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Promoting Self-Management for Cancer Survivors

December 5, 2017 | Lillie's Corner
Featuring:
Lillie D. Shockney, RN, BS, MAS, ONN-CG
Lillie D. Shockney, RN, BS, MAS, ONN-CG
Editor-in-Chief, JONS; Program Director, AONN+; University Distinguished Service Professor of Breast Cancer, Administrative Director, The Johns Hopkins Breast Center; Director, Johns Hopkins Cancer Survivorship Programs; Professor of Surgery and Oncology, JHU School of Medicine; Co-Creator, Work Stride-Managing Cancer at Work
shockli@jhmi.edu

While patients with cancer are actively receiving treatment, their navigators are in frequent contact with them, making sure they have and keep their appointments; remain on track for tests, scans, and other consultations; and the list goes on. When treatment is completed, patients receive a treatment summary and survivorship care plan, and then what? These individuals must be strongly encouraged at that point to engage in self-management. Why? Because you, their navigator, will not be calling them or seeing them frequently anymore. And if they expect their primary care physician or other community provider to contact them with reminders of the need to schedule follow-up appointments, screening tests, and any other necessary visits with healthcare providers, they need to know that simply isn’t going to happen. Not only is the survivor losing contact with you, they are also at a crossroads that can feel quite scary. Do not fall into the enabling trap of telling the survivor she can contact you “anytime”—because if you do, she will. Constantly. And you will lack time for your newly diagnosed patients, who are the ones who need you most.

Set these expectations very early in the process, when you are explaining your role as the patient’s navigator, including how often you will be in touch and why, as well as when your role as a navigator for that patient will come to a close. Promote and plan for the survivor to assume responsibility for arranging follow-up appointments with the appropriate providers, and provide guidance on how to keep track of and schedule their future cancer screening tests. Encourage the survivor to embrace ways to reduce their risk for recurrence by focusing on healthy lifestyle behaviors, too.

Although self-management may feel scary to patients, it is an excellent way to give them control of their lives again. Connect them with a support group that includes other survivors who have completed treatment and are willing to support a “newbie” to survivorship. Also consider developing a survivor mentorship program, in which specially trained survivor volunteers could provide one-on-one support to those who have just finished acute treatment.

Our goal is for the patient to never need us again.

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