Download Self Management - Jessica Corner March 2010

National Cancer Survivorship Initiative
Supported Self-Management
Workstream
Professor Jessica Corner
National Development Programme
19th March, 2010
NCSI Vision 2009: Three ‘Enablers’
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• Skills development programmes for professionals
• Self-management support options for
patients/survivors
• Institutional support for service redesign
Co-Creating Health: The Three Enablers
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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)
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Six Functions of Communication in Cancer
Care (Epstein and Street, 2007)
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1) Fostering health relationships.
2) Exchanging information
3) Responding to emotions
4) Managing uncertainty
5) 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).
Communication and Supported Self-Management6
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).