Multilevel Model Of Health on the Cancer Care Continuum

Cancer Care is a complex and multifaceted system. Using the social-ecological healthcare model one can identify a hierarchy of potential intervention objectives that are prevalent to patients healthcare delivery. The Cancer Care Continuum not only includes patient treatments but also includes cancer screening, diagnostic staging interventions, and follow-up. This diagram below presents the groups and organizations involved in the Multilevel system of cancer care. Taplin et al, (2012) suggests this model is consistent with the complex adaptive system theory. This model does move linearly but rather interactions between levels can travel in multiple directions. As well, this theory suggests that the layers within the system are constantly adapting.

(Taken from: Journal of National Cancer Institute Monographs, 2012)

Furthermore, looking specifically at the center of the Multilevel model one study looked into links between social and psychosocial supports affecting the symptoms and quality of life of patients (Saucer et al, 2019). Social support is shown to have positive effects on health and longevity. This study found that positive support decreases during the first year after cancer diagnosis. It emphasized the need to detect patients early on with low or decreased support systems- those who have fewer sources of positive support (Saucer et al, 2019).

Although cancer care is a complex collaborative effort that is constantly changing, health care practitioners can do their part to improve care from the level of the patient. Multilevel modeling can appear intimidating and complex but remaining patient centered is key to ensuring excellent quality of care. Moving forward in my practice I will continue to speak with patients about their support systems and provide psychosocial resources when necessary. Every healthcare practitioner can work together to improve care and outcomes for our patients.

Resources:

Saucer, C., Weis, J., Faller, H., Junne, F., Hönig, K., Bergalt, C., Hornemann, B., Stein, B., Teufel, M., Goerling, U., Erim, Y., Geiser, F., Niecke, A., Senf, B., Weber, D., & Maatouk, I. (2019). Impact of social support on psychosocial symptoms and quality of life in cancer patients: results of a multilevel model approach from a longitudinal multicenter study. Acta Oncologica, 58:9, 1298-1306, DOI: 10.1080/0284186X.2019.1631471

Taplin, S., Price, R., Edwards, H., Foster, M., Breslau, E., Chollette, V., Das, I., Clauser, S., Fennell, M., Zapka, J. (2012). Journal of the National Cancer Institute Monographs. DOI: 10.1093/jncimonographs/lgs008