Oncology Nurse Participation in Survivorship Care

Abstract

Oncology nurses are playing an important role in the provision of survivorship care. Their involvement includes educating and coordinating multidiscipline teams to initiate and provide care to patients and families. Oncology nurses participate in this evolving model of care in a variety of ways. Using the IOM report recommendations for the provision of quality cancer care nurses provide care based on the specific characteristics of individual health care settings and the populations they serve. Evaluating the settings resources and goals for desired survivorship activities as part of the planning process can be the difference between success and failure. Collaborating with local and national resources for cancer survivors can help expand services for a setting in an efficient and cost effective manner. Models of care vary and resources and communication differs among cancer care settings. Survivorship care differs as a result, across different models. Nurses are key to the dissemination and coordination of survivorship activities and are critical in facilitating communication between health care providers, the patients and caregivers. Nurses have a significant role in the dissemination and coordination of information between the patient and other health care providers. Oncology care does not end when treatment ends.

Differences Between Primary Care Physicians’ and Oncologists’ Knowledge, Attitudes and Practices Regarding the Care of Cancer Survivors

“…These findings are significant, because lack of receptiveness to PCP involvement in cancer survivors' care, especially among oncologists, could compromise efforts to promote shared care or PCP-led delivery models, which may be a key strategy to meet the care needs of the many survivors who see only their PCP annually 11-13 . However, 22% of physicians in both groups endorsed the alternative model of specialty clinics either led by physicians, oncology nurses, or physician assistants, such as those already established by some cancer centers 43 . With PCP shortages projected 5,6 and likely to accelerate due to efforts to expand access to primary care under health care reform, this model may offer a more feasible and cost-efficient alternative to physicianled programs 4,[21][22][23] . Given the anticipated shortage of oncologists and growth in the cancer survivor population, there is a clear need for closer examination of the costs and effectiveness of such alternative delivery models for cancer survivor care.…”

Implementing the Commission on Cancer Standards for Survivorship Care Plans

“…Nurse-led models are described in a variety of program-implementation articles (Grant et al, 2010;Hewitt et al, 2006;Irwin, Klemp, Glennon, & Frazier, 2011;McCabe & Jacobs, 2008;Patton, 2010;Rosenberg, 2008), and research is underway to evaluate outcomes of these models of care. Novel approaches to survivorship care delivery, including telephone, Internet, mail-based, and peer-led interventions are being explored (Oeffinger et al, 2010).…”

“…Across all models of care, nurses, including advanced practice providers (APPs), are taking an increasingly central role in the implementation of survivorship care and care planning efforts (Grant et al, 2010;Stricker et al, 2011). Nurse-led models are described in a variety of program-implementation articles (Grant et al, 2010;Hewitt et al, 2006;Irwin, Klemp, Glennon, & Frazier, 2011;McCabe & Jacobs, 2008;Patton, 2010;Rosenberg, 2008), and research is underway to evaluate outcomes of these models of care.…”

“…Parry, Kent, Forsythe, Alfano, and Rowland (2013) reinforced that "we cannot expect a document to do the work of a process" (p. 2651), and urged PCPs to carefully consider the process of survivorship care planning more carefully than the content of an SCP. A number of survivorship care models have previously been described, but few have been studied (Grant, Economou, & Ferrell, 2010;Landier, 2009;McCabe & Jacobs, 2008;Oeffinger & McCabe, 2006). Although approaches vary widely, the delivery of SCPs should be integral to each of these models of care, particularly for shared care models where PCPs and oncology providers are each responsible for distinct components of care.…”

Palliative Care Needs of Cancer Survivors

“…1). [3][4][5] The recommended components of survivorship care in the IOM report include communication and coordination of care, prevention and detection of recurrence or new cancers, surveillance for cancer recurrence, and assessment and management of long-term and late effects of cancer.…”