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P-141 ‘smile’ developing a self-management programme within a hospice out-patient setting
  1. Victoria O’Cuinneagain,
  2. Nicola Davies and
  3. Wendy Valentine
  1. The Hospice of St Francis, Berkhamsted, UK


Background The hospice out-patient service offers support to patients, carers and the bereaved, we identified that clients presented with problems often poorly recognised or understood. These were significant in creating barriers and impacting on ability to self-manage and maintain independence.

Aim To educate and empower through the promotion of self-management skills and coping strategies; using a series of interlinked workshops addressing commonalities of symptoms impacting on everyday living.

Method A rolling programme of workshops was designed, running bi-monthly entitled; ‘SMILE’- Self- Management and Independent Living Everyday. The programme comprises four workshops;

· Fatigue management

· Sleep and relaxation

· Mindfulness and resilience

· Movement and exercise.

Results Each workshop is evaluated with positive feedback being obtained in all areas. The most notable being:

· The information and skills I have learnt have helped me now – 76% strongly agree

· The information and skills I have learnt will help me in the future – 80% strongly agree.

The Well-Being Star Outcome Measure is also used. Areas of particular influence noted were on ‘symptom management’,’ feeling positive’, ‘looking after yourself’ and ‘lifestyle’.

Feedback received:

· ‘Realising sleep problems are very common and I am not alone!’

· ‘giving me insight into multiple causes of fatigue’

· ‘being given coping examples’.

Conclusion Patients have demonstrated a greater level of empowerment and self-management, seeking additional support. This has included requests for help returning to work, an area of support not previously in high demand. As a result of the positive outcomes there has been an increased referral rate. Attendance at sessions is variable with ‘Fatigue Management’ and ‘Sleep and Relaxation’ being most popular. The programme has been enhanced to offer individual sessions for those not suited to a group setting. Additionally increased promotion is required to encourage carers and bereaved people to recognise ‘SMILE’ is not a patient only programme.

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