Implications of a needs assessment intervention for people with progressive cancer: Impact on clinical assessment, response and service utilisation

Waller, Amy; Girgis, Afaf; Johnson, Claire E.; Lecathelinais, Christophe; Sibbritt, David; Seldon, Michael; Bonaventura, Tony; Currow, David C.

doi:10.1002/pon.1933

Cited by 21 publications

(24 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With regards to sample sources, six studies [ 32 , 40 , 45 , 46 , 49 , 61 ] reported no information regarding the recruitment setting, while in the remaining studies patients, and/or caregivers were mainly recruited from outpatient departments ( n = 16), inpatient departments ( n = 11), home/home-based care units ( n = 10), and mixed settings ( n = 7). In terms of cancer sites, 29 studies focused on patients with mixed cancer site and/or their caregivers, 11 studies focused on specific patients with cancer and/or caregivers (3 studies on prostate cancer [ 57 , 69 , 73 ], 5 studies on breast cancer [ 41 , 48 , 58 , 60 , 75 ], and three on lung cancer [ 35 , 42 , 71 ]), while 10 other studies [ 47 , 50 , 51 , 53 , 59 , 64 , 66 , 68 ] reported no information about cancer types. The diagnostic criteria of advanced cancer were presented in 13 studies (13/50), with five studies [ 6 , 30 , 31 , 60 , 61 ] adopting the criteria of cancer with metastasis, and seven studies [ 9 , 41 , 42 , 45 , 58 , 63 , 75 ] using the stage III/IV criterion according to TNM staging system.…”

Section: Resultsmentioning

confidence: 99%

Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review

et al. 2018

View full text Add to dashboard Cite

BackgroundThis systematic review aimed to identify the unmet care needs and their associated variables in patients with advanced cancer and informal caregivers, alongside summarizing the tools used for needs assessment.MethodsTen electronic databases were searched systematically from inception of each database to December 2016 to determine eligible studies. Studies that considered the unmet care needs of either adult patients with advanced cancer or informal caregivers, regardless of the study design, were included. The Mixed Methods Appraisal Tool was utilized for quality appraisal of the included studies. Content analysis was used to identify unmet needs, and descriptive analysis was adopted to synthesize other outcomes.ResultsFifty studies were included, and their methodological quality was generally robust. The prevalence of unmet needs varied across studies. Twelve unmet need domains were identified in patients with advanced cancer, and seven among informal caregivers. The three most commonly reported domains for patients were psychological, physical, and healthcare service and information. The most prominent unmet items of these domains were emotional support (10.1–84.4%), fatigue (18–76.3%), and “being informed about benefits and side-effects of treatment” (4–66.7%). The most commonly identified unmet needs for informal caregivers were information needs, including illness and treatment information (26–100%) and care-related information (21–100%). Unmet needs of patients with advanced cancer were associated with their physical symptoms, anxiety, and quality of life. The most commonly used instruments for needs assessment among patients with advanced cancer were the Supportive Care Needs Survey (N = 8) and Problems and Needs in Palliative Care questionnaire (N = 5). The majority of the included studies investigated unmet needs from the perspectives of either patients or caregivers with a cross-sectional study design using single time-point assessments. Moreover, significant heterogeneity, including differences in study contexts, assessment methods, instruments for measurement, need classifications, and reporting methods, were identified across studies.ConclusionBoth advanced cancer patients and informal caregivers reported a wide range of context-bound unmet needs. Examining their unmet needs on the basis of viewing patients and their informal caregivers as a whole unit will be highly optimal. Unmet care needs should be comprehensively evaluated from the perspectives of all stakeholders and interpreted by using rigorously designed mixed methods research and longitudinal studies within a given context.

show abstract

Section: Resultsmentioning

confidence: 99%

Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…They sought a more pragmatic needs assessment to include aspects of physical and social functioning, nutrition and symptom burden to support their self-management and guide their understanding of illness progression. This broader assessment approach has already been successfully employed in time pressured clinics in other settings including cancer [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The care needs of patients with idiopathic pulmonary fibrosis and their carers (CaNoPy): results of a qualitative study

et al. 2015

View full text Add to dashboard Cite

BackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, fibrotic interstitial lung disease of unknown origin. It has a median survival of three years but a wide range in survival rate which is difficult to predict at the time of diagnosis. Specialist guidance promotes a patient centred approach emphasising regular assessment, information giving and supportive care coordinated by a multidisciplinary team (MDT). However understanding of patient and carer experience across the disease trajectory is limited and detailed guidance for MDTs on communication, assessment, and triggers for supportive and palliative interventions is lacking. This study addresses uncertainties relating to care needs of patients and carers at different stages of the IPF disease trajectory.MethodsFollowing ethical approval a multi-centre mixed-methods study recruited participants with IPF at four stages of the disease trajectory. Qualitative analysis was used to analyse 48 semi-structured interviews with patients (27) and paired carers (21).ResultsPatients and carers outlined key elements of MDT activity capable of having significant impact on the care experience. These were structured around:Focus of clinical encountersTimely identification of changes in health status and functional activityUnderstanding of symptoms and medical interventionsCoping strategies and carer roles.ConclusionsPatients diagnosed with IPF have a clear understanding of their prognosis but little understanding of how their disease will progress and how it will be managed. In depth analysis of the experiences of patients and carers offers guidance for refining IPF clinical pathways. This will support patients and carers at key transition points in line with National Institute for Health and Care Excellence (NICE) guidance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0145-5) contains supplementary material, which is available to authorized users.

show abstract

“…The NAT-C is modelled on an assessment completed by health professionals, the Needs Assessment Tool: Progressive Disease -Cancer, which has been extensively validated and trialed. [11][12][13][14] The NAT-C allows carers to identify and prioritise their own needs, and aims to focus the GP consultation quickly onto relevant matters. The carer and/or patient aimed to book a long appointment and present with a completed NAT-C within a week of the introductory GP interview.…”

Section: Intervention Group Processmentioning

confidence: 99%

Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial

Mitchell¹,

Girgis²,

Jiwa³

et al. 2013

Br J Gen Pract

Self Cite

View full text Add to dashboard Cite

Implications of a needs assessment intervention for people with progressive cancer: Impact on clinical assessment, response and service utilisation

Abstract: The NAT: PD-C is an efficient and acceptable strategy for supporting needs-based cancer care that can potentially be incorporated into standard routine care without increasing the burden on care providers.

Cited by 21 publications

References 47 publications

Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review

Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review

The care needs of patients with idiopathic pulmonary fibrosis and their carers (CaNoPy): results of a qualitative study

Providing general practice needs-based care for carers of people with advanced cancer: a randomised controlled trial

Contact Info

Product

Resources

About