Holistic needs assessment in the community: exploring concern severity and predictors of concern amongst cancer patients


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Jenny Young1,Austyn Snowden1,Jan Savinc1
1Edinburgh Napier University

Abstract

Background

A cancer diagnosis can impact on patients and their families practically, physically and psychologically. This study introduces a multidisciplinary UK based cancer service designed to support people affected by cancer with all areas of concern. Nonclinical “link officers” use holistic needs assessment (HNA) to help individuals identify and quantify the severity of their physical, psychological, practical, financial, and social concerns. A care plan is then agreed, usually involving community interventions from partner agencies. Following intervention, assessment is repeated. The primary aim of this study was to establish whether there was a significant difference between initial assessment and follow‐up, postintervention. Secondary aim was to identify potential predictors of increased levels of concern at baseline and follow‐up.

Method

Pre‐ and postintervention observational cohort study. Paired t test examined the difference in mean (SD) concern severity between baseline and follow‐up. Multiple linear regression models were computed to hypothesize potential predictors of initial concern severity and severity change.

Results

The service saw 2413 people 2014‐2017. Participants identified average 5.5 (4.7) concerns, financial concerns being most frequent. Mean severity at baseline was 7.12 (out of 10) (2.50), reducing to 3.83 (3.49) post‐treatment, paired t(4454) = 64.68, P < 0.0001, reduction of 3.31 (95% CI 3.21‐3.41). Factors associated with higher initial concern included unemployment and caring responsibilities. Unemployment was also associated with a smaller reduction of concern severity at follow‐up.

Conclusion

Severity of concern reduced significantly demonstrating that this integrated approach to support can help to to successfully meet the wide‐ranging concerns that can impact on someone's life following a cancer diagnosis. Consequently, research that provides insight into initiatives that have successfully embedded integrated care can be used to inform colleagues across the cancer care profession.