The patient needs assessment in cancer care: identifying barriers and facilitators to implementation in the UK and Canada

Valerio Benedetto,Thomas F Hack,Susan Williamson,Kinta Beaver,Munirah Bangee

doi:10.1007/s00520-020-05542-6

Valerio Benedetto, Thomas F Hack + Show 3 more

Open Access

https://doi.org/10.1007/s00520-020-05542-6

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Abstract

PurposePersonalised information and support can be provided to cancer survivors using a structured approach. Needs assessment tools such as the Holistic Needs Assessment (HNA) in the UK and the Comprehensive Problem and Symptom Screening (COMPASS) questionnaire in Canada are recommended for use in practice; however, they are not widely embedded into practice. The study aimed to determine the extent to which nurses working in cancer care in the UK and Manitoba value NA and identify any barriers and facilitators they experience.MethodOncology nurses involved in the care of cancer patients in the UK (n = 110) and Manitoba (n = 221) were emailed a link to an online survey by lead cancer nurses in the participating institutions. A snowball technique was used to increase participation across the UK resulting in 306 oncology nurses completing the survey in the UK and 116 in Canada.ResultsParticipants expressed concerns that these assessments were becoming bureaucratic “tick-box exercises” which did not meet patients’ needs. Barriers to completion were time, staff shortages, lack of confidence, privacy, and resources. Facilitators were privacy for confidential discussions, training, confidence in knowledge and skills, and referral to resources.ConclusionMany busy oncology nurses completed this survey demonstrating the importance they attach to HNAs and COMPASS. The challenges faced with implementing these assessments into everyday practice require training, time, support services, and an appropriate environment. It is vital that the HNA and COMPASS are conducted at optimum times for patients to fully utilise time and resources.

Highlights

The United Kingdom (UK) and Canada have similar public healthcare systems which are struggling to manage the needs of increasing numbers of patients diagnosed and treated for cancer [1, 2]
In 2010, a report published by the National Cancer Survivorship Initiative (NCSI) in the UK stated that people who have been diagnosed and treated for cancer face many long-term difficulties and need support and information to live well with and beyond the cancer diagnosis [3]
A snowball sampling technique was used to recruit clinical nurse specialists (CNSs) working in cancer care across the UK through their national societies

Summary

Introduction

The United Kingdom (UK) and Canada have similar public healthcare systems which are struggling to manage the needs of increasing numbers of patients diagnosed and treated for cancer [1, 2]. In 2010, a report published by the National Cancer Survivorship Initiative (NCSI) in the UK stated that people who have been diagnosed and treated for cancer face many long-term difficulties and need support and information to live well with and beyond the cancer diagnosis [3]. The Recovery Package, which is a national initiative in the UK, is intended to improve communication about care needs between secondary and primary care but aims to provide people with the information and support they need to enable them to return to work, self-manage, and live their lives well [4, 7], [http://www.ncsi.org.uk/what-we-

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