. 2017 May 7;4(4):187–199. doi: 10.1002/nop2.83

Table 1.

The case study

The case study
A randomized, controlled trial began in 2013 to examine the impact of holistic needs assessment (HNA) in community palliative care. Holistic needs assessment is: “…a process of gathering and discussing information with the patient and/or carer/supporter in order to develop an understanding of what the person living with and beyond cancer knows, understands and needs. This holistic assessment is focused on the whole person, their entire well‐being is discussed – physical, emotional, spiritual, mental, social, and environmental. The process culminates when the assessment results are used to inform a care plan.” (National Cancer Survivorship Initiative 2013) The UK Gold Standards Framework and NICE guidelines (2004) promote the importance of holistic assessment in palliative care, yet there is limited research on the impact of this intervention. Therefore, a protocol was developed to examine its efficacy, consistent with a comparable study in acute care (Snowden et al. 2015). Two community hospice teams volunteered to participate. The teams provided care to individuals across two contrasting geographical areas; one urban and one rural. Community nurses were required at their routine home visits to invite patients with a diagnosis of cancer to take part. Inclusion and exclusion criteria were: Inclusion: Community outpatient under the palliative care of the site. Over 18, capable of informed consent and expresses a wish to participate. Diagnosed with cancer. Exclusion criteria: Non English speaker Person deemed incapable of consenting to participate as defined by the Adults with Incapacity Act (2000)l Individuals that are in the last weeks of their life as identified by a member of the clinical care team. If patients agreed then the clinician would either integrate the HNA into their visits (experimental group) or not (control group). All consultations were to be audio‐recorded and then analysed by the research team to establish the impact of the intervention (Snowden et al., 2015).The NHS and university ethics committees had approved the study and the participating organizations were keen to be involved. The research team was multi‐disciplinary including an international team specializing in conversation analysis (Lussier et al. 2013). For sufficient power the study needed 60 participants in each arm, 120 in total. Before recruitment began the clinicians received training in holistic needs assessment from a clinical psychologist who specialised in psycho‐oncology. The research team attended six staff meetings and informal visits to offer ongoing support to the clinicians throughout the trial period. However, after 2 years only 10 participants had been recruited in total and so the trial was stopped.

A randomized, controlled trial began in 2013 to examine the impact of holistic needs assessment (HNA) in community palliative care. Holistic needs assessment is:

“…a process of gathering and discussing information with the patient and/or carer/supporter in order to develop an understanding of what the person living with and beyond cancer knows, understands and needs. This holistic assessment is focused on the whole person, their entire well‐being is discussed – physical, emotional, spiritual, mental, social, and environmental. The process culminates when the assessment results are used to inform a care plan.” (National Cancer Survivorship Initiative 2013)

The UK Gold Standards Framework and NICE guidelines (2004) promote the importance of holistic assessment in palliative care, yet there is limited research on the impact of this intervention. Therefore, a protocol was developed to examine its efficacy, consistent with a comparable study in acute care (Snowden et al. 2015). Two community hospice teams volunteered to participate. The teams provided care to individuals across two contrasting geographical areas; one urban and one rural. Community nurses were required at their routine home visits to invite patients with a diagnosis of cancer to take part. Inclusion and exclusion criteria were:

Inclusion:

Community outpatient under the palliative care of the site.
Over 18, capable of informed consent and expresses a wish to participate.
Diagnosed with cancer.

Exclusion criteria:

Non English speaker
Person deemed incapable of consenting to participate as defined by the Adults with Incapacity Act (2000)l
Individuals that are in the last weeks of their life as identified by a member of the clinical care team.

If patients agreed then the clinician would either integrate the HNA into their visits (experimental group) or not (control group). All consultations were to be audio‐recorded and then analysed by the research team to establish the impact of the intervention (Snowden et al., 2015).The NHS and university ethics committees had approved the study and the participating organizations were keen to be involved. The research team was multi‐disciplinary including an international team specializing in conversation analysis (Lussier et al. 2013). For sufficient power the study needed 60 participants in each arm, 120 in total. Before recruitment began the clinicians received training in holistic needs assessment from a clinical psychologist who specialised in psycho‐oncology. The research team attended six staff meetings and informal visits to offer ongoing support to the clinicians throughout the trial period. However, after 2 years only 10 participants had been recruited in total and so the trial was stopped.