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"Holistic Competence": How Is it Developed, Shared, and Shaped by Health Care Professionals Caring for Adolescents and Young Adults with Cancer?

Lea, S; Gibson, F; Taylor, RM; (2021) "Holistic Competence": How Is it Developed, Shared, and Shaped by Health Care Professionals Caring for Adolescents and Young Adults with Cancer? Journal of Adolescent and Young Adult Oncology 10.1089/jayao.2020.0120. (In press).

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Abstract

Purpose: In England, specialist cancer services for adolescents and young adults (young people) aged 15–24 are provided in 13 specialist units, with additional care provided in child and adult cancer units in the region. As a result of specialization, health care professionals (HCPs) have refined their competence, to deliver holistic care that has become central to the culture of young people's cancer care. We sought to understand and describe how HCPs developed this competence. / Methods: We conducted a multiple case study in four regions across England in 24 hospitals. Data were collected through observation of clinical areas, shadowing members of the multidisciplinary team, and semistructured interviews with young people. Data were analyzed thematically and triangulated to draw meaning applicable to a range of contexts. / Results: Young people (n = 29) and HCP (n = 41) across 24 different care settings were interviewed. Holistic competence enabled HCPs to deliver care that considered the age-specific needs of young people, including social, emotional, and psychological needs, in accordance with their life stage and psychosocial development. Development of holistic competence was facilitated by the following four factors: the environment, the experience continuum, enthusiasm, and education. / Conclusion: The four factors facilitating holistic competence were interlinked. Working in a specialist/dedicated environment for young people increased HCPs' exposure to young people. This enabled them to become experienced in young people's cancer care, supported through education and training. Without frequent exposure to young people, HCPs were less able to achieve holistic competence, the impact of which was acutely felt by young people.

Type: Article
Title: "Holistic Competence": How Is it Developed, Shared, and Shaped by Health Care Professionals Caring for Adolescents and Young Adults with Cancer?
Location: United States
DOI: 10.1089/jayao.2020.0120
Publisher version: https://doi.org/10.1089/jayao.2020.0120
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: BRIGHTLIGHT, competence, health care professional, holistic care, knowledge, qualitative research
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10124260
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