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Evaluating holistic needs assessment in outpatient cancer care--a randomised controlled trial: the study protocol

Snowden, wAustyn; Young, Jenny; White, Craig; Murray, Esther; Richard, Claude; Lussier, Marie-Therese; MacArthur, Ewan; Storey, Dawn; Schipani, Stafano; Wheatley, Duncan; McMahon, Jeremy; Ross, Elaine


Jenny Young

Craig White

Esther Murray

Claude Richard

Marie-Therese Lussier

Ewan MacArthur

Dawn Storey

Stafano Schipani

Duncan Wheatley

Jeremy McMahon

Elaine Ross


Introduction People living with and beyond cancer are vulnerable to a number of physical, functional and psychological issues. Undertaking a holistic needs assessment (HNA) is one way to support a structured discussion of patients’ needs within a clinical consultation. However, there is little evidence on how HNA impacts on the dynamics of the clinical consultation. This study aims to establish (1) how HNA affects the type of conversation that goes on during a clinical consultation and (2) how these putative changes impact on shared decision-making and self-efficacy.

Methods and analysis The study is hosted by 10 outpatient oncology clinics in the West of Scotland and South West England. Participants are patients with a diagnosis of head and neck, breast, urological, gynaecological and colorectal cancer who have received treatment for their cancer. Patients are randomised to an intervention or control group. The control group entails standard care—routine consultation between the patient and clinician. In the intervention group, the patient completes a holistic needs assessment prior to consultation. The completed assessment is then given to the clinician where it informs a discussion based on the patient's needs and concerns as identified by them. The primary outcome measure is patient participation, as determined by dialogue ratio (DR) and preponderance of initiative (PI) within the consultation. The secondary outcome measures are shared decision-making and self-efficacy. It is hypothesised that HNA will be associated with greater patient participation within the consultation, and that shared decision-making and feelings of self-efficacy will increase as a function of the intervention.

Ethics and dissemination This study has been given a favourable opinion by the West of Scotland Research Ethics Committee and NHS Research & Development. Study findings will be disseminated through peer-reviewed publications and conference attendance


Snowden, W., Young, J., White, C., Murray, E., Richard, C., Lussier, M., …Ross, E. (2015). Evaluating holistic needs assessment in outpatient cancer care--a randomised controlled trial: the study protocol. BMJ Open, 5(5), Article e006840.

Journal Article Type Article
Acceptance Date Apr 10, 2015
Online Publication Date May 11, 2015
Publication Date May 11, 2015
Deposit Date Aug 14, 2015
Publicly Available Date Aug 14, 2015
Journal BMJ Open
Print ISSN 2044-6055
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 5
Issue 5
Article Number e006840
Keywords Cancer care; holistic needs assessment; shared decision-making; self-efficacy;
Public URL
Publisher URL


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