PRevention,Intervention, andSustained wellnessModel (PRISM) Care Philosophy in Cancer Survivorship, Palliative Care, and Chronic Disease Management in the Era of Healthcare Reform: A Perspective Paper

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Abstract

Background:

Multiple agencies have recognized the increasing care demands and the associated costs of a growing aging population with incurable or life-threatening conditions, including cancer. Although the core concepts of physical therapy (PT), cancer survivorship and palliative care (PC) appear to be congruent and complimentary, there is little evidence in the literature demonstrating a consistent role of PT in these settings. This article will outline a care philosophy to use for educating PTs, patients/clients, interdisciplinary team members, and as a guide for PT care for the longitudinal management of the patient with a cancer diagnosis, incurable illness, or a life threatening illness.

Methods:

Literature review and perspective regarding PT within cancer survivorship, PC and chronic disease management in the context of healthcare reform to provide a perspective of the PRevention, Intervention, and Sustained wellness Model (PRISM) care philosophy.

Discussion:

The PRISM promotes the longitudinal management by the physical therapist for a patient with a number of long-term conditions, including cancer survivorship, chronic disease or life threatening illness and its side effects. Prevention includes primary, secondary, and tertiary prevention in the presence of a disease. Intervention is generally considered conventional or traditional physical therapy, while Sustained wellness incorporates concepts related to maintaining health or slowing the decline of a progressive illness, injury prevention, and anticipation and management of potential medical crises.

Conclusion:

The PRISM may have utility to guide and educate care providers on PT's role in managing individuals with these conditions.

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