Another notable concern for many woman after cancer is the significant financial loss after the diagnosis and treatment of cancer, due not only to treatment costs but also lost time from their employment (Anderson et al., 2011). Thus the completion of treatment is a time when many women to return to the workforce and may have limited opportunity to attend conventional face-to-face support groups. Similarly, the geographic isolation experienced by women from rural, remote or regional areas means that survivorship programs may be unavailable to them without significant travel (Meneses et al., 2009).
Despite the current health recognition of the chronic nature of cancer, many use traditional delivery modes to target specific symptoms rather than exploring novel ways of delivering interventions based on sound chronic disease self-management principles (Faithfull, Cockle Hearne, Khoo, 2011; McDougall, Becker, Acee, Vaughan, Delville, 2011).
Methods: Self-management interventions such as the Women’s Wellness After Cancer Program or WWACP have been shown to be helpful in reducing risk and increasing adherence to National clinical guidelines on improving diet, reducing alcohol consumption, increasing physical exercise, and smoking cessation. Delivered by specialist cancer nurses, the primary outcomes for this trial demonstrated a positive change in health-related quality of life (HRQoL) an improvement in anthropometric measures and in sexual health concerns in the women undertaking WWACP compared to those women who received usual care and demonstrated cost effectiveness. Evaluation from the nurses who undertook training to deliver the intervention indicated the flexibility and holistic nature of the program provided them with the appropriate tools to support and empower their patients to make appropriate lifestyle changes and manage side effects of treatment once acute treatment was completed and women had less health professional support.
Outcomes and final remarks: The translation of research findings into sustainable improvements in clinical practice and patient outcomes is important to improving quality of health care. Evaluation at completion of the WWACP trial demonstrated that this model of care is feasible, acceptable, clinically and cost-effective. The challenge then, was to start to embed this evidence based program into clinical practice as a ‘prescription’ for self-empowerment and management after cancer.
This presentation describes the development of nurse training and a subsequent ‘train the trainer’ program to enable the delivery of the WWACP to patients by a wide range of health professionals. It also discusses the challenges of developing training processes, and encouraging support and acceptance of using a peer support delivery model with clinical nurse or other health professional facilitation, with the aim of increasing cost effectiveness and broader delivery. Managing issues around costs, updating of resources, collaboration and referral to other health professionals and agencies is discussed. Finally, how the key outcomes to develop a sustainable model of care that can be used across a variety of health settings (hospital, outpatient clinics and community are demonstrated.