Journal of Cancer Education

, Volume 27, Issue 2, pp 226–232 | Cite as

Educating Health Care Professionals to Provide Institutional Changes in Cancer Survivorship Care

  • Marcia Grant
  • Denice Economou
  • Betty Ferrell
  • Gwen Uman
Article

Abstract

The Institute of Medicine (IOM) 2006 report, From Cancer Patient to Cancer Survivor: Lost in Transition (In M. Hewitt, S. Greenfield and E. Stovall (Eds.), (pp. 9–186). Washington DC: The National Academies Press, 2006) identifies the key components of care that contribute to quality of life for the cancer survivor. As cancer survivorship care becomes an important part of quality cancer care oncology professionals need education to prepare themselves to provide this care. Survivorship care requires a varied approach depending on the survivor population, treatment regimens and care settings. The goal of this program was to encourage institutional changes that would integrate survivorship care into participating centers. An NCI-funded educational program: Survivorship Education for Quality Cancer Care provided multidiscipline two-person teams an opportunity to gain this important knowledge using a goal-directed, team approach. Educational programs were funded for yearly courses from 2006 to 2009. Survivorship care curriculum was developed using the Quality of Life Model as the core around the IOM recommendations. Baseline data was collected for all participants. Teams were followed-up at 6, 12 and 18 months postcourse for goal achievement and institutional evaluations. Comparison data from baseline to 18 months provided information on the 204 multidiscipline teams that participated over 4 years. Teams attended including administrators, social workers, nurse practitioners, registered nurses, physicians and others. Participating centers included primarily community cancer centers and academic centers followed by pediatric centers, ambulatory/physician offices and free standing cancer centers. Statistically significant changes at p = <0.05 levels were seen by 12 months postcourse related to the effectiveness, receptiveness and comfort of survivorship care in participant settings. Institutional assessments found improvement in seven domains of care that related to institutional change. This course provided education to participants that led to significant changes in survivorship care in their settings.

Keywords

Cancer survivorship education Institutional change Quality of life Institutional survey Institutional assessment 

Notes

Acknowledgment

This study was supported by NCI-R25CA107109. Authors would like to thank the faculty: Kimlin Ashing-Giwa, PhD; Smita Bhatia, MD; Diane Blum, MSW; Marilyn Bookbinder, RN, PhD; Katherine Brown-Saltzman, RN, MSN; Michael Feuerstein, PhD, MPH; Patricia Ganz, MD; Sheldon Greenfield, MD; Sue Hieney, PhD, FAAN; Melissa Hudson, MD; Linda Jacobs, RN, PhD; Paul Jacobsen, PhD; Diana Jeffery, PhD; Judi Johnson, RN, MPH, PhD, FAAN; Vicki Kennedy, LCSW; Wendy Landier, NP; Susan Leigh, RN, BSN; Mary McCabe, RN, MA; Ruth McCorkle, PhD, FAAN, AOCN; Sandra Millon-Underwood, RN, PhD Shirley Otis-Green, MSW, ACSW, LCSW, OSW-C; Margaret Riley, RN, MN, CNAA; Leslie Robison, PhD; Sheila Santacroce, APRN, PhD; Renee Sevy-Rickles, MSW; and Bradley Zebrack, PhD, MSW, MPH.

References

  1. 1.
    American Association of Colleges of Nursing (2010, September 20, 2010) Nursing shortage fact sheet Retrieved November 7, 2011, from http://www.aacn.nche.edu/media-relations/NrsgShortageFS.pdf
  2. 2.
    American College of Surgeons, and Commission on Cancer (2012) Cancer program standards—2012: ensuring patient centered care Retrieved November 3, 2011, 2011, from http://www.facs.org/cancer/coc/cocprogramstandards2012.pdf
  3. 3.
    American Hospital Association (2010) Fast facts on U.S. hospitals Retrieved November 7, 2011, 2011, from http://www.aha.org/research/rc/stat-studies/101207fastfacts.pdf
  4. 4.
    American Society of Clinical Oncology (2011) Future supply and demand of oncologists: challenges to assuring access to oncology services Retrieved November 7, 2011, from www.asco.org/workforce
  5. 5.
    Aziz NM (2007) Late effects of cancer treatment. In: Ganz PA (ed) Cancer survivorship today and tomorrow. Springer, New York, pp 54–76CrossRefGoogle Scholar
  6. 6.
    Burkett V, Cleeland CS (2007) Symptom burden in cancer survivorship. [PDF]. Journal of Cancer Survivorship 1(2):167–175PubMedCrossRefGoogle Scholar
  7. 7.
    Cadmus E (2011) Your role in redesigning healthcare. Nurs Manage 42(10):32–42. doi: 10.1097/01.NUMA.0000405221.94055.5c, quiz 43PubMedGoogle Scholar
  8. 8.
    Ferrell B, Dow KH (1997) Quality of life among long-term cancer survivors. Oncology 11:565–576PubMedGoogle Scholar
  9. 9.
    Grant M, Economou D (2011) Building a critical mass of health-care providers, administrators, and services for cancer survivors. In: Feuerstein M, Ganz PA (eds) Health services for cancer survivors. Springer, New York, pp 261–274CrossRefGoogle Scholar
  10. 10.
    Grant M, Economou D, Ferrell B, Bhatia S (2007) Preparing professional staff to care for cancer survivors. J Cancer Surviv 1(1):98–106. doi: 10.1007/s11764-007-0008-z PubMedCrossRefGoogle Scholar
  11. 11.
    Grant M, Hanson J, Mullan P, Spolum M, Ferrell B (2007) Disseminating end-of-life education to cancer centers: overview of program and of evaluation. J Cancer Educ 22(3):140–148. doi: 10.1080/08858190701589074 PubMedCrossRefGoogle Scholar
  12. 12.
    Institute of Medicine [IOM] (2006) In: Hewitt M, Greenfield S, Stovall E (eds) From cancer patient to cancer survivor: Lost in transition. The National Academies Press, Washington DC, pp 9–186Google Scholar
  13. 13.
    Lance Armstrong Foundation. Retrieved 2007, from http://www.livestrong.org
  14. 14.
    Lewis FM (2006a) The effects of cancer survivorship on families and caregivers. More research is needed on long-term survivors. [PDF]. Am J Nurs 106(3 Suppl):20–25CrossRefGoogle Scholar
  15. 15.
    Mao JJ, Bowman MA, Stricker CT, DeMichele A, Jacobs L, Chan D, Armstrong K (2009) Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients. J Clin Oncol 27(6):933–938PubMedCrossRefGoogle Scholar
  16. 16.
    Miller K, Triano L (2008) Medical issues in cancer survivors—a review. The Cancer Journal 14(6):375–387PubMedCrossRefGoogle Scholar
  17. 17.
    Miller KD (2008) Cancer survivors, late and long-term issues. Cancer J 14(6):358–360. doi: 10.1097/PPO.0b013e31818f046c00130404-200811000-00003[pii] PubMedCrossRefGoogle Scholar
  18. 18.
    NCCS. National Coalition of Cancer Survivors (NCCS), from www.canceradvocacy.org
  19. 19.
    Office of Cancer Survivorship (2006) Fact sheet Retrieved May 17, 2010, from http://cancercontrol.cancer.gov/ocs/
  20. 20.
    Periyakoil VS (2009) Change management: the secret sauce of successful program building. J Palliat Med 12(4):329–330. doi: 10.1089/jpm.2009.9645 PubMedCrossRefGoogle Scholar
  21. 21.
    Rechis R, Reynolds K, Beckjord EB, Nutt S, Burns RM, Schaefer J (2011) “I learned to live with it” is not good enough: challenges reported by post-treatment cancer survivors in the LIVESTRONG surveys. LIVESTRONG. Austin. Retrieved from http://livestrong.org/pdfs/3-0/LSSurvivorSurveyReport_final
  22. 22.
    Rowland JH (2008) What are cancer survivors telling us? Cancer J 14(6):361–368PubMedCrossRefGoogle Scholar
  23. 23.
    Rowland JH, Stefanek M (2008) Introduction: partnering to embrace the future of cancer survivorship research and care. Cancer 112(11 Suppl):2523–2528PubMedCrossRefGoogle Scholar
  24. 24.
    Surveillance Epidemiology and End Results Program (2007 released) US estimated complete prevalence counts on 1/1/2004. From National Cancer Institute, DCCPS, Surveillance Research Program, Statistical Research and Applications Branch, based on November 2006 SEER data submission. www.seer.cancer.gov
  25. 25.
    Yancik R (1997) Cancer burden in the aged: an epidemiologic and demographic overview. Cancer 80(7):1273–1283. doi: 10.1002/(SICI)1097-0142(19971001)80:7<1273::AID-CNCR13>3.0.CO;2-4 PubMedCrossRefGoogle Scholar
  26. 26.
    Yancik R, Ganz PA, Varricchio CG, Conley B (2001) Perspectives on comorbidity and cancer in older patients: approaches to expand the knowledge base. J Clin Oncol 19(4):1147–1151PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Marcia Grant
    • 1
  • Denice Economou
    • 1
  • Betty Ferrell
    • 1
  • Gwen Uman
    • 2
  1. 1.City of Hope, Division of Nursing Research and EducationDuarteUSA
  2. 2.Vital Research, LLCLos AngelesUSA

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