Exploring how well MidCentral DHB cancer services are meeting the supportive needs of their patients : a mixed methods approach : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Manawatū, Aotearoa/New Zealand

Abstract

Cancer will affect most people in their lifetime, directly or through a family/whānau member or friend. It can have a profound impact on those affected, not just physically, but emotionally, socially, and spiritually. As those affected try to deal with cancer and its treatment, they experience certain needs to help cope with the experience. Supportive care aims to provide the support required to meet these needs. The current study aimed to find out how well MidCentral DHB cancer services are meeting the supportive care needs of their patients, using audit methodology. A mixed-method approach was employed to explore the perspectives of staff and patients. Surveys were utilised with both groups, and interviews were conducted with seven patients to further explore the supportive care needs and unmet needs of this group. The staff survey results found high agreement for having sufficient understanding of patient needs, however, staff were less confident in using tools to identify these needs with patients. Thematic analysis of the staff comments identified one key theme; 𝘤𝘰𝘯𝘴𝘵𝘳𝘢𝘪𝘯𝘵𝘴, and three subthemes: 𝘓𝘪𝘮𝘪𝘵𝘴 𝘰𝘧 𝘴𝘱𝘢𝘤𝘦 𝘢𝘯𝘥 𝘱𝘭𝘢𝘤𝘦; 𝘐𝘮𝘱𝘰𝘳𝘵𝘢𝘯𝘵, 𝘣𝘶𝘵 𝘯𝘰𝘵 𝘱𝘳𝘢𝘤𝘵𝘪𝘤𝘢𝘭; and 𝘞𝘰𝘳𝘬𝘪𝘯𝘨 𝘸𝘪𝘵𝘩𝘪𝘯 𝘤𝘰𝘯𝘴𝘵𝘳𝘢𝘪𝘯𝘵𝘴. Overall, patient survey results found that most believed their needs were well met. Lower agreement was found with patients’ psychological, social and spiritual needs being identified and addressed. Thematic analysis of patient qualitative data identified four themes: 1. 𝘗𝘦𝘰𝘱𝘭𝘦 𝘸𝘪𝘭𝘭 𝘯𝘦𝘷𝘦𝘳 𝘧𝘰𝘳𝘨𝘦𝘵 𝘩𝘰𝘸 𝘺𝘰𝘶 𝘮𝘢𝘥𝘦 𝘵𝘩𝘦𝘮 𝘧𝘦𝘦𝘭 (𝘴𝘶𝘣𝘵𝘩𝘦𝘮𝘦𝘴: 𝘱𝘰𝘴𝘪𝘵𝘪𝘷𝘦 𝘪𝘯𝘵𝘦𝘳𝘢𝘤𝘵𝘪𝘰𝘯𝘴, 𝘫𝘶𝘴𝘵 𝘢𝘯𝘰𝘵𝘩𝘦𝘳 𝘤𝘢𝘴𝘦, 𝘢𝘯𝘥 𝘤𝘰𝘯𝘤𝘦𝘳𝘯 𝘧𝘰𝘳 𝘴𝘵𝘢𝘧𝘧); 2. 𝘙𝘰𝘭𝘦 𝘰𝘧 𝘧𝘢𝘮𝘪𝘭𝘺/𝘸𝘩𝘢̄𝘯𝘢𝘶 (subthemes: 𝘍𝘰𝘶𝘯𝘥𝘢𝘵𝘪𝘰𝘯 𝘰𝘧 𝘴𝘶𝘱𝘱𝘰𝘳𝘵 𝘢𝘯𝘥 𝘕𝘶𝘢𝘯𝘤𝘦𝘴 𝘰𝘧 𝘴𝘶𝘱𝘱𝘰𝘳𝘵); 3. 𝘓𝘢𝘤𝘬 𝘰𝘧 𝘱𝘳𝘪𝘷𝘢𝘤𝘺 and 4. 𝘛𝘩𝘦 𝘪𝘮𝘱𝘰𝘳𝘵𝘢𝘯𝘤𝘦 𝘰𝘧 𝘤𝘰𝘮𝘮𝘶𝘯𝘪𝘤𝘢𝘵𝘪𝘰𝘯 𝘢𝘯𝘥 𝘪𝘯𝘧𝘰𝘳𝘮𝘢𝘵𝘪𝘰𝘯 𝘯𝘦𝘦𝘥𝘴 𝘢𝘤𝘳𝘰𝘴𝘴 𝘵𝘩𝘦 𝘤𝘰𝘯𝘵𝘪𝘯𝘶𝘶𝘮. Patients valued the positive interactions they had with staff and the role their family/whānau had in their experience. The other themes highlighted some unmet needs around privacy and communication.