooke, 2000).
• SCP’s are not only a conduit between active
cancer care and survivorship care, but
between health professionals and cancer
survivors (Hill-Kayser, Vachani, Hampshire,
Jacobs & Metz, 2009).
Why SCP????
It has been recommended that at the
completion of cancer treatment, patients
should be provided with a treatment
summary and a detailed plan of ongoing
care which includes:
• Follow-up schedules
• Clinical examinations
• Lifestyle adjustments
• Psycho-social support
What is a SCP???
• A comprehensive and individualised
summary and follow-up plan once the acute
phase of cancer care has ended
• Owned by the survivor
• Undertaken in partnership with health care
professionals
• Enables the survivor to take responsibility
and ownership of their care, particularly in the
area of lifestyle
• Provides the survivor with a guide on what to
respond to
The Benefits of SCP’s
• A SCP provides a unique opportunity for
those involved in oncology care to
strengthen the coordination of services
for cancer survivors to ensure that their
continuing needs are met.
• This shifts the paradigm of cancer care
from a medical model to a wellness
model, and supports the transition from
patient to survivor.
What should a SCP contain??
• Issues of health maintenance and
surveillance
• lifestyle behaviours
• Late effects of treatment
• Possible signs of recurrence
• Who to contact should they have
concerns.
• Support services and their contact
numbers
Slide Master
Survivorship Care Plan
This useful tool will help guide your future health care needs.
Conclusion
• Survivorship care plans (SCP) should be tailored to
the needs of the individual and effective coordination
and communication between the primary and
secondary tertiary care teams is vital.
• Promoting self-management for people living with
and beyond cancer should move from a clinically led
approach to a supported self-management one,
which is based on the individual’s needs and
preferences.
• This will empower individuals to take on responsibility
for their health condition which is supported by the
appropriate clinical assessment, support and
treatment.
A quote from Herbie Mann
“When you have cancer , its like really
time to look at what your life was and is,
and I decided that everything I’ve done
so far is not as important as what I am
going to do now”
Helpful websites
• http://www.canceradvocacy.org/resources/journeyforward.html
• http://www.livestrongcareplan.org/
• http://www.ncsi.org.uk/
And Finally…….
• Supporting cancer survivors to live healthy
and active lives for as long as possible should
be a priority for health care providers across
primary and secondary services.
• This can be achieved through the
implementation of individualised assessments
and forward care planning which includes
information and support to enable people to
get back to as normal a life as possible after
cancer treatment has concluded.
References
Hill-Kayser, C. E., Vachani, C., Hampshire, M. K., Jacobs, L. A., & Metz, J. M. (2009). An
Internet Tool for Creation of Cancer Survivorship Care Plans for Survivors and Health Care
Providers: Design, Implementation, Use and User Satisfaction. Journal of Medical Internet
Research, 11(3), e39.
National Cancer Institute (2006). About cancer survivorship research: survivorship definitions
Retrieved 15th October 2010, from http://cancercontrol.cancer.gov/ocs/definitions.html
National Institute for Clinical Excellence (2004). Guidance on Cancer Services:
supportive and palliative care for adults with cancer - The manual. London
Improving
New Zealand Guidelines Group (2010). Guidance for Improving Supportive Care for Adults
with Cancer in New Zealand. Wellington: Ministry of Health.
Turton, P., & Cooke, H. (2000). Meeting the needs of people with cancer for support and selfmanagement. Complimentary Therapies in Nursing and Midwifery, 6(3), 130-137.
Template taken from - http://journeyforward.org/sites/journeyforward.org/files/Cancer-survivoradvocacy.ppt
Thank you , any questions?