Clinical Update: Survivorship Care - Models and Programs

Cancer Survivorship Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Seminars in Oncology Nursing 08/2012; 28(3):e1-8. DOI: 10.1016/j.soncn.2012.05.001
Source: PubMed


To provide a clinical update of models of care for adult cancer survivors and the challenges in program development.
Review of the literature.
In the 4 years since the publication of the original article, survivorship is becoming a distinct phase of cancer care that includes surveillance for recurrence, evaluation of and treatment for medical and psychosocial consequences of treatment, recommendations for screening for new primary cancers, health promotion recommendations, and provision of a written treatment summary and care plan to the patient and other health professionals.
Implementing comprehensive services and evaluating care models continue to pose significant challenges for cancer care providers across the country; however, oncology nurses are uniquely positioned to take the lead in the care of cancer survivors of all ages and their role in the care of survivors is gaining recognition nationally and internationally.

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    • "It has become clear that the model used to care for a cancer survivor population is dependent upon the setting in which the care is provided , the cancer diagnosis and/or treatment, and the resources available to the practice or institution, as well as a host of other factors (McCabe & Jacobs, 2012). A widely utilized model is the APNdriven survivorship care program (Gates, Seymour, & Krishnasamy, 2012; McCabe & Jacobs, 2012). The holistic nursing focus in conjunction with clinical knowledge and skills makes the APN well suited to coordinate "

    Full-text · Article · Feb 2015
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    • "A nursing model of practice will: • Be framed by nursing theory and knowledge • Be aligned with the strategic aims of the organization or funding body • Be framed by clearly defined standards (e.g., nursing, organizational, government) • Include clearly articulated outcome measures (including health outcome for consumers; practice outcomes for nurses and other health professionals; and levels of satisfaction of consumers, nurses, and other staff) • Identify processes for systematic evaluation • Be derived from the comprehensive assessment of the needs and preferences of consumers, carers, nurses, and other stakeholders • Define the roles, responsibilities, decision-making authorities, accountabilities, common goals, and agreed upon outcomes of care for nurses • Identify how the nursing team is organized • Identify how the safety and well-being of consumers, carers, nurses, and other stakeholders are supported • Articulate and respect legal, cultural, and ethical positions, including equity of access for all • Articulate how ongoing consultation and collaboration between key stakeholders is achieved • Articulate how health care resources are utilized, including governance, quality, financial, and budgetary impact factors • Demonstrate currency or contemporaneity • Articulate how nurses will be supported and educated during both the implementation and maintenance stages • Take into account staff mix, including the levels and types of skills of those who comprise the team and their employment status (e.g., full-time, part-time, self-employed, contract) • Allow for flexible application, adapted according to service setting, needs, and preferences of consumers and carers, available resources, and the systems and structures of the organization within which it is located. (Developed from: Davidson et al., 2006; Fowler et al., 2006; Fernandez et al., 2012; McCabe & Jacobs, 2012; Venturato & Drew, 2010) patients during the shift; the team nursing model, which involves a leader with major responsibilities for coordinating personnel, resources, and patient activities for a shift or a defined period of time; and the functional nursing model, which focuses on the assignment of tasks to each staff member, rather than the assignment of comprehensive health care to the patient or consumer (Fernandez et al., 2012). Such examples support the proposition that nursing models of practice are operational in focus—that is, nursing models of practice inform, support, and guide the practice of nurses in an organizational or service setting (Fowler et al., 2006; Schaffer, Sandau, & Diedrick, 2013). "
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    ABSTRACT: The terms "model of health care," "service model." and "nursing model of practice" are often used interchangeably in practice, policy, and research, despite differences in definitions. This article considers these terms in the context of consumer-centred recovery and its implementation into a publicly-funded health service organization in Australia. Findings of a case study analysis are used to inform the discussion, which considers the diverse models of health care employed by health professionals; together with the implications for organizations worldwide that are responsible for operationalizing recovery approaches to health care. As part of the discussion, it is suggested that the advent of recovery-oriented services, rather than recovery models of health care, presents challenges for the evaluation of the outcomes of these services. At the same time, this situation provides opportunities for mental health nurses to lead the way, by developing rigorous models of practice that support consumers who have acute, chronic, or severe mental illness on their recovery journey; and generate positive, measureable outcomes.
    Full-text · Article · Mar 2014 · Issues in Mental Health Nursing
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    • "For instance, the NP Program uses the term model as a generic description for each of the thirty different organisational arrangements that are receiving federal funding to provide NP aged care services in their community. However, the evaluation framework uses a more specific definition of model as a set of arrangements that provide service user orientated services across clinical and community settings while aiming to provide a continuity of care within a broader philosophy of nursing (McCabe & Jacobs, 2012). In this sense, models are both different sets of arrangements that fund a NP role and thirty different configurations of NPs using their scopes of practice. "
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    ABSTRACT: A frustration often expressed by researchers and policy-makers in public health is an apparent mismatch between respective priorities and expectations for research. Academics bemoan an oversimplification of their work, a reticence for independent critique and the constant pressure to pursue evaluation funding. Meanwhile, policy-makers look for research reports written in plain language with clear application, which are attuned to current policy settings and produced quickly. In a context where there are calls in western nations for evidence based policy with stronger links to academic research, such a mismatch can present significant challenges to policy program evaluation. The purpose of this paper is to present one attempt to overcome these challenges. Specifically, the paper describes the development of a conceptual framework for a large-scale, multifaceted evaluation of an Australian Government health initiative to expand Nurse Practitioner models of practice in aged care service delivery. In doing so, the paper provides a brief review of key points for the facilitation of a strong research-policy nexus in public health evaluations, as well as describes how this particular evaluation embodies these key points. As such, the paper presents an evaluation approach which may be adopted and adapted by others undertaking public health policy program evaluations.
    Full-text · Article · Jun 2013 · Evaluation and program planning
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