HOPE Protocol [PDF, 420KB] - National Cancer Survivorship Initiative

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Anna Lynall – Project Support o Responsible for supplying onsite support, including facilitating data collection. 20/08/09 14
Footnotes 1 A rapid review aimed at updating that of ‘Evidence to inform the Cancer Reform Strategy: The clinical effectiveness and cost-effectiveness of follow-up services after treatment for cancer, ‘as conducted by the Centre for Reviews and Dissemination (2007) is currently underway. 2 Davies, NJ (2009a,b) Self-Management Programmes for Cancer Survivors: A Structured Review of Outcome Measures, commissioned by Macmillan Cancer Support for the NCSI. 3 A report by the Picker Institute, commissioned by NHS Improvement and Macmillan Cancer Support, demonstrated an implicit assumption among survivors and carers that ‘follow-up’ care occurs when treatment has ended (Sheldon, Davis, and Parsons, 2008). Therefore, the baseline measurement period of 6-weeks post-treatment encompasses this shared definition whilst also providing time between final treatment and the intervention for survivors to become socially reintegrated. 4 Health status evaluations have been demonstrated to change according to age and illness (Kaplan and Orna Baron-Epel, 2002); Demographic variables such as age and educational status might be important predictors of quality of life and thus need to be controlled when analysing data (Wenzel et al, 1999). 5 Evidence exists in the way of social support being a potential buffer against disease progression (Smith et al., 1994), as well as being positively associated with better psychological well-being (Stanton and Snider, 1993; Rodrigue, Behen, and Tumlin, 1994) and better psychosocial adjustment (Heim et al., 1997). 6 It is important to control for socio-economic status (SES) as it is related to health behaviours, such as breast screening (Yarbrough and Braden, 2001). However, the most effective method of measuring SES has been under debate, with potential indicators being income, occupation, postcode, educational status, to name a few (Deonandan et al., 2000; Shavers, 2007). Educational attainment is perhaps the most widely used indicator of SES due to the ability to characterise the educational achievement level of most individuals. Furthermore, education can be seen as the most basic component of SES because of its influence on other SES indicators such as occupation and income (Adler and Newman, 2002). There are several possible mechanisms through which education might influence health status. For example, people with higher education may have developed better information-processing and critical thinking skills, skills in navigating health services, and abilities required to interact effectively with healthcare providers. Individuals with higher education may also be more likely to be socialised to health-promoting behaviour and lifestyles, and have better work, economic conditions, and psychological resources (Ross and Mirowsky, 1995; Yen and Moss, 1999). An advantage of using education as a measure of SES for adults is that the likelihood of reverse causation (e.g., which came first, poor health or low SES)—which can be a problem with other standard SES measures—is reduced, as education is usually complete before detrimental health effects occur (Stewart, 2001). 7 Co-morbidities have been found to correlate with various dimensions of quality of life in women with breast cancer (Davies et al., 2008). 20/08/09 15
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Page 17 and 18: References 1. Adler NE, Newman K. (
Page 19 and 20: 26. Lorig K, Sobel DS, Stewart AL,

HOPE Protocol [PDF, 420KB] - National Cancer Survivorship Initiative

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