A literature review examines needs assessment for people with cancer and identified needs in the domains of medical care, psycho-social support, information, distress amelioration, psychological support, existential and spiritual well-being. The review also considers the emerging literature concerned with the benefits some people describe as resulting from their experience of cancer. The literature reviewed, suggests that non-medical aspects of a person's well-being have a significant role in the person's adjustment to cancer and treatment. The small amount of research in the domains of existential and spiritual well-being suggests the need for these aspects of a person's functioning to be included in any holistic assessment of need. Further, the need for furihdr research of the links between existential and spiritual well-being and adjustment to cancer is highlighted as an important first step in understanding the needs of people with cancer in a holistic way. The Empirical study was conducted as part of the larger `CancerCAN' study (see Zinovieff, Morrison, Coles and Cartmel, 2005) that has developed a tool for the assessment of cancer patients' needs'. The present study employed focus groups to explore the existential and spiritual needs of 9 people with cancer. A content analysis identified a wide range of psychosocial needs. An Interpretative Phenomenological Analysis (IPA) idehtified a master theme labelled as `positive coping as a priority in dealing with adversity'. Existential and spiritual sub-themes were identified and labelled as 1: the possession of faith; 2: meaning and purpose from cancer; 3: changes in perspective as a result of experiencing cancer; 4: anxieties about the future, and; 5: issues of control. It is concluded that Existential and spiritual aspects of the person are personally significant for people with cancer and require inclusion in holistic assessment of cancer patients' needs'. Theoretical and clinical implications are considered in a final chapter.

Cette recherche exploratoire longitudinale a pour objectif principal d'évaluer l'impact psychologique de la découverte et du traitement de cancer chez la femme enceinte et chez la femme en post-partum. De manière plus précise nous évaluons l'influence de la maternité sur l'ajustement à la maladie cancéreuse et l'influence de la survenue du cancer sur le processus de parentalisation. Cette recherche permet d'appréhender le risque psychopathologique réel de cette situation comportant de nombreux éléments dépressiogènes et anxiogènes ainsi que le risque de pathologisation du lien mère-enfant. L'analyse quantitative et qualitative des données permettra in fine d'établir des recommandations concernant l'accompagnement psychologique des femmes rencontrant cette situation. Ce travail a pour particularité de faire le lien entre deux champs théoriques distincts: la psychologie périnatale et la psycho-oncologie. / This longitudinal exploratory study aims at assessing the psychological impact of the discovery and cancer treatment in pregnant women and in women postpartum. More specifically we evaluate the influence of motherhood on adjusting to cancer disease and the influence of the occurrence of cancer in the parentalisation process. This research allows us to understand the real psychopathological risk of this situation with many elements dépressiogènes and anxiety and the risk of pathologizing the mother-child bond. The quantitative and qualitative analysis of the data will ultimately establish recommendations for counseling of women encountering this situation. This work has the particularity to make the connection between two different theoretical fields: perinatal psychology and psycho-oncology.