Meeting the needs of people with cancer for support and self-management.

Health professionals tend to consider that they are in the best position to decide treatment options for cancer patients despite research evidence that a feeling of powerlessness can affect health outcomes and the inclusion of patient empowerment within government policy. This article describes a focus group study, carried out in collaboration with the University of Warwick, aiming to elicit the needs of people with cancer and their carers/supporters, the reactions to these needs and the strategies adopted to obtain support and self-management skills. The methodology was II two-stage focus groups carried out in four English cities in 1998, involving 54 people with cancer and 14 supporters. The main study findings identified a parallel 'journey' to the previously described emotional and medical cancer journey in the form of an epistemological journey of 'identity shifts' as people progressed through their disease. People required additional emotional and psychological support when these shifts were taking place and used a variety of strategies to obtain this, including the use of complementary therapies and other strategies designed to increase their sense of control. The article concludes by describing a 'holistic' approach to cancer care which supports patient empowerment and recommendations for implementing the research findings into practice.