There are a number of challenges to meeting the supportive care needs of people affected by cancer. Factors influencing provision of effective evidence based supportive care can be organised into three categories:70
- Knowledge of what is evidence based practice
- Attitudes and beliefs about supportive care
- The value attributed to supportive care
- The extent to which the person believes they can manage on their own.
- Time to discuss supportive care issues
- Skills in detecting supportive care issues and systems to support the assessment
- Skills to intervene
- Reminders to remind the clinician to address supportive care issues
- Resources including environmental and clinicians
- A clear understanding of the roles of each of the multidisciplinary team members
- Support available to relieve stress of clinicians.
- Receiving feedback regarding performance of clinician and outcomes
- Rewards and negative consequences.
Some strategies to improve provision of supportive care include:71
- undertaking communication skills training and education in the use of supportive care tools
- identifying a person’s current supportive care resources, such as family, friends, local doctor or local minister who may reduce the need for other services. Remembering the inverted triangle model and that many people do not require high levels of intervention
- mapping the resources and developing a service directory of what services are available to provide supportive care in the community.
- Appraise current supportive care practices in your practice setting in light of the challenges identified.
- Develop a plan to implement a supportive care screening and referral process in your practice setting. In your plan, consider training and support mechanisms, resources and organisational challenges and enablers.