{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:41:52Z","timestamp":1788406912609,"version":"build-2803163510"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vrienden UMC Utrecht"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>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: <jats:italic><jats:italic>\u2018Medical 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\u2019.<\/jats:italic><\/jats:italic><\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330384","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T17:24:45Z","timestamp":1757438685000},"page":"e0330384","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Towards a definition of an existential approach in cancer patients: a co-produced scoping review"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1295-2052","authenticated-orcid":true,"given":"Anouk M.","family":"de Sain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Ruis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot L.","family":"Zomers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjon E. G.","family":"ten Hoor-Suykerbuyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Kuunders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9082-5991","authenticated-orcid":true,"given":"Filip Y. F. L.","family":"de Vos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Janssens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Seute","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"issue":"1","key":"pone.0330384.ref001","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejso.2022.08.021","article-title":"Effect of standardised surgical assessment and shared decision-making on morbidity and patient satisfaction after breast conserving therapy: A cross-sectional study","volume":"49","author":"I Aristokleous","year":"2023","journal-title":"European Journal of Surgical Oncology"},{"issue":"6","key":"pone.0330384.ref002","doi-asserted-by":"crossref","DOI":"10.1093\/annonc\/mdv131","article-title":"Life expectancy of colon, breast, and testicular cancer patients: An analysis of US-SEER population-based data","volume":"26","author":"R Capocaccia","year":"2015","journal-title":"Annals of Oncology"},{"issue":"16","key":"pone.0330384.ref003","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1093\/jnci\/djn250","article-title":"A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue","volume":"100","author":"O Minton","year":"2008","journal-title":"J Natl Cancer Inst"},{"issue":"7","key":"pone.0330384.ref004","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1016\/j.pec.2021.11.010","article-title":"\u201cEh - What type of cells are these - flourishing in the liver?\u201d Cancer patients\u2019 disclosure of existential concerns in routine hospital consultations","volume":"105","author":"BH Larsen","year":"2022","journal-title":"Patient Educ Couns"},{"issue":"5","key":"pone.0330384.ref005","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1002\/(SICI)1099-1611(199909\/10)8:5<378::AID-PON406>3.0.CO;2-A","article-title":"Seeking meaning and hope: self-reported spiritual and existential needs among an ethnically-diverse cancer patient population","volume":"8","author":"A Moadel","year":"1999","journal-title":"Psychooncology"},{"issue":"2","key":"pone.0330384.ref006","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1017\/S1478951511000745","article-title":"The salience of existential concerns across the cancer control continuum","volume":"10","author":"V Lee","year":"2012","journal-title":"Palliat Support Care"},{"issue":"10","key":"pone.0330384.ref007","doi-asserted-by":"crossref","first-page":"3062","DOI":"10.1016\/j.pec.2022.06.007","article-title":"Physicians\u2019 responses to advanced cancer patients\u2019 existential concerns: A video-based analysis","volume":"105","author":"BH Larsen","year":"2022","journal-title":"Patient Educ Couns"},{"issue":"1","key":"pone.0330384.ref008","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1177\/0898010108323302","article-title":"Existential and spiritual needs in mental health care: an ethical and holistic perspective","volume":"27","author":"T Koslander","year":"2009","journal-title":"J Holist Nurs"},{"issue":"11","key":"pone.0330384.ref009","doi-asserted-by":"crossref","first-page":"2525","DOI":"10.1002\/pon.4872","article-title":"Existential distress in cancer: Alleviating suffering from fundamental loss and change","volume":"27","author":"S Vehling","year":"2018","journal-title":"Psychooncology"},{"issue":"1","key":"pone.0330384.ref010","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijsu.2006.01.005","article-title":"The evolution of the doctor-patient relationship","volume":"5","author":"R Kaba","year":"2007","journal-title":"International Journal of Surgery"},{"issue":"3","key":"pone.0330384.ref011","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1177\/0022146520943514","article-title":"The Engaged Patient: The Relevance of Patient-Physician Communication for Twenty-First-Century Health","volume":"61","author":"S Timmermans","year":"2020","journal-title":"J Health Soc Behav"},{"issue":"1","key":"pone.0330384.ref012","doi-asserted-by":"crossref","DOI":"10.1177\/0825859719839332","article-title":"The physician\u2019s role in responding to existential suffering: what does it mean to comfort always?","volume":"35","author":"HL Amonoo","year":"2020","journal-title":"J Palliat Care"},{"issue":"2","key":"pone.0330384.ref013","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1080\/02813432.2018.1459235","article-title":"Developing and evaluating a course programme to enhance existential communication with cancer patients in general practice","volume":"36","author":"EA Hvidt","year":"2018","journal-title":"Scand J Prim Health Care"},{"issue":"11","key":"pone.0330384.ref014","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1136\/jme.2010.041988","article-title":"Courteous but not curious: how doctors\u2019 politeness masks their existential neglect. A qualitative study of video-recorded patient consultations","volume":"37","author":"KM Agledahl","year":"2011","journal-title":"J Med Ethics"},{"issue":"2","key":"pone.0330384.ref015","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1177\/0300891618765546","article-title":"Relationships among unmet needs, depression, and anxiety in non-advanced cancer patients","volume":"105","author":"M Ferrari","year":"2019","journal-title":"Tumori"},{"key":"pone.0330384.ref016","doi-asserted-by":"crossref","unstructured":"Bibbins-Domingo K, Brubaker L, Curfman G. The 2024 Revision to the Declaration of Helsinki. JAMA [Internet]. 2024 Oct 19; Available from: https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2825292","DOI":"10.1001\/jama.2024.22530"},{"issue":"3","key":"pone.0330384.ref017","doi-asserted-by":"crossref","DOI":"10.1038\/s41893-019-0448-2","article-title":"Principles for knowledge co-production in sustainability research","volume":"3","author":"AV Norstr\u00f6m","year":"2020","journal-title":"Nat Sustain"},{"key":"pone.0330384.ref018","doi-asserted-by":"crossref","DOI":"10.17226\/12458","article-title":"Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research","author":"SJ Nass","year":"2009","journal-title":"Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research"},{"key":"pone.0330384.ref019","doi-asserted-by":"crossref","DOI":"10.1111\/hex.12821","article-title":"The potential for coproduction to add value to research","volume":"21","author":"G Hickey","year":"2018","journal-title":"Health Expectations"},{"key":"pone.0330384.ref020","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s40900-015-0003-x","article-title":"Patients\u2019, clinicians\u2019 and the research communities\u2019 priorities for treatment research: there is an important mismatch","volume":"1","author":"S Crowe","year":"2015","journal-title":"Res Involv Engagem"},{"key":"pone.0330384.ref021","doi-asserted-by":"crossref","DOI":"10.1002\/pon.1424","article-title":"Existential concerns among patients with cancer and interventions to meet them: An integrative literature review","volume":"18","author":"I Henoch","year":"2009","journal-title":"Psycho-Oncology"},{"issue":"5","key":"pone.0330384.ref022","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.outlook.2019.03.006","article-title":"A concept analysis of the existential experience of adults with advanced cancer","volume":"67","author":"EC Tarbi","year":"2019","journal-title":"Nurs Outlook"},{"issue":"2","key":"pone.0330384.ref023","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/SPC.0b013e3283530e25","article-title":"An existential approach to oncology: meeting the needs of our patients","volume":"6","author":"ID Wexler","year":"2012","journal-title":"Curr Opin Support Palliat Care"},{"key":"pone.0330384.ref024","doi-asserted-by":"crossref","DOI":"10.1002\/pon.4829","article-title":"Effects of existential interventions on spiritual, psychological, and physical well-being in adult patients with cancer: systematic review and meta-analysis of randomized controlled trials","volume":"27","author":"N Bauerei\u00df","year":"2018","journal-title":"Psycho-Oncology"},{"issue":"1","key":"pone.0330384.ref025","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s12874-018-0611-x","article-title":"Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach","volume":"18","author":"Z Munn","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"pone.0330384.ref026","doi-asserted-by":"crossref","DOI":"10.1111\/hex.13787","article-title":"The benefits, challenges, and best practice for patient and public involvement in evidence synthesis: A systematic review and thematic synthesis","volume":"26","author":"E Agyei-Manu","year":"2023","journal-title":"Health Expectations"},{"issue":"1","key":"pone.0330384.ref027","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"H Arksey","year":"2005","journal-title":"Int J Soc Res Methodol"},{"issue":"1","key":"pone.0330384.ref028","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/XEB.0000000000000277","article-title":"Updated methodological guidance for the conduct of scoping reviews","volume":"19","author":"MDJ Peters","year":"2021","journal-title":"JBI Evid Implement"},{"key":"pone.0330384.ref029","doi-asserted-by":"crossref","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"AC Tricco","year":"2018","journal-title":"Annals of Internal Medicine"},{"issue":"1","key":"pone.0330384.ref030","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12904-023-01221-5","article-title":"Interdisciplinary collaboration in serious illness conversations in patients with multiple myeloma and caregivers - a qualitative study","volume":"22","author":"CB Myrh\u00f8j","year":"2023","journal-title":"BMC Palliat Care"},{"issue":"1","key":"pone.0330384.ref031","article-title":"Serious illness conversations in patients with multiple myeloma and their family caregivers-A qualitative interview study","volume":"31","author":"C Borregaard Myrh\u00f8j","year":"2022","journal-title":"Eur J Cancer Care (Engl)"},{"issue":"10","key":"pone.0330384.ref032","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1089\/jpm.2020.0696","article-title":"I Had a Lot More Planned: The Existential Dimensions of Prognosis Communication with Adults with Advanced Cancer","volume":"24","author":"EC Tarbi","year":"2021","journal-title":"J Palliat Med"},{"issue":"4","key":"pone.0330384.ref033","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/nuf.12595","article-title":"Lived experiences and caring needs in young adults diagnosed with cancer","volume":"56","author":"MEJ Alander","year":"2021","journal-title":"Nurs Forum"},{"issue":"4","key":"pone.0330384.ref034","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3928\/00485713-20120323-06","article-title":"A 60-Year-Old Male with Hairy-Cell Leukemia and Existential Distress","volume":"42","author":"RC Meisner","year":"2012","journal-title":"Psychiatr Ann"},{"issue":"8","key":"pone.0330384.ref035","first-page":"625","article-title":"Existential support in brain tumour patients and their spouses","volume":"9","author":"S Strang","year":"2001","journal-title":"Support Care Cancer"},{"issue":"3","key":"pone.0330384.ref036","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ejon.2005.06.002","article-title":"Life, illness and death--existential reflections of a Swedish sample of patients who have undergone curative treatment for breast or prostatic cancer","volume":"10","author":"B Westman","year":"2006","journal-title":"Eur J Oncol Nurs"},{"issue":"11","key":"pone.0330384.ref037","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1002\/pon.4823","article-title":"Perceived doctor-patient relationship and its association with demoralization in patients with advanced cancer","volume":"27","author":"L Quintero Garz\u00f3n","year":"2018","journal-title":"Psychooncology"},{"key":"pone.0330384.ref038","article-title":"Compassionate Presence in Seriously Ill Cancer Patients","author":"M Renz","year":"2024","journal-title":"Am J Hosp Palliat Care"},{"issue":"2","key":"pone.0330384.ref039","article-title":"The illness reframing process in an ethnic-majority population of older people with incurable cancer: variations of cultural- and existential meaning-making adjustments","volume":"19","author":"SHK Haug","year":"2016","journal-title":"Ment Health Relig Cult"},{"issue":"4","key":"pone.0330384.ref040","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1017\/S1478951520000899","article-title":"What symptoms tell us: A multiple case study of oncology consultations","volume":"19","author":"C Bourquin","year":"2021","journal-title":"Palliat Support Care"},{"key":"pone.0330384.ref041","doi-asserted-by":"crossref","first-page":"700285","DOI":"10.3389\/fpsyg.2021.700285","article-title":"Older Adults\u2019 Experience of Meaning at the End of Life in Two Danish Hospices: A Qualitative Interview Study","volume":"12","author":"DT Viftrup","year":"2021","journal-title":"Front Psychol"},{"issue":"4","key":"pone.0330384.ref042","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1177\/1363459315617312","article-title":"The existential cancer journey: Travelling through the intersubjective structure of homeworld\/alienworld","volume":"21","author":"EA Hvidt","year":"2017","journal-title":"Health (London)"},{"issue":"7","key":"pone.0330384.ref043","doi-asserted-by":"crossref","DOI":"10.1503\/cmaj.111622","article-title":"Social, psychological and existential well-being in patients with glioma and their caregivers: a qualitative study","volume":"184","author":"D Cavers","year":"2012","journal-title":"CMAJ"},{"issue":"1","key":"pone.0330384.ref044","doi-asserted-by":"crossref","DOI":"10.1188\/12.CJON.E1-E8","article-title":"The challenge of existential issues in acute care: nursing considerations for the patient with a new diagnosis of lung cancer","volume":"16","author":"RH Lehto","year":"2012","journal-title":"Clin J Oncol Nurs"},{"issue":"9","key":"pone.0330384.ref045","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1016\/j.jclinepi.2014.12.017","article-title":"Using data sources beyond PubMed has a modest impact on the results of systematic reviews of therapeutic interventions","volume":"68","author":"CW Halladay","year":"2015","journal-title":"J Clin Epidemiol"},{"issue":"1","key":"pone.0330384.ref046","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1186\/s13643-017-0644-y","article-title":"Optimal database combinations for literature searches in systematic reviews: a prospective exploratory study","volume":"6","author":"WM Bramer","year":"2017","journal-title":"Syst Rev"},{"key":"pone.0330384.ref047","doi-asserted-by":"crossref","DOI":"10.1111\/jocn.14372","article-title":"Patients\u2019 experiences and care needs during the diagnostic phase of an integrated brain cancer pathway: A case study","volume":"27","author":"TW Vedel\u00f8","year":"2018","journal-title":"J Clin Nurs"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0330384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T17:24:52Z","timestamp":1757438692000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0330384"}},"subtitle":[],"editor":[{"given":"Nicola","family":"Diviani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":47,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0330384","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]}}}