National Cancer Survivorship Initiative Supported Self-Management Workstream

1. National Cancer Survivorship InitiativeSupported Self-Management Workstream Professor Jessica Corner National Development Programme 19th March, 2010

2. NCSI Vision 2009: Three ‘Enablers’ • Skills development programmes for professionals • Self-management support options for patients/survivors • Institutional support for service redesign

3. Co-Creating Health: The Three Enablers

4. 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)

5. Six Functions of Communication in Cancer Care (Epstein and Street, 2007) • Fostering health relationships. • Exchanging information • Responding to emotions • Managing uncertainty • 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).

6. Communication and Supported Self-Management The 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).