Skip to main content Accessibility help
×
Home
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 1
  • Print publication year: 2004
  • Online publication date: December 2009

15 - Needs assessment in cancer

Summary

Introduction

The needs of a person facing a serious illness such as cancer are very complex. Maslow argues that human needs arrange themselves in “hierarchies of pre-potency” such that the appearance of one depends upon prior satisfaction of more pre-potent needs. The most pre-potent of Maslow's needs are the physiological (e.g., maintaining homeostasis of oxygen, water). When these are not satisfied, as may be the case in a terminal cancer patient, no other needs are important. As long as those needs are satisfied, a patient or family member may be concerned about higher order needs such as the “safety” needs for predictability and orderliness that underlie the fear of the unknown often faced by newly diagnosed cancer patients. As long as these needs are met, one can hope that providers (as well as family and friends) will satisfy needs for affection and caring. And if these needs are met, one can seek to satisfy “esteem” needs such as the need for respect sought by many health care consumers today. Thus needs change as a patient's condition changes.

What are needs?

As discussed in Langley et al., Kano suggests that needs fall into three categories: expected, desired, and unexpected. And different types of needs have different effects on satisfaction. For instance, most patients and family members expect that they will be given the proper medication. Avoiding medication errors will not improve satisfaction, but making errors could devastate satisfaction.

REFERENCES
Maslow, A. (1943). A theory of human motivationPsychology Review 50:370–96
Langley, G., Nolan, K., Nolan, T. et al. (1996). The Improvement Guide. San Francisco: Jossey-Bass
Berwick, D. (1997). The total customer relationship in health care: broadening the bandwidthThe Joint Commission Journal On Quality Improvement 23:245–50
Ross, C., Steward, C., Sinacore, J. M. (1993). The importance of patient preferences in the measurement of health care satisfactionMedical Care 31:138–49
Suchman, A. L., Markakis, K., Beckman, H. B.et al. (1997). A model of empathic communication in the medical interviewJournal of the American Medical Association 277:678–82
Guadagnoli, E., Ward, P. (1998). Patient participation in decision-makingSocial Science and Medicine 47:329–39
Frosch, D. L., Kaplan, R. M. (1999). Shared decision making in clinical medicine: past research and future directionsAmerican Journal of Preventive Medicine 17:285–94
Charles, C., Gafni, A., Whelan, T. (1999). Decision making in the physician-patient encounter: revisiting the shared treatment decision-making modelSocial Science and Medicine 49:651–61
Maguire, P. (1999). Improving communication with cancer patientsEuropean Journal of Cancer 35:1415–22
Cull, A., Stewart, M., Altman, D. (1995). Assessment of and intervention for psychosocial problems in routine oncology practiceBritish Journal of Cancer 72:229–35
Osoba, D. (1996). Rationale for the timing of health related HRQOL assessments in oncological palliative therapyCancer Treatment Review 22A:69–73
Ford, S., Fallowfield, L., Lewis, S. (1996). Doctor-patient interactions in oncologySocial Science and Medicine 42:1511–19
Holland, J. C., Almanza, J. (1999). Giving bad news: is there a kinder, gentler way?Cancer 86:738–40
Kim, M. K., Alvi, A. (1999). Breaking the bad news of cancer: the patient's perspectiveLaryngoscope 109:1064–7
Sabo, D. (1990). Men, death anxiety and denial. In Clinical Sociological Perspectives of Illness and Loss, ed. D. Clark, J. Fritz, P. Rieder, pp. 71–84. Philadelphia, PA: Charles Press
Peters-Golden, H. (1982). Varied perceptions of social support in the illness experienceSocial Science and Medicine 16:463–91
Northouse, L.Peters-Golden, H. (1993). Cancer and the family: strategies to assist spousesSeminars in Oncology Nursing 9:74–82
Cegala, D. J. (1997). A study of doctors' and patients' communication during a primary care consultation: implications for communication trainingJournal of Health Communication 2:169–94
Northouse, L. (1988). Social support in patients and husbands adjustment to breast cancerNursing Research 37:91–5
Northouse, P., Northouse, L. (1987). Communication and cancer: Issues confronting patients, health professionals and caregiversJournal of Psychosocial Oncology 5:17–46
Vitaliano, P. (1997). Physiological and physical concomitants of caregiving; introduction to special issueAnnals of Behavioral Medicine 19:75–7
Schulz, R., Beach, S. (1999). Caregiving as a risk factor for mortalityJournal of the American Medical Association 282:2215–19
Morris, J., Sussa, S., Sherwood, S.et al. (1986). Last days: a study of the HRQOL of terminally ill cancer patientsJournal of Chronic Disease 39:47–62
Ward, S., Goldberg, N., Miller-McCauley, V.et al. (1993). Patient-related barriers to management of cancer painPain 52:319–24
Bretsher, M., Rummons, R., Sloan, J.et al. (1999). HRQOL in hospice patientsPsychosomatics 40:309–13
Silveira, M., Piero, A., Gerrity, M.et al. (2000). Patients knowledge of options at the end of lifeJournal of the American Medical Association 284:2483–8
Institute of Medicine (1997). Approaching Death: Improving Care at the End of Life, ed. M. Field, C. Cassel. Washington, DC: Institute of Medicine
Lawton, M. (2000). The End of Life: Scientific and Social Issues (Annual Review of Gerontology and Geriatrics). New York: Springer
Mor, V., Masterson-Allen, S., Houts, P.et al. (1992). The changing needs of patients with cancer at homeCancer 69:829–38
Northouse, L. (1988). A longitudinal study of the adjustment of patients and husbands to breast cancerOncology Nurses Forum 16:511–16
Ell, K., Nishimoto, R., Mantell, J.et al. (1988). Longitudinal analysis of psychological adaptation among family members of patients with cancerJournal of Psychosomatic Research 32:429–38
Wilson, S., Morse, J. (1991). Living with a wife undergoing chemotherapyImage 23: 78–84
Wilkerson, S. (1991). Factors which influence how nurses communicate with cancer patientsJournal of Advanced Nursing 16:677–88
Gustafson, D. (1991). Expanding on the role of patient as customerQuality Review Bulletin 17:324–5
Ferrans, this volume, Chapter 2
Marvel, M. K., Epstein, R. M., Flowers, K.et al. (1999). Soliciting the patient's agenda: have we improved?Journal of the American Medical Association 281:283–7
Grobe, M. E., Ahmann, D. L., Ilstrup, D. M. (1982). Needs assessment for advance cancer patients and their familiesOncology Nursing Forum 9:26–30
Longman, A. J., Atwood, J. R., Sherman, J. B.et al. (1992). Care needs of home-based cancer patients and their caregiversCancer Nursing 15:182–90
Thomas, S., Jones, Glynne R., Chait, I. (1997). Is it worth the wait? A survey of patients' satisfaction with an oncology outpatient clinicEuropean Journal of Cancer Care in England 6:50–8
Davis, S. W., Quinn, S., Fox, L.et al. (1988). Satisfaction among cancer outpatientsPrograms for Clinical Biological Research 278:227–32
Darby, this volume, Chapter 14
Schag, C. C., Heinrich, R. L., Ganz, P. A. (1983). Cancer Inventory of Problem Situations: an instrument for assessing cancer patients' rehabilitation needsJournal of Psychosocial Oncology 1:11–24
Schag, C. C., Ganz, P. A., Heinrich, R. L. (1991). Cancer Rehabilitation Evaluation System-Short Form (CARES-SF). A cancer specific rehabilitation and quality of life instrumentCancer 15:1406–13
Gates, M. F., Lackey, N. R., White, M. R. (1995). Needs of hospice and clinic patients with cancerCancer Practice 3:226–32
Foot, G., Sanson-Fisher, R. (1995). Measuring the unmet needs of people living with cancerCancer Forum 19:131–5
Bonevski, B., Sanson-Fisher, R., Girgis, A.et al. (2000). Evaluation of an instrument to assess the needs of patients with cancerCancer 88:217–25
McCusker, J. (1984). Development of scales to measure satisfaction and preferences regarding long-term and terminal careMedical Care 22:476–93
Tamburini, M., Gangeri, L., Brunelli, C.et al. (2000). Assessment of hospitalized cancer patients' needs by the Needs Evaluation QuestionnaireAnnals of Oncology 11:31–7
Coyle, N., Goldstein, L., Passik, S.et al. (1996). Development and validation of a patient needs assessment tool (PNAT) for oncology cliniciansCancer Nursing 19:81–92
Derdiarian, A. K. (1986). Informational needs of recently diagnosed cancer patientsNursing Research 36:276–81
Mesters, I., Borne, B., Boer, M. D.et al. (2001). Measuring information needs among cancer patientsPatient Education and Counseling 43:253–62
Boberg, E., Gustafson, D., Hawkins, R. (2002). Assessing the unmet information, support and care delivery needs of men with prostate cancerPatient Education and Counseling 49 (3):233–42
Galloway, S., Graydon, J., Harrison, D.et al. (1997). Informational needs of women with a recent diagnosis of breast cancer: development and initial testing of a toolJournal of Advanced Nursing 25:1175–83
McCarthy, M., Higginson, I. (1991). Clinical audit by a palliative care teamPalliative Medicine 5:215–21
Ellershaw, J. E., Peat, S. J., Boys, L. C. (1995). Assessing the effectiveness of a hospital palliative care teamPalliative Medicine 9:145–52
Emanuel, L. L., Alpert, H. R., Baldwin, D. C.et al. (2000). What terminally ill patients care about: toward a validated construct of patients' perspectivesJournal of Palliative Medicine 3:419–31
Kristjanson, L. J., Atwood, J., Degner, L. F. (1995). Validity and reliability of the Family Inventory of Needs (FIN): measuring the care needs of families of advanced cancer patientsJournal of Nursing Measurement 3:109–26
Kipatrick, M. G., Kristjanson, L. J., Tataryn, D. (1998). Measuring the information needs of husbands of women with breast cancer: validity and reliability of the Family Inventory of Needs-HusbandsOncology Nursing Forum 25:1347–51
Kristjanson, L. J. (1993). Validity and reliability testing of the FAMCARE scale: Measure Family Satisfaction with Advance Cancer CareSocial Science and Medicine 36:693–701
Chalmers, K. I., Luker, K. A., Leinster, S. J.et al. (2001). Information and support needs of women with primary relatives with breast cancer: development of the Information and Support Needs QuestionnaireJournal of Advance Nursing 35:497–507
Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F.et al. (1995). Inventory of complicated grief: a scale to measure maladaptive symptoms of lossPsychiatry Research 59:65–79
Lev, E. L., Munro, B. H., McCorkle, R. (1993). A shortened version of an instrument measuring bereavementInternational Journal of Nursing Studies 30:213–26
Gustafson, D. H., Arora, N. K., Nelson, E. C.et al. (2001). Increasing understanding of patient needs during and after hospitalizationThe Joint Commission Journal on Quality Improvement 27:81–92
Reise, this volume, Chapter 21
Miller, M. (1995). Coefficient alpha: a basic introduction from the perspectives of classical theory and structural equation modelingStructural Equation Modeling 2:255–73
Novick, M., Lewis, C. (1967). Coefficient alpha and the reliability of composite measurementsPsychometrika 32:1–13
Siegel, K., Palamara, M., Karus, D.et al. (1992). Reducing the prevalence of unmet needs for concrete services of patients with cancerCancer 69:1873–83
Flanagan, J. (1954). The critical incident techniquePsychology Bulletin 51:327–58
Craig, T. J., Comstock, G. W., Geiser, P. B. (1974). Quality of survival in breast cancer care — control comparisonCancer 33:1451–7
Fieldman, J. G., Gardner, B., Carter, A. C.et al. (1989). Relationship of race to functional status among breast cancer patients after surgeryJournal of Surgical Oncology 11:333–9
Lehmann, J. F., Delisa, J. A., Warren, C. G.et al. (1978). Cancer rehabilitation: assessment of need, development and evaluation of a model of careArchives of Physical Medicine and Rehabilitation 58:410–19
Mor, V., Guadagnoli, E., Wool, M. (1987). An examination of the concrete service needs of advanced cancer patientsJournal of Psychosocial Oncology 5:1–17
Hilerman, J., Ackerman, N., Hassanein, R. (1992). Identifying the needs of home caregivers of patients with cancerOncology Nursing Forum 19:771–7
Leis, A., Kristjanson, L., Koop, P.et al. (1997). Family health and the palliative care trajectory: a cancer research agendaPrevention et Controle en Cancerologie 1:352–60
Galloway, S. (1994). Meeting information needs of women with breast cancer (Abstract)Canadian Oncology Nursing Journal 14:29
Graf, M. A., Tanner, D. D., Swinyard, W. R. (1993). Optimizing the delivery of patient and physician satisfaction: a conjoint analysis approachHealth Care Management Review 18:34–43
Green, P. E., Srinivasan, V. (1978). Conjoint analysis in customer research: issues and outlookJournal of Customer Research 5:103–23
Green, P. E. (1974). On the design of choice experiments involving multifactor alternativesJournal of Customer Research 1:61–8
Huber, G. P. (1974). Multiattribute utility models: a review of field and field-like studiesManagement Science 20:1393–402
Green, P. E. (1984). Hybrid conjoint analysis: an expository reviewJournal of Marketing Research 21:155–9