Towards a definition of an existential approach in cancer patients: a co-produced scoping review

Attention to existential needs has become part of daily treatment. Studies have described the concepts of existential experiences and existential interventions. However, a consensus or conceptual clarity regarding an existential approach in cancer patients is currently missing. This scoping review investigates the term existential approach and suggests a definition.

We searched PubMed, Embase, Web of Science, and PsycINFO databases until March 2024. We used the Joanna Briggs Institute guidance, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews to conduct the review in a systematic manner. The review was conducted in collaboration with patient colleagues who were diagnosed with cancer. Two categories were included: 1) articles investigating elements that are present in existential approaches according to patients and 2) articles investigating elements that are not yet present in existential approaches but recommended by patients.

2791 articles were identified for title and abstract screening, of which 90 were screened for full text. Seventeen articles were eligible for inclusion. Elements were identified that led to the following definition of an existential approach: 'Medical practice based on a holistic and interdisciplinary view wherein the personal alliance provides room for mutual sharing of thoughts, acknowledging existential issues besides medical issues, whilst paying attention to personal values and what matters most'.

This definition provides a framework and therefore makes an existential approach more applicable. Different healthcare providers (e.g., nurses/physicians) can be part of an existential approach. To provide an existential approach in daily treatment, future studies should focus on training in communication skills.