Using a whole person approach to support people with cancer: a longitudinal, mixed methods service evaluation

Introduction: Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this paper is to (1) evaluate short and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC); (2) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods: Longitudinal mixed-methods service evaluation (n=135). Data collected included health related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity - MYCaW); lifestyle behaviour (bespoke questionnaire) and participants’ experiences over 12 months post course. Results: Statistically and clinically significant improvements from baseline - 12 months in severity of MYCaW Concerns (n=64; p<0.000) and mean total HRQoL (n=66; p<0.000). The majority of MYCaW concerns were ‘psychological and emotional’ and about participants’ wellbeing. Spiritual, emotional and functional wellbeing contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. 3-6 months post-course was identified as the time when more support was most likely to be needed. Conclusions: Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behaviour change were also identified. These data then informed wider and more person-centred clinical provision to increase the maintenance of positive long-term behaviour changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.

Introducing Intercultural Communication into the Teaching of Translation

This article examines how the teaching of translation at university level can come to include the systematic development of intercultural skills. It will do this initially by presenting the methodology and outcomes of a European Union funded project entitled ‘Promoting Intercultural Competence in Translators’. The precise aims, context, participants, timing and working methodology of the project will be clearly outlined. This will be followed by an explanation of key theoretical principles which underlay the project and which were embodied in a ‘good practice guide’ at its conclusion. The project produced three key outputs freely available on the project website aimed to help university lecturers in Translation to enhance the development of students’ intercultural skills – a ‘curriculum framework’ (syllabus), teaching materials and assessment materials, for each of which the theoretical/pedagogical underpinning will be explained and examples provided. The article will conclude with an extended reflective section examining some of the limits of the project, areas in which it could be further developed or adapted to context, finishing with an indication of areas in which further research is needed.