Cancer care should no longer be limited to hospital facilities. Many people diagnosed with cancer now self-manage aspects of their health and disease, reflecting the limits of healthcare resources, but also acknowledging patient preferences to be involved in their own care pathway.
However, people diagnosed with cancer require support and guidance from their healthcare team to self-manage.
Reegan Knowles, a Research Fellow with the Caring Futures Institute’s Cancer Survivorship Program, is part of a team examining what skills cancer care providers need to provide optimal self-management support (SMS).
“Many cancer survivors prefer to be involved in self-care and take responsibility for aspects of their health and care. It empowers them if they feel a sense of engagement in parts of their care, but how to self-care has to be clearly explained and facilitated by their health care team,” says Ms Knowles.
“People with cancer see a variety of health care providers, so it is critical that all those providers have the ability to provide consistent self-management support, and there is a systematic integration of SMS into everyday care.
“Given the increasing importance of SMS provision, it is necessary for the cancer care community to establish a shared understanding of the ideal, minimum standard of SMS that should be afforded to all people with cancer.”
To address this, in 2023 Flinders researchers developed a competency framework for cancer nursing professionals to best inform, support and provide people with cancer to pursue effective SMS behaviours.
This research identified a comprehensive list, with 42 competencies identified as necessary for nursing professionals to provide effective SMS – spread across six domains that embrace the main areas of clear communication with patients so that self-care procedures, aims and outcomes are clearly understood. These competencies are designed to be of specific benefit to individual patients, rather than being a generic application for all people who have been diagnosed with cancer.
This list of competencies for nursing professionals highlighted such areas as demonstrating person-centred communication skills, to establish rapport and understand an individual’s health values, perceptions of health, situational and life context, ethnicity and cultural background, and socioecological determinants that can impact self-management.
To expand the influence of this SMS system, Flinders researchers have revisited the list of 42 competencies with the aim of creating a more condensed list of core competencies, so that the essential self-management support capabilities can be more easily promoted among all oncology staff.
This research, which saw input from 27 cancer care providers around the world, pulled tight focus on 18 competencies – which are also spread across the same six domains of essential cancer care. In the second phase of the SMS study, patient advocates (people with a lived experience of cancer) provided feedback on the 18 competencies identified by cancer care providers.
“There were no surprises in what was selected, but we realised through this list that we also had an opportunity to expand its influence beyond oncology staff – because it could also be a point of reference for people diagnosed with cancer, and their carers.”
“It’s important that these competencies are also accessible to the public, especially so that people diagnosed with cancer can more clearly understand what they can expect from their healthcare team, and what questions they can and should ask about effective SMS.”
“We anticipate that identifying core competencies can inform health care provider education and training, which can contribute to the implementation of enhanced SMS for individuals, organisations and across health care systems,” says Ms Knowles.
Findings from this research will be presented at the Multinational Association for Supportive Care in Cancer Annual Scientific Meeting at Seattle in the United States in June 2025, and are expected to be published later in 2025.