National Cancer Survivorship Initiative

Supported Self-Management Workstream

Professor Jessica Corner

National Development Programme

19th March, 2010

NCSI Vision 2009: Three ‘Enablers’

• Skills development programmes for professionals

• Self-management support options for patients/survivors

• Institutional support for service redesign

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Co-Creating Health: The Three Enablers 3

Support for Self-Management – Fundamental Culture Change• A relationship with health professionals which is based on partnership

is fundamental – both patient and professional are experts from their different perspectives (Powell et al., 2009; Epstein & Street, 2007)

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Six Functions of Communication in Cancer Care (Epstein and Street, 2007)

1) Fostering health relationships.

2) Exchanging information

3) Responding to emotions

4) Managing uncertainty

5) Enabling patient self-management

• Self-efficacy to self-manage – the patient/clinician partnership is often one of the most important

factors in boosting self-efficacy (Cimprich et al., 2005).

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Communication and Supported Self-Management6The consultation/interaction between a patient and their healthcare professional is the widest and most ubiquitous context in which patients can be advised and supported to self-manage (Davies and Batehup, 2010)

There remains a challenge to bring about change in practice, as the role of the patient as an active partner in their healthcare is not yet sufficiently recognised or supported.

Self-management is likely to be enhanced by a whole systems approach, where both patients and healthcare providers are considered as experts within a partnership (Grazin, 2009).

A US review reports that 85% of doctors considered they shared decisions with their patients; 50% of patients considered that this was the case (Hibbard and Tusler, 2007).

To effectively support survivors in self-management, cancer healthcare professionals require patient-in-partnership communication skills training, incorporating motivational interviewing skills (Davies and Batehup, 2010).