The Evolution of Encore
Encore ‘comes of age’ with the first In-Service Training for Coordinators

By Jane Bissell

YWCA Encore is a free 8-week programme of gentle exercises designed for women who have experienced breast cancer surgery at any time in their lives. Since 2006, trained Encore Coordinators have delivered 80 programmes to around 800 women nationwide and now the YWCA plans to improve the overall quality of Encore. The first In-Service Training for Coordinators was held mid-September and an external evaluation of the programme is in the pipeline. Both initiatives will continue Encore’s evolution as a supportive part of a woman’s breast cancer journey.

Thirty Coordinators from Dunedin to Whangarei attended the In-Service Training in Auckland. Napier participant Cath Thorp knew she was in for a full-on two days. ‘It’s great to see the enthusiasm within the group. We’re a professional team of women, coming together with all our knowledge and power to help women with breast cancer. It’s so beneficial to share information and experiences.’

National Encore Training Manager Julie Cummins designed the course. ‘The programme was developed both from needs identified by the Coordinators and my own observations noted during site visits to each of the Encore groups in their regions,’ says Julie. ‘I wanted it to be relevant and practical.’

The Training was structured to provide a wide variety of topics and presentations with opportunities for informal networking and fun. Presentations were given by the Coordinators themselves and local professionals working within the medical, psychosocial and general health arenas. Both days offered a balance of group and individual activities to facilitate discussion of issues, exchange information and experiences, develop new ideas and to learn and practice new skills.

National Encore Manager Marlene Sorby has worked tirelessly to spread Encore throughout the country and having all her Coordinators together was a proud accomplishment.   ‘The In-Service Training was not just about revising the delivery of all aspects of an Encore programme,’ said Marlene, ‘but also about revitalising the spirit of Encore. We’ve held four training courses for new Encore Coordinators since early 2006 but this is the first time we’ve had them all together in one place. It’s just wonderful!’

There is no doubt the programme works. ‘We conducted a survey recently, randomly selecting the end of course evaluation assessments of 69 women who had taken part in 2009 programmes,’ said Marlene. ‘78% of these women reported improvement in their physical evaluations and 77% felt their overall wellbeing had improved after completing the programme.’

YWCA CEO Hilary Sumpter introduced the Training, saying Encore was a great source of pride for her organisation, acknowledging the New Zealand Breast Cancer Foundation and the Ted and Mollie Carr Trust for their support of Encore.

Day One focused on floor and pool exercise revision: particular emphasis was placed on the safety and wellbeing of women taking part in Encore. YWCA Trainer Sef Erasito conducted a pool session on lifesaving techniques and Auckland Physiotherapist Susan Lugton offered an informative hour about ‘breathing well’ as poor breathing can cause a range of health problems.

The second day focused on information: questioning a panel of experts that included breast surgeon John Harman, breast care product specialist Roz Burkitt, Breast Nurse and lymphoedema therapist Denise Flett and lymphoedema educator Claire Doole; managing the administrative side of an Encore programme; and finding out general information about breast cancer.

Lymphoedema can affect many women post-surgery and yet is often not fully explained or understood. Encore exercises are designed to benefit the lymphatic system so information about lymphoedema is offered at every course. ‘There is evidence that muscular movement is critical to good lymphatic drainage,’ said Denise. ‘The muscle pump anddeep abdominal breathing arethe driving forces of the lymphatic system.’

Sessions on techniques for facilitating groups and handling emotional issues were of particular value.

‘I found it difficult to facilitate groups initially because I’ve never had breast cancer and didn’t understand the journey these women were experiencing. So I did a lot of listening and have learned so much from the women I work with. I consider it a privilege,’ said Esther Amon, one of the first Co-ordinators to be trained in New Zealand.

Coordinator Rosie Scott plans to use the Training to improve delivery of her programmes in Auckland. She is a ten-year survivor of breast cancer and passionate about Encore. ‘Some women in my groups have said that after only two sessions they sleep better and feel more relaxed. These women need support. Encore gives them confidence to go out on their own and that’s what I’m here for. It’s like teaching little birds to fly.’