A range of skills are needed to provide comprehensive supportive care throughout the cancer trajectory in multiple care settings. Supportive care provision is not the responsibility of one discipline or service. Aspects of supportive care need to be integral to the practice of all health care professionals and demonstrated through actions such as:2, 18
- screening for supportive care needs
- offering emotional support
- providing information in the course of interactions
- alleviating symptoms and complications of cancer
- reducing or preventing effects of treatment
- referring to other providers as necessary.
Fitch (2008), defined five clinical standards of supportive care:2
- All individuals receive ongoing supportive care screening and assessment
- All individuals have the opportunity to be referred to an appropriate supportive care resource
- All individuals have the opportunity for self-referral to supportive care resources
- All individuals have access to understandable, relevant information regarding the medical, practical and emotional aspects of their cancer and its treatment
- All individuals receive supportive care that is relevant to their needs and sensitive to their age, gender, language, culture, sexual preferences, religion and economic status.
The Supportive Care model in Figure 1 provides a description of the service delivery responses required to meet the supportive care needs of cancer patients. The model recognises that individuals have differing needs and therefore require different levels of response. In all cases, supportive care approaches should be evidence based, and customised to the individual and may not be available in one health care setting.
|Figure 1: Model of Supportive Care service provision (Fitch, 2008)2|
|Cancer Patients Entering the Cancer System 100%||Providing Supportive Care Services|
This model can assist nurses to identify where in the model the supportive care services offered by the health service and the primary care service may fit. For example, the nurse may consider whether there are information resources readily accessible in multimedia format for a person. Figure 2 shows an application of the model to the domain of information needs with examples of some evidence based interventions.
Figure 2: Application of the Fitch model to information provision3