The implementation and impact of Holistic Needs Assessments for people affected by cancer: A systematic review and thematic synthesis of the literature

Johnston, Lucy; Young, Jenny; Campbell, Karen

Abstract

Objective:
Globally, cancer services herald the use of Holistic Needs Assessments (HNA). Implementation is, however, heterogeneous. There is a need to understand what effect implementation variation has on patient experience, outcomes and service demand. This is the first study to examine whether the way in which HNA is implemented, impacts on patient outcomes.

Methods:
MEDLINE, AMED, CINAHL, PsycINFO and the Psychological and Behavioural Sciences Collection were searched (June 2000–June 2018). Search strategy included international HNA tools and synonyms for “needs.” An overview of quality was obtained through application of the Mixed Methods Appraisal Tool. Key themes were identified through thematic synthesis.

Results:
Twenty studies were included (RCTs [n = 4], service evaluations [n = 8] and feasibility studies [n = 8]). Implementation approaches and assessor actions were identified and through thematic synthesis were defined as detecting, discussing/dealing, directing and downstream care. The way in which HNA is implemented is more important to understanding outcomes than what is implemented.

Conclusion:
There is a need to conceptualise HNA as a means and not an end in itself. Pursuers of HNA‐led outcomes must understand and strengthen connections between assessment and outcomes. The conceptual framework can assist development of more insightful measures of both process and outcomes.

• Journal Article Type: Article
• Acceptance Date: Apr 17, 2019
• Online Publication Date: May 14, 2019
• Publication Date: 2019-05
• Deposit Date: Jul 15, 2019
• Publicly Available Date: May 15, 2020
• Journal: European Journal of Cancer Care
• Print ISSN: 0961-5423
• Electronic ISSN: 1365-2354
• Publisher: Wiley
• Peer Reviewed: Not Peer Reviewed
• Volume: 28
• Issue: 3
• Article Number: e13087
• DOI: https://doi.org/10.1111/ecc.13087
• Keywords: Oncology
• Public URL: http://researchrepository.napier.ac.uk/Output/1810904