Using a Whole Person Approach to Support People With Cancer

Abstract

Introduction. Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this article is to (a) evaluate short- and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC) and (b) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods. Longitudinal mixed-methods service evaluation (n = 135). Data collected included health-related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity–MYCaW); lifestyle behavior (bespoke questionnaire), and participants’ experiences over 12 months postcourse. Results. Statistically and clinically significant improvements from baseline to 12 months in severity of MYCaW Concerns (n = 64; P < .000) and mean total HRQoL (n = 66; P < .000). The majority of MYCaW concerns were “psychological and emotional” and about participants’ well-being. Spiritual, emotional, and functional well-being contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. Three to 6 months postcourse was identified as the time when more support was most likely to be needed. Conclusions. Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behavior change were also identified. These data then informed wider and more person-centered clinical provision to increase the maintenance of positive long-term behavior changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.

A Qualitative Study Exploring Models of Supportive Care in Men and Their Partners/Caregivers Affected by Metastatic Prostate Cancer

“…Walker, Tran, Wassersug, Thomas, & Robinson, 2013). Supportive care is a person-centered approach to the provision of the necessary services for those living with or affected by cancer to meet their informational, spiritual, emotional, social, or physical needs during diagnosis, treatment, or follow-up phases including issues of health promotion and prevention, survivorship, palliation and bereavement (Polley et al, 2016). The consequences of metastatic prostate cancer and treatment side-effects, affect the couple living with this disease, not just the man.…”

Characteristics and Symptom Burden of Patients Accessing Acupuncture Services at a Cancer Hospital

“…In a study where MYCaW was collected at UK integrative cancer support centers, the main presenting concerns were psychological and emotional (45%); seeking an integrative approach (32.3%), herbs/ supplements (31.9%), nutrition (20.4%). 27 This could either suggest that patients who attended acupuncture at our center experienced more physical concerns, or while psychological and emotional concerns existed, physical concerns were more severe and thereby prioritized, or physical concerns were perceived to be more relevant for treatment with acupuncture. To our knowledge, no other study has used MYCaW to assess reasons why people with cancer present for acupuncture.…”

Evaluations of psychosocial cancer support services: A scoping review

“…All articles were published after 2001, where eight articles were published after 2010. One study chose an RCT design [23], six studies were cohort studies with pre-and post-measures [24][25][26][27][28][29] and five studies were cross-sectional with retrospective measures [30][31][32][33][34]. The study populations comprised patients with all types of cancer for eight articles [24-26, 28, 29, 31-33], three included only patients with breast cancer [27,30,34] and one solely patients with breast and colon cancer [23].…”

“…One article stated a sample size of < 100 participants [25]. Eight articles reported a sample size between 101-500 participants [23,24,[26][27][28][30][31][32]. Two articles included between 501-1000 participants [29,34] and one study included 1930 participants [33].…”

“…The type of service evaluated differ between the studies. In eight studies, the support services evaluated offered psychosocial support delivered by health care professionals with focus on psychological and/or social concerns [25,26,28,29,[31][32][33][34]. Two studies focused solely on complementary medicine [24,27] and two offered support by trained cancer survivors (volunteer mentoring) [23,30].…”