Breast Cancer Continuum of Care: Addressing the Challenges of Rural Areas

Spegman, Adele M.

Saturday, 29 October 2011

Adele M. Spegman, PhD, RN¹
Gale Y. Shalongo, MSN, RN²
Ellen B. Leighow, MSN, RN²
Susan L. Krum, CRNP²
(1)Henry Hood Center for Health Research MC 44-00, Geisinger Health System, Danville, PA
(2)Breast Clinic MC 21-70, Geisinger Medical Center, Danville, PA

Learning Objective 1: describe the difficulties of facilitating health promotion after breast cancer treatment is completed.

Learning Objective 2: describe how patient portal system is likely to support ongoing communication between breast cancer survivors and their health care providers.

Advances in early detection and treatment of breast cancer have transformed this disease to chronic health condition. Living well as a breast cancer survivor (BCS) requires effective strategies regarding health behaviors, ongoing screenings, and empowerment to seek information and make informed choices. Little is reported regarding the self-care challenges specific to women in rural areas. Current approaches appear to be ineffective for women in our rural region, as evidenced by the above national average age- and stage-adjusted disease specific mortality rate.

We are developing a website-based survivor program that focuses on the health issues after breast cancer treatment is completed, emphasizing overall wellness and health management strategies for women across the rural health system. Its specific aims are to
1) Empower self-care as a breast cancer survivor through relevant information and strategies;
2) Emphasize women’s roles in their own health as active partners with providers to implement a personal cancer survivorship plan; and
3) Facilitate patient-provider communication regarding survivorship concerns, leveraging the health system’s internet-based patient portal.

Development of this web-based resource is guided an advisory board of nurses, BCS, and other health professionals. Features include information to assist with self-management, problem solving and collaboration with providers. Cancer survivorship plans are promoted, with suggestions regarding developing and implementing. The website is linked to the healthcare system’s Patient-Provider Communication Portal for networking among the BCS, her oncology team and primary care providers.

Moving Beyond Pink Ribbons is intended as a hybrid, drawing on the convenience of the internet, trust with known experts, and opportunities for personal connections at local and regional breast cancer events. We hope to expand this feature to include other systems’ patient-provider links. Following completion of user testing, the site will be publicly available; tracking metrics will be evaluated for ongoing assessment.

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