title: Promotion of self-management for post treatment cancer survivors: evaluation of a risk-adapted visit.
abstract: OBJECTIVE
  The LIFE Cancer Survivorship Program at NorthShore University HealthSystem provides risk-adapted visits (RAV) facilitated by an oncology nurse during which a survivorship care plan (SCP) is provided and discussed. In this report, we describe and evaluate RAV in promoting individualized health care and self-management during survivorship transition.
  
  
  METHODS
  Patients complete a post-RAV questionnaire at their RAV and another ≥1 year after their RAV.
  
  
  RESULTS
  One thousand seven hundred thirteen (1713) RAVs, majority for breast cancer, occurred from January 2007 to March 2014. One thousand six hundred fifteen (1615) "day-of" post-RAV questionnaires were completed. Respondents scaled statements as strongly agree/agree/disagree/strongly disagree. Combined strongly agree/agree ratings are 94 % felt more confident in communicating information about their treatments to other health care providers, 90 % felt more comfortable recognizing signs/symptoms to report to providers, and 98 % had a better appreciation for community programs/services. Of 488 respondents (RAV January 2007 to December 2012 n = 1366) to a questionnaire at least 1 year after the RAV, nearly 100 % found SCP useful to summarize medical information, 97 % to reinforce follow-up, 85 % to recognize symptoms of recurrence, 93 % to identify healthy lifestyle practices, 91 % to assist in identifying resources for support, 72 % discussed their SCP with their healthcare provider, and 97 % made at least one positive lifestyle change.
  
  
  CONCLUSIONS
  Participation in LIFE RAV following treatment helps survivors to guide future self-care behavior. Data suggest that benefits may persist 1 year after the visit and support the feasibility of a nurse-led RAV to establish a SCP in cancer survivors.
  
  
  CONCLUSIONS
  Combined provision and discussion of SCPs help survivors construct a useful understanding of their cancer experience and may promote long-term self-management.
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA. crosenberg@northshore.org.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Rosenberg
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Flanagan
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Brockstein
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Obel
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Leon H
authors.initials: LH
authors.lastname: Dragon
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Merkel
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Wade
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Law
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Janardan D
authors.initials: JD
authors.lastname: Khandekar
authors.affiliation: Highland Park Hospital, NorthShore University HealthSystem, 777 Park Avenue West Room 1170, Highland Park, IL, 60035, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Hensing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003266:Continuity of Patient Care; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009369:Neoplasms / Q000401:mortality / Q000451:nursing / Q000628:therapy*; D010347:Patient Care Planning; D010353:Patient Education as Topic / Q000379:methods; D018802:Patient-Centered Care / Q000379:methods; D012307:Risk Factors; D012648:Self Care; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data; D000069341:Transitional Care; D055815:Young Adult
keywords: Aftercare; Cancer survivorship program; Patient education; Self-management; Survivorship care plan; Survivorship transitions in care