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

activities, and health distress), as well as decrease days in the hospital (The British Liver
Trust, 1999).
This gave rise to the concept of the expert patient and the introduction in the UK of the
Expert Patient Programme (EPP) (an anglicised version of the CDSMP) in 2001 (DH, 2001).
Like the CDSMP, the EPP is a lay-led self-management programme for all long-term
conditions. The programme was motivated by the ‘Your Health, Your Care, Your Say’
consultation showing that people with long-term conditions, for which cancer has now
become, desire more control of their health via self-management (DH, 2006a). Evaluations
of the EPP have provided support for the programme’s utility, but little engagement from
health professionals has been highlighted as a potential limitation for cancer survivors
(Wilson, 2008), and the respective benefits of lay versus professional trainers is yet
unproven (Chodosh and Morton et al., 2005)
Similarly, Macmillan provide the ‘New Perspectives course, a cancer version of the CDSMP
(previously the ‘Living with Cancer’ course), a free six-week course for people living with and
beyond cancer, which is facilitated by trained tutors who have also experienced cancer.
Attendees meet each week for two and a half hours to learn new skills and techniques.
Feedback from participants has been encouraging, and particularly favourable in terms of
the positive thinking and goal-setting components of the course. A limitation of the course is
the inflexibility of the programme, since tutors are required to follow guidelines rigidly.
Interest is being shown in establishing whether a ‘co-creating health model’ might offer better
outcomes. The Health Foundation uses the term ‘co-creating health’ to describe an active
and collaborative partnership between patients and health professionals (Coulter and Ellins,
2006). For guided self-management to be successful, a positive patient/physician
relationship has been shown to be a key factor (Coulter, 1997; Clark and Gong, 2000;
Holman and Lorig, 2000). In terms of patient preference, nurse-delivery is most often
favoured (Pennery and Mallet, 2000).
Taking into consideration the limitations of previous self-management programmes, the
Helping Overcome Problems Effectively (HOPE) SMP, has been selected for this pilot study.
Designed by Dr Andy Turner and Dave McHattie of Coventry University, HOPE is set within
the theoretical framework of positive health psychology. It draws on evidence-based
techniques to help enhance participants’ well-being and motivation and has been shown to
improve positive affect (Barlow et al. 2000). Interestingly, 83% of participants attending
Macmillan’s LWC Programme rated the positive thinking activity as beneficial, indicating the
potential utility of a programme such as HOPE for cancer survivors. The programme also
offers flexibility in that participants contribute to the final content of the course. The aim is to
eventually integrate such a programme into service delivery.
In order for this to be achieved, a mixed methodology approach will be required for the
assessment of the pilot SMP, utilising both quantitative and qualitative data. Such an
approach has been recognised as being essential in gaining a comprehensive
understanding of the human experience (Yardley and Bishop, 2008). Any outcome
measures utilised throughout the assessment will have undergone a comprehensive
appraisal (Davies, 2009a,b).
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