title: Using a Whole Person Approach to Support People With Cancer: A Longitudinal, Mixed-Methods Service Evaluation.
abstract: Introduction Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this article is to (a) evaluate short- and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC) and (b) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods Longitudinal mixed-methods service evaluation (n = 135). Data collected included health-related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity-MYCaW); lifestyle behavior (bespoke questionnaire), and participants' experiences over 12 months postcourse. Results Statistically and clinically significant improvements from baseline to 12 months in severity of MYCaW Concerns (n = 64; P < .000) and mean total HRQoL (n = 66; P < .000). The majority of MYCaW concerns were "psychological and emotional" and about participants' well-being. Spiritual, emotional, and functional well-being contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. Three to 6 months postcourse was identified as the time when more support was most likely to be needed. Conclusions Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behavior change were also identified. These data then informed wider and more person-centered clinical provision to increase the maintenance of positive long-term behavior changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.
authors.affiliation: University of Westminster, London, UK m.polley01@westminster.ac.uk.
authors.forename: Marie J
authors.initials: MJ
authors.lastname: Polley
authors.affiliation: Penny Brohn UK, Bristol, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Jolliffe
authors.affiliation: Penny Brohn UK, Bristol, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Boxell
authors.affiliation: Penny Brohn UK, Bristol, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Zollman
authors.affiliation: Penny Brohn UK, Bristol, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jackson
authors.affiliation: Penny Brohn UK, Bristol, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Seers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: MYCaW concerns; cancer; evaluation; health-related quality of life; healthy lifestyle changes; spiritual well-being; whole person approach