Improving personalised care and support planning for people living with treatable-but-not-curable cancer.

Autor:	Le Boutillier C; Division of Methodologies, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK clair.le_boutillier@kcl.ac.uk.; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.; THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK., Jeyasingh-Jacob J; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.; Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK., Jones L; Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK.; Maggie's West London, London, UK., King A; Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK., Archer S; Department of Psychology, University of Cambridge, Cambridge, UK.; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK., Urch C; Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.; Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2023 Sep; Vol. 12 (3).
DOI:	10.1136/bmjoq-2023-002322
Abstrakt:	People living with treatable-but-not-curable (TbnC) cancer encounter cancer-related needs. While the NHS long-term plan commits to offering a Holistic Needs Assessment (HNA) and care plan to all people diagnosed with cancer, the content, delivery and timing of this intervention differs across practice. Understanding how people make sense of their cancer experience can support personalised care. A conceptual framework based on personal narratives of living with and beyond cancer (across different cancer types and all stages of the disease trajectory), identified three interlinked themes: Adversity, Restoration and Compatibility, resulting in the ARC framework.Our aim was to use the ARC framework to underpin the HNA to improve the experience of personalised care and support planning for people living with TbnC cancer. We used clinical work experience to operationalise the ARC framework and develop the intervention, called the ARC HNA, and service-level structure, called the ARC clinic. We sought expert input on the proposed content and structure from patients and clinicians through involvement and engagement activities. Delivered alongside standard care, the ARC HNA was piloted with patients on the TbnC cancer (myeloma and metastatic breast, prostate or lung) pathway, who were 6-24 months into their treatment. Iterations were made to the content, delivery and timing of the intervention based on user feedback.Fifty-one patients received the intervention. An average of 12 new concerns were identified per patient, and 96% of patients achieved at least one of their goals. Patients valued the space for reflection and follow-up, and clinicians valued the collaborative approach to meeting patients' supportive care needs. Compared with routine initial HNA and care plan completion rates of 13%, ARC clinic achieved 90% with all care plans shared with general practitioners. The ARC clinic adopts a novel and proactive approach to delivering HNAs and care plans in a meaningful and personalised way. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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