Sunday, June 22, 2014

Cancer Survivorship Conference - Part 1 The Social Ecological Method

The theme of  the Biennial Cancer Survivorship Research Conference was  "Advancing Survivorship Through Multilevel Collaboration" . I heard from social workers, researchers , physicians, advocates, on many different topics which I will start to present in the next few posts.

I heard a term, that was new to me, repeated on multiple occasions at the meeting.  The term was Social Ecological Model or  Method - SEM for short.  The SEM helps you understand the different and ever changing interactions an individual has with others and their environment. Below is a graph of an SEM model from the CDC for colorectal cancer control program.

But a similar layout can be used for survivorship. If you notice at the center and overlapping all the other circles is the individual. In the case of cancer survivorship this would be the patient diagnosed with cancer. The next circle, Interpersonal, is for the interactions with caregiver, family and friends, health care providers and patient navigators.  The next level, Organizational, represents the interactions the patient has with their hospital, clinics & health care plans/ insurance company. The fourth level, Community,represents the local cancer coalition groups in the patient's state, the advocacy groups that help raise awareness and communicates about survivorship issues. And the outer level, Policy, represents the local, state and federal agencies that support public policy regarding survivorship issues. 

I found this diagram interesting and empowering. Why? Because as you can see the patient - the survivor - is at the center. I like that patient-centeredness is key to survivorship.  By thinking this way and not in a "silo" the researchers and health care providers will be looking at how the treatment and follow-up care affects us at all different levels. This will help them think about how it is in the real world of the survivor and those we interact with. For example how does "chemo-brain" or reduced cognitive function impact a cancer patient's return to work , or how they interact with their family? Will online, or in person support groups be beneficial to cancer survivors or can the local faith community play a role in improving the survivorship experience of their members. In essence this model or method has the system revolving around the survivor. 

One speaker at the plenary session made a great point in looking at the entire person and their environment. They stated that health care providers should ask their patients before cancer treatment begins what they want to be able to do after treatment. That way they would have the information regarding how the patient wants to interact with their environment. In my opinion, asking that question gives the patient hope that they will have a future. 

Every Day is a Blessing!

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