673 resultados para Cardiac-Diabetes Self-Management Program (CDSMP)


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This qualitative two-site case study examined the capacity building practices that Children’s Services Councils (CSCs), independent units of local government, provide to nonprofit organizations (NPOs) contracted to deliver human services. The contracting literature is replete with recommendations for government to provide capacity building to contracted NPOs, yet there is a dearth of scholarship on this topic. The study’s purpose was to increase the understanding of capacity building provided in a local government contracting setting. Data collection consisted primarily of in-depth interviews and focus groups with 73 staff from two CSCs and 28 contracted NPOs. Interview data were supplemented by participant observation and review of secondary data. The study analyzed capacity building needs, practices, influencing factors, and outcomes. The study identified NPO capacity building needs in: documentation and reporting, financial management, program monitoring and evaluation, participant recruitment and retention, and program quality. Additionally, sixteen different types of CSC capacity building practices were identified. Results indicated that three major factors impacted CSC capacity building: CSC capacity building goals, the relationship between the CSC and NPOs, and the level of NPO participation. Study results also provided insight into the dynamics of the CSC capacity building process, including unique problems, challenges, and opportunities as well as necessary resources. The results indicated that the CSCs’ relational contracting approach facilitated CSC capacity building and that CSC contract managers were central players in the process. The study provided evidence that local government agencies can serve as effective builders of NPO capacity. Additionally, results indicated that much of what is known about capacity building can be applied in this previously unstudied capacity building setting. Finally, the study laid the groundwork for future development of a model for capacity building in a local government contracting setting.

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Solid waste disposal is a major concern today. This study seeks to identify the current practices and attitudes of managers of independent food services toward solid waste management and the characteristics of food services which were most likely to be involved with a solid waste management program

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In - Managing Quality In the Hospitality Industry – an observation by W. Gerald Glover, Associate Professor, Hospitality Management Program, Appalachian State University, initially Glover establishes: “Quality is a primary concern in the hospitality industry. The author sees problems in the nature of the way businesses are managed and discusses approaches to ensuring quality in corporate cultures.” As the title suggests, the author wants to point out certain discrepancies in hospitality quality control, as well as enlighten you as to how to address some of these concerns. “A discussion of quality presents some interesting dilemmas. Quality is something that almost everyone wants,” Assistant Professor Glover notes. “Service businesses will never admit that they don't provide it to their customers, and few people actually understand what it takes to make it happen,” he further maintains. Glover wants you to know that in a dynamic industry such as hospitality, quality is the common denominator. Whether it be hotel, restaurant, airline, et al., quality is the raison d’être of the industry. “Quality involves the consistent delivery of a product or service according to the expected standards,” Glover provides. Many, if not all quality deficiencies can be traced back to management, Glover declares. He bullet points some of the operational and guest service problems managers’ face on a daily basis. One important point of note is the measuring and managing of quality. “Standards management is another critical area in people and product management that is seldom effective in corporations,” says Glover. “Typically, this area involves performance documentation, performance evaluation and appraisal, coaching, discipline, and team-building.” “To be effective at managing standards, an organization must establish communication in realms where it is currently non-existent or ineffective,” Glover goes on to say. “Coaching, training, and performance appraisal are methods to manage individuals who are expected to do what's expected.” He alludes to the benefit quality circles supply as well. In addressing American organizational behavior, Glover postures, “…a realization must develop that people and product management are the primary influences on generating revenues and eventually influencing the bottom line in all American organizations.” Glover introduces the concept of pro-activity. “Most recently, quality assurance and quality management have become the means used to develop and maintain proactive corporate cultures. When prevention is the focus, quality is most consistent and expectations are usually met,” he offers. Much of the article is dedicated to, “Appendix A-Table 1-Characteristics of Corporate Cultures (Reactive and Proactive. In it, Glover measures the impact of proactive management as opposed to the reactive management intrinsic to many elements of corporate culture mentality.

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The concept analysis process carefully examines the description and uses of a word or term, enabling the standardization of language, in addition to providing representation to the profession, and facilitate the work of taxonomies. The aim of the study was to analyze the concept of nursing diagnosis ineffective self-health in patients undergoing hemodialysis. Study concept analysis, based on Walker and Avant model and operationalized through integrative literature review. The databases searched were: SCOPUS, CINAHL, PUBMED, LILACS and COCHRANE, with descriptors: Selfmanagement, Adherence and Hemodialysis. The inclusion criteria were: articles published in the last five years, complete articles are available free in selected databases; articles available in Portuguese, English or Spanish; and articles that address the self-concept of health, the antecedents and the consequent. And Exclusion: editorials, letters to the editor, theses and dissertations. The survey of the articles occurred in the months from January to March 2014. The initial sample of 16785 articles, with 11748 in PUBMED, 4767 in Scopus, 174 in CINAHL, the Cochrane 70 and 26 in LILACS. After applying the criteria, 76 articles were selected, 19 in CINAHL, 18 in PUBMED, 30 in Scopus, and 9 in LILACS. In analyzing the data, given that the concept was sought in the literature was self-health, was held interpretation to ineffective self-health diagnosis through the transposition in the denial of the attributes, antecedents and consequences identified. It is noteworthy that the terms identified in the literature as defining characteristics and related factors of the diagnosis under study were added to the survey, not even the transposition into opposite term is possible. The results show that the concept developed for the inefficient self-health diagnosis was: the patient's inability to control habits and achieve the negotiated with professionals therapeutic targets, resulting in health complications. 33 antecedents relating to social, psychological and therapeutic aspects and 16 consequential, involving physiological, social, psychological and therapeutic aspects were identified. Thus, it is concluded that the ineffective self-health concept is broad and involves individual patient factors and the therapeutic relationship between patient and professionals. It is believed that the study contributed to the improvement of diagnosis in renal clientele, besides being an important base for the growth of the scientific body of nursing, subsidizing the development of own technology area

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This Thesis main objective is to implement a supporting architecture to Autonomic Hardware systems, capable of manage the hardware running in reconfigurable devices. The proposed architecture implements manipulation, generation and communication functionalities, using the Context Oriented Active Repository approach. The solution consists in a Hardware-Software based architecture called "Autonomic Hardware Manager (AHM)" that contains an Active Repository of Hardware Components. Using the repository the architecture will be able to manage the connected systems at run time allowing the implementation of autonomic features such as self-management, self-optimization, self-description and self-configuration. The proposed architecture also contains a meta-model that allows the representation of the Operating Context for hardware systems. This meta-model will be used as basis to the context sensing modules, that are needed in the Active Repository architecture. In order to demonstrate the proposed architecture functionalities, experiments were proposed and implemented in order to proof the Thesis hypothesis and achieved objectives. Three experiments were planned and implemented: the Hardware Reconfigurable Filter, that consists of an application that implements Digital Filters using reconfigurable hardware; the Autonomic Image Segmentation Filter, that shows the project and implementation of an image processing autonomic application; finally, the Autonomic Autopilot application that consist of an auto pilot to unmanned aerial vehicles. In this work, the applications architectures were organized in modules, according their functionalities. Some modules were implemented using HDL and synthesized in hardware. Other modules were implemented kept in software. After that, applications were integrated to the AHM to allow their adaptation to different Operating Context, making them autonomic.

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Coral reefs face unprecedented threats throughout most of their range. Poorly planned coastal development has contributed increased nutrients and sewage contamination to coastal waters, smothering some corals and contributing to overgrowth by macroalgae. My approach to assessing the degree to which coral reef ecosystems have been influenced by terrestrial and anthropogenic organic carbon inputs is through the use of carbon (C) and nitrogen (N) stable isotopes and lipid biomarkers in a marine protected area, the Coral Reef System of Veracruz: Parque Nacional Sistema Arrecifal Veracruzano (PNSAV) in the southwest Gulf of Mexico. Firstly, I used a C and N stable isotope mixing model and a calculated fatty acid (FA) retention factor to reveal the primary producer sources that fuel the coral reef food web. Secondly, I used lipid classes, FA and sterol biomarkers to determine production of terrestrial and marine biogenic material of nutritional quality to pelagic and benthic organisms. Finally, I used coprostanol to determine pollutant loading from sewage in the suspended particulate matter. Results indicate that phytoplankton is the major source of essential metabolite FA for marine fish and that dietary energy from terrestrial sources such as mangroves are transferred to juvenile fish, while seagrass non-essential FA are transferred to the entire food web mainly in the rainy season. Sea urchins may be the main consumers of brown macroalgae, especially in the dry season, while surgeon fish prefer red algae in both dry and rainy seasons. C and N isotopic values and the ratio C:N suggest that fertilizer is the principal source of nitrogen to macroalgae. Thus nitrogen supply also favored phytoplankton and seagrass growth leading to a better nutritional condition and high retention of organic carbon in the food web members during the rainy season when river influence increases. However, the great star coral Montastrea cavernosa nutritional condition decreased significantly in the rainy season. The nearest river to the PNSAV was polluted in the dry season; however, a dilution effect was detected in the rainy season, when some coral reefs were contaminated. In 2013, a new treatment plant started working in the area. I would suggest monitoring δ¹⁵N and the C: N ratio in macroalgae as indicators of the nitrogen input and coprostanol as an indicator of human feces pollution in order to verify the efficiency of the new treatment plant as part of the management program of the PNSAV.

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This thesis, part of the research line "Work, Society and Education" analyzes, in a dialectical perspective, in the light of Tragtenberg´s studies, the conception of subject of schoolwork, considering the organization and the complexity of this context and inviting the investigative gaze. Our hypothesis is that the workers of education have, in the schoolwork, a fragile politicization field and overcoming the installed model, accepting themselves as executers with self-organizing difficulties, distanced from the effective participation, autonomy and self-management. We consider studies on the logic of the work, believing that the understanding of schoolwork is constitute into the current societal model, in whom its bureaucratic and hierarchical matrix, linked to articulated / articulators of the dominant socio-economic class interests. Scholars such as Braverman, Frigotto and Tragtenberg, among others, are important contributions to this reflection. We have analyzed the logic of the work also in dialogue with pedagogies differentiated, among them, the Libertarian defended by Tragtenberg, aiming to understand the conceptions and practices of the subjects involved. We accomplished a bibliographical critical analysis, in a dialectical character, focusing on the categories: work, schoolwork, control, autonomy and self-management, in order to understand the complexity of the praxis in study, dialoguing with the pillars categories historicity, contradiction and totality, which transversalize the developed analysis. The consideration of these concepts allows us to uncover the dominant bureaucratic structure and its possible overcoming fields. We believe contribute to problematizing and proposers studies, reflections and discussions, strengthening debates, deconstructing naturalizations and contributing to the political process of the subjects.

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The restructuring of English social care services in the last three decades, as services are provided through a shifting collage of state, for-profit and non-profit organisations, exemplifies many of the themes of governance (Bevir, 2013). As well as institutional changes, there have been a new set of elite narratives about citizen behaviours and contributions, undergirded by modernist social science insights into the wellbeing benefits of ‘self-management’ (Mol, 2008). In this article, we particularly focus on the ways in which a narrative of personalisation has been deployed in older people’s social care services. Personalisation is based on an espoused aspiration of empowerment and autonomy through universal implementation to all users of social care (encapsulated in the Making it Real campaign [Think Local, Act Personal (TLAP), no date)], which leaves unproblematised the ever increasing residualisation of older adult social care and the abjection of the frail (Higgs and Gilleard, 2015). In this narrative of universal personalisation, older people are paradoxically positioned as ‘the unexceptional exception’; ‘unexceptional’ in the sense that, as the majority user group, they are rhetorically included in this promised transformation of adult social care; but ‘the exception’ in the sense that frail older adults are persistently placed beyond its reach. It is this paradoxical positioning of older adult social care users as the unexceptional exception and its ideological function that we seek to explain in this article.

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This thesis examines the rise and decline of the New Left in Toronto from 1958 to 1985. It argues that New Leftism — whose three leading ideals were self-management, national liberation, and community — arose as much from the Old Left as it did from the peace movement. In contrast to earlier readings that interpret the New Left narrowly — essentially, as the combined forces of the white student and peace movements evident mainly on university campuses — this thesis documents the extent to which New Leftism, interpreted as a political formation, provided a framework for a diversity of radical social movements, especially feminism, Black Power, gay liberation, resistance to the capitalist redevelopment of the city, and transnational solidarity. It also questions a declensionist narrative that adopts a “decadal” approach to the radicalism of the sixties, according to which 1970 spelled the end of “60s” radicalism. Quite the contrary, this thesis argues: in Toronto, it would be truer to say that 1970s were “the sixties,” in that only in this later decade did many New Left movements attain their full maturity. New Leftists successfully challenged a host of institutions, sometimes with permanent effects. The educational system was transformed. Cultural institutions and practices were revolutionized. Questions of race and gender, once peripheral to the left, were made central to it. Democratic community institutions became far more powerful. A token of the strength and durability of the New Left in Toronto was the extent to which it remained the bête noir of a series of other radical groups upholding the model of the vanguard communist party — which challenged the New Leftists’ prominence but many members of which often wound up agreeing with their positions. It was only in the early 1980s, with the ascent of a new right, that Toronto’s New Left unmistakably entered a period of decline. Yet, even then, many of its key themes were picked up by fast-growing anarchist and socialist feminist currents. Far from constituting a minor phenomenon, Toronto’s New Left, one of the largest movements for social justice in Canadian history, bequeathed to its progressive successors an imposing legacy of struggle and cultural achievements. It is the purpose of this thesis to evaluate, both critically and sympathetically, the extent to which the New Left attained its radical ambition.

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AIMS: Heart failure has been demonstrated in previous studies to have a dismal prognosis. However, the modern-day prognosis of patients with new onset heart failure diagnosed in the community managed within a disease management programme is not known. The purpose of this study is to report on prognosis of patients presenting with new onset heart failure in the community who are subsequently followed in a disease management program.

METHODS AND RESULTS: A review of patients referred to a rapid access heart failure diagnostic clinic between 2002 and 2012 was undertaken. Details of diagnosis, demographics, medical history, medications, investigations and mortality data were analysed. A total of 733 patients were seen in Rapid Access Clinic for potential new diagnosis of incident of heart failure. 38.9% (n=285) were diagnosed with heart failure, 40.7% (n=116) with HF-REF and 59.3% (n=169) with HF-PEF. There were 84 (29.5%) deaths in the group of patients diagnosed with heart failure; 41 deaths (35.3%) occurred in patients with HF-REF and 43 deaths (25.4%) occurred in patients with HF-PEF. In patients with heart failure, 52.4% (n=44) died from cardiovascular causes. 63.8% of HF patients were alive after 5 years resulting on average in a month per year loss of life expectancy over that period compared with aged matched simulated population.

CONCLUSIONS: In this community-based cohort, the prognosis of heart failure was better than reported in previous studies. This is likely due to the impact of prompt diagnosis, the improvement in therapies and care within a disease management structure.

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Background: We sought to describe the theory used to design treatment adherence interventions, the content delivered, and the mode of delivery of these interventions in chronic respiratory disease. Methods: We included randomized controlled trials of adherence interventions (compared to another intervention or control) in adults with chronic respiratory disease (8 databases searched; inception until March 2015). Two reviewers screened and extracted data: post-intervention adherence (measured objectively); behavior change theory, content (grouped into psychological, education and self-management/supportive, telemonitoring, shared decision-making); and delivery. “Effective” studies were those with p < 0.05 for adherence rate between groups. We conducted a narrative synthesis and assessed risk of bias. Results: 12,488 articles screened; 46 included studies (n = 42,91% in OSA or asthma) testing 58 interventions (n = 27, 47% were effective). Nineteen (33%) interventions (15 studies) used 12 different behavior change theories. Use of theory (n = 11,41%) was more common amongst effective interventions. Interventions were mainly educational, self-management or supportive interventions (n = 27,47%). They were commonly delivered by a doctor (n = 20,23%), in face-to-face (n = 48,70%), one-to-one (n = 45,78%) outpatient settings (n = 46,79%) across 2–5 sessions (n = 26,45%) for 1–3 months (n = 26,45%). Doctors delivered a lower proportion (n = 7,18% vs n = 13,28%) and pharmacists (n = 6,15% vs n = 1,2%) a higher proportion of effective than ineffective interventions. Risk of bias was high in >1 domain (n = 43, 93%) in most studies. Conclusions: Behavior change theory was more commonly used to design effective interventions. Few adherence interventions have been developed using theory, representing a gap between intervention design recommendations and research practice.

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This thesis studies preschool socialization in terms of identity -formation, -regulation, and subjectification. Both the methodology and theoretical backdrop draws on Critical Management Studies, and the contribution to research comes from studying a subject otherwise non-prioritized. I have performed a qualitative study entailing interviews of pedagogues and preschool chiefs working within the same company in the Stockholm region. The study indicate that preschool discourse emphasize the importance of social competences and rituals, and moreover that the institution also accentuates its role in setting the proper ‘preconditions’. Furthermore, the study demonstrates how pedagogues – using mechanisms such as individual discourses, the children’s agency, and the milieu – try to form individuals who are: social, independent, self-reliant, have a strong ‘self’, joyful towards learning, and ‘can do it themselves’. I make a liaison between the aforementioned ideals and certain trends discussed by managerial literature, like for instance currents towards: self-management, neo-normative control, self-entrepreneurial attitudes, ambidextrousness, and the ‘principle of potential’ (Costea et al., 2012; Fleming & Study, 2009; Holmqvist & Spicer, 2013; Maravelias, 2011; Pongratz & Voß, 2003). Finally the thesis concludes by firstly underscoring that the Discourse of for example ‘joyful learning’ and ‘independency’ in preschools tend to demolish physical modes of control in place of psychological ones; and secondly, by discussing historical practices, the thesis brings attention to a shift from safekeeping children to preparing them for industrial, urbanistic, and capitalistic social existence. 

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The theme of this dissertation is social technology for self-management: a study in economic enterprise supportive of Rio Grande do Norte. The research aimed to obtain evidence that the reapplication of technology management, basic economic-financial and pricing, as production costs, has the potential to contribute to the self-management of APABV. The social technology and self-management are theoretical frameworks used and where workers are central figures in both the generation and replication of technologies that are compatible with their realities, as in the conduct and management approach adopted by them in their venture, they are makers decisions. To achieve the proposed objective was accomplished participatory research, which was used in addition to document analysis, participatory methodologies such as the construction of the DRP, group interview, experience in the production environment and family of entrepreneurs APABV. This research allowed the management technologies such as spreadsheets controls basic economic and financial costs, when socialized and understood by workers has the potential informational and become part of their daily decision-making process of the project, making up social technology

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This dissertation is about Architect and town planner inserts in the technical support of the Rural establishment and of the possibilities of changes in their habitat. It also looks for its participation through the production of those spaces with or without its performance through two references cases, in Rio Grande do Norte , one called settlement Eldorado de Carajás and another one called Maria da Paz. At first the process represents the model that was adopted systematically by Incra until the middle of the year 2000 with the sub-contracting of their construction work through small companies. These standardized projects which are executed without registration in the system CONFEA/CREA without demand of professional authorship and of technical responsibility of the work. But the process taken place at Maria da Paz s area was configured as one of the first initiatives that stopped with those practices. Consolidated through a partnership among UFRN MST and INCRA/RN, the Architect s technical support and town planner brought new technician-scientific organization and execution of the soil parcels and its habitat. The participation of UFRN was done through a group of studies in land reform and Habitat (GERAH) being this author and coordinator of the methodological proposal, based on the regressive-progressive method and in the inclusion of the conflict as responsible of the ruptures and transductions both done by Henry Léfèbvre and in the research action approached by Carlos Brandão. Therefore it included the process of social learning and collective production of new knowledge and attitudes in relation to the environment in the process called as attended self management in spite of the transformations happened with this new agent s participation. The people re-located to the new areas that got involved in the process and finished their constructions reelaborating the daily practice of the collective effort passed to the self management without technical support. Years later the implantation of those two experiences our research verified that there is a positive image concerning the Architect and town planner, related, most of all to the conception of the activities, orientation and execution of constructions projects and of acceptance of those professionals to the processes of implementation of the Habitats of the Rural establishments. This dissertation analyses this form of performance, from and beyond these images trying to find the professional, specificities or methodological in such a way to demonstrate the importance of its insertion in the formulation and attendance of the more of 100.000 habitats of Rural establishments of the land reform of the country that correspond to most of the housing social interest in the country side

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La fin du traitement actif et le début de la phase de survie correspondent à une période de transition qui présente de nombreux défis pour la personne survivante au cancer, les soignants et le système de santé. La phase de survie au cancer est une phase distincte mais négligée du continuum de soins. Pour faciliter la transition de la fin du traitement actif vers la survie et optimiser la coordination des soins de suivi, la mise en place d’un plan de soins de suivi (PSS) est proposée. Le but de cette recherche est de développer, de mettre en place et d’évaluer si un plan de soins de suivi (PSS) permet de répondre aux besoins globaux, de diminuer la détresse émotionnelle et de favoriser les comportements d’autogestion de santé de femmes atteintes du cancer de l’endomètre (FACE) lors de la transition de la fin du traitement actif vers la survie au cancer. Elle comprend deux phases distinctes. La première phase visait d’abord le développement d’un plan de soins de suivi (PSS) pour des femmes atteintes du cancer de l’endomètre avec traitements adjuvants. La sélection du contenu du PSS a été faite à partir de la recension des écrits et des données recueillies lors d’entrevues individuelles avec 19 FACE, 24 professionnels de la santé travaillant avec cette clientèle et quatre gestionnaires de proximité en oncologie. Cette première phase avait également pour but la validation du contenu du PSS auprès de dix professionnels de la santé impliqués dans l’étude. La seconde phase consistait à évaluer la faisabilité, l’acceptabilité du PSS et à en pré-tester l’utilité à répondre aux besoins globaux, à diminuer la détresse émotionnelle (peur de la récidive) et à favoriser l’autogestion de santé auprès d’un groupe de 18 femmes atteintes du cancer de l’endomètre avec traitements adjuvants à la fin du traitement actif vers la survie. Sur le plan de la faisabilité, les résultats suggèrent que la mise en place du PSS comporte des défis en termes de temps, de ressources et de coordination pour l’infirmière pivot en oncologie (IPO). Concernant l’acceptabilité du PSS, les FACE le perçoivent comme un outil d’information utile qui favorise la communication avec le médecin de famille ou d’autres professionnels de la santé. Les IPO soutiennent sa valeur ajoutée à la fin du traitement et soulignent que la discussion du contenu du PSS fait ressortir des éléments de surveillance et de suivi essentiels à prendre en compte pour la phase de survie et permet de mettre l’emphase sur l’autogestion de sa santé. Pour les médecins de famille, le PSS est un outil d’information pour les survivantes qui favorise la réassurance, la communication et la continuité des soins entre professionnels de la santé. Enfin, pour ce qui est de l’utilité du PSS à répondre aux besoins globaux, les résultats suggèrent que l’ensemble des besoins sont plus satisfaits trois mois après la fin des traitements pour le groupe ayant reçu un PSS. Bien que la peur de récidive du cancer (PRC) s’améliore au suivi de trois mois pour le groupe exposé au PSS, 55% des FACE conservent un score cliniquement significatif de 13 à la sous-échelle de sévérité de peur de récidive à la fin du traitement et 42% au suivi de trois mois. Les comportements d’autogestion de santé s’améliorent entre la fin du traitement et le suivi de trois mois pour le groupe exposé un PSS. Considérant ces résultats, la démarche soutient la pertinence de mettre en place un PSS à la fin du traitement actif pour les FACE pour répondre à des besoins d’information, favoriser la communication et la continuité des soins avec les professionnels de la santé et les comportements d’autogestion de santé dans la phase de survie. Cependant, des contraintes de temps, de ressources et de coordination doivent être prises en compte pour sa mise en place dans le milieu clinique. Mots-clés : Transition, fin du traitement actif, besoins, survie au cancer, plan de soins de suivi.