Understanding how the Support Needs Approach for Patients (SNAP) enables identification, expression and discussion of patient support needs: A qualitative study.

A Carole Gardener,Gail Ewing,Christi Deaton,Morag Farquhar

doi:10.1177/17423953211047840

A Carole Gardener, Gail Ewing + Show 2 more

Open Access

https://doi.org/10.1177/17423953211047840

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Abstract

To identify whether and how the support needs approach for patients enables patients with chronic progressive conditions to identify, express and discuss their unmet support needs. Thirteen healthcare professionals trained in the Support Needs Approach for Patients (SNAP), recruited from three pilot sites in the East of England (across primary, community and secondary care) delivered SNAP to 56 patients with the exemplar condition chronic obstructive pulmonary disease over a 4-month period. Healthcare professionals participated in a mid-pilot semi-structured interview (pilot site representatives) and end-of pilot focus group (all healthcare professionals). Twenty patients who received SNAP were interviewed about their experiences (topic-guided). Transcripts analysed using a framework approach. There were differences in how healthcare professionals delivered SNAP and how patients engaged with it; analysing the interaction of these identified a continuum of care (from person-centred to healthcare professional-led) which impacted patient identification and expression of need and resulting responses. When delivered as intended, SNAP operationalised person-centred care enabling patient-led identification, expression and discussion of support needs. SNAP addresses the rhetoric within policy, good practice guidance and the person-centred care literature espousing the need to involve patients in identifying their needs and preferences by providing healthcare professionals with a mechanism for achieving holistic person-centred care in everyday practice.

Highlights

There were differences in how healthcare professionals (HCPs) delivered Support Needs Approach for Patients (SNAP) and how patients engaged with it; analysing the interaction of these identified a continuum of care which impacted on patient identification and expression of need and resulting responses
SNAP addresses the rhetoric within policy, good practice guidance and the person-centred care literature espousing the need to involve patients in identifying their needs and preferences by providing HCPs with a mechanism for achieving holistic person-centred care in everyday practice
HCP approaches to SNAP delivery HCPs either delivered SNAP as planned or deviated from the intended delivery with subsequent consequences

Summary

Introduction

Recommended approaches to involving patients in identifying and discussing their support needs usually comprise assessment followed by personalised care planning, typically supported by tools completed with, or by, the patient.[4,5] such approaches do not necessarily enable patients to identify and express where they need more support, nor to do so comprehensively. Most tools underpinning these approaches focus on identification of symptoms, illness burden and problems;[6,7,8] whilst these can be useful indicators of need, they do not directly enable patients to comprehensively identify and communicate their priorities regarding support they need.[9,10] Further, healthcare professionals (HCPs) sometimes use these indicators of need within their assessments of individuals’ needs rather than using an approach enabling patients to prioritise and discuss issues that currently matter to them (i.e. direct consideration of their unmet support needs).[11]

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