title: Holistic needs assessment in advanced, intensively treated multiple myeloma patients.
abstract: OBJECTIVE
  It is recommended that patients with multiple myeloma should be assessed for unmet holistic needs at key times in their disease trajectory. The aim of this exploratory study was to characterise the holistic needs of advanced, intensively treated multiple myeloma using a structured assessment tool.
  
  
  METHODS
  Patients with multiple myeloma who had undergone a haematopoietic stem cell transplantation and subsequent treatment for at least one episode of progressive disease but were in stable plateau phase were included in the study. Patients' holistic needs were assessed using the self-reporting tool, Sheffield Profile for Assessment and Referral for Care (SPARC).
  
  
  RESULTS
  Thirty-two patients with a median age of 60 years at assessment and a median of 5.5 years from diagnosis were recruited. Using the SPARC, half of the patients reported tiredness as 'quite a bit/very much,' while one third complained that daytime somnolence and insomnia were 'quite a bit/very much.' Forty-four percent of patients reported pain. One third of patients were bothered and distressed by the side effects from their treatment and were worried about long-term effects of their treatment. Thirty-one percent of patients felt that the effect of their condition had an impact on their sexual life, and 40 % were worried about the effect that their illness was having on their family or other people.
  
  
  CONCLUSIONS
  This is the first study to use a self-reported holistic needs assessment tool in multiple myeloma. A multidimensional structured questionnaire like the SPARC could provide a useful first step in the effective delivery of supportive and palliative care for patients with multiple myeloma.
authors.affiliation: Academic Unit of Supportive Care, Department of Oncology, University of Sheffield, Sheffield, UK, elaine.boland@nhs.net.
authors.forename: E G
authors.initials: EG
authors.lastname: Boland
authors.forename: J W
authors.initials: JW
authors.lastname: Boland
authors.forename: Y
authors.initials: Y
authors.lastname: Ezaydi
authors.forename: D M
authors.initials: DM
authors.lastname: Greenfield
authors.forename: S H
authors.initials: SH
authors.lastname: Ahmedzai
authors.forename: J A
authors.initials: JA
authors.lastname: Snowden
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000523:psychology* / Q000628:therapy; D020380:Needs Assessment; D011594:Psychometrics / Q000295:instrumentation*; D011795:Surveys and Questionnaires / Q000592:standards*
references.citation: Age Ageing. 2010 Sep;39(5):554-9
references.pmid: 20647596
references.citation: Br J Haematol. 2011 Jul;154(1):32-75
references.pmid: 21569004
references.citation: Support Care Cancer. 2009 Jun;17(6):665-73
references.pmid: 18982363
references.citation: Psychooncology. 2011 Jan;20(1):88-97
references.pmid: 20187072
references.citation: Eur J Oncol Nurs. 2012 Jul;16(3):212-9
references.pmid: 21778113
references.citation: Br J Haematol. 2011 Jul;154(1):76-103
references.pmid: 21517805
references.citation: Support Care Cancer. 2011 Nov;19(11):1879-86
references.pmid: 21725827
references.citation: J Pain Symptom Manage. 2013 Nov;46(5):671-80
references.pmid: 23535325
references.citation: Thorax. 2010 Oct;65(10):937-8
references.pmid: 20671310
references.citation: Support Care Cancer. 2007 Oct;15(10):1125-44
references.pmid: 17235503
references.citation: Support Care Cancer. 2014 Apr;22(4):1059-69
references.pmid: 24292015
references.citation: J Pain Symptom Manage. 2012 Dec;44(6):916-22
references.pmid: 22926084
references.citation: Blood. 2008 Mar 1;111(5):2516-20
references.pmid: 17975015
references.citation: Br J Gen Pract. 2011 Nov;61(592):e763-5
references.pmid: 22054341
references.citation: Bone Marrow Transplant. 2011 Oct;46(10):1345-52
references.pmid: 21113189
references.citation: BMC Palliat Care. 2013 Feb 26;12:11
references.pmid: 23442926
references.citation: J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
references.pmid: 8433390
references.citation: BMC Palliat Care. 2013 May 28;12:24
references.pmid: 23714682
references.citation: Eur J Cancer. 1996 Jan;32A(1):78-81
references.pmid: 8695247
references.citation: Oncologist. 2011;16(11):1600-3
references.pmid: 21968047
references.citation: Health Expect. 2015 Aug;18(4):562-77
references.pmid: 23414548
references.citation: Support Care Cancer. 2011 Jan;19(1):101-11
references.pmid: 19998045
references.citation: Palliat Med. 2013 Jan;27(1):76-83
references.pmid: 22619261
references.citation: Psychooncology. 2008 Jul;17(7):690-8
references.pmid: 18033733
references.citation: Eur J Haematol. 2012 Dec;89(6):437-57
references.pmid: 22985406
references.citation: Br J Cancer. 2011 Nov 22;105(11):1684-92
references.pmid: 22045184