Common, important, and unmet needs of cancer outpatients

Morrison, Val; Henderson, Bethan J.; Zinovieff, F.; Davies, Glesni; Cartmell, R.; Hall, Alix; Gollins, Simon

doi:10.1016/j.ejon.2011.04.004

Cited by 66 publications

(90 citation statements)

References 27 publications

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“…Morrison et al, 2012;Uchida et al, 2011), making it unsurprising that the same has been found in this patient group. The presence of needs relating to tiredness, uncertainty, and fear are bound to make people feel as though they are suffering.…”

Section: Discussionmentioning

confidence: 80%

“…anxiety, depression) in cancer patients (e.g. Uchida et al, 2011;Morrison et al, 2012), though there is increased recognition that non-clinical distress is both problematic and an important patient reported outcome indicator in its own right (Bultz & Johansen, 2009). In haematological cancer groups specifically, prevalence of anxiety (27%), depression (17%), and adjustment disorder (19.4%) are high (Clinton-McHarg et al, 2014;Mitchell et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…The relationship between presence of unmet need and psychological wellbeing has been recognised within the broader psycho-oncology literature (Armes et al, 2009) and so ongoing assessment of needs is recommended as a way of ensuring that supportive care provision is sufficient to meet the needs of cancer patients and their families Hodgkinson et al, 2007;Morrison et al, 2012), and thus as a pathway to reducing distress and poor quality of life. Unmet needs are typically broken down into sub-domains, often encompassing physical, psychological and emotional, information, care and support, and sexual needs.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

Swash

Bramwell

Hulbert‐Williams

2017

Journal of Contextual Behavioral Science

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BackgroundThe period immediately after the end of cancer treatment is a time when supportive care for the cancer patient decreases; this is known to increase risk of psychological distress and poor wellbeing.While there is broad recognition that unmet psychological and supportive care needs correlate with psychological wellbeing, little is understood about the factors that influence this relationship. This study explores the role of psychological flexibility, with a particular focus on its potential moderating role between unmet needs and psychological distress in haematological cancer survivors. Materials and MethodHaematological cancer survivors were recruited for this cross-sectional study through two major UK blood cancer charities. Participants (n=91) were all over the age of 16 and had been diagnosed with any sub-type of haematological cancer more than 18 months previously. Participants completed selfreport questionnaires assessing unmet psychological and supportive care needs (SCNS SF34), anxiety and depression (HADS), quality of life (EORTC QLQ-C30) and psychological flexibility (AAQ II). ResultsHigh levels of both unmet need and distress were present in the sample, indicating on-going care needs for these cancer survivors. Statistically significant correlations between unmet needs, psychological flexibility and all outcome variables (anxiety, depression, quality of life) were found.Using regression analysis based on Hayes' methodology (Hayes, 2013), psychological flexibility was found to act as a moderator between unmet need and distress in four out of 15 models; specifically, the statistical relationship between need and distress emerged only when levels of psychological flexibility were at average level or above. DiscussionHaematological cancer survivors have on-going supportive care needs that persist well beyond the end of active treatment. Unmet needs can, in turn, increase levels of anxiety and depression, and reduce quality of life in this patient group. The understanding offered by our data that psychological flexibility plays a moderating relationship between need and psychological distress creates opportunities for the development of theoretically-informed interventions to reduce both unmet need and distress in cancer patients. As such, these findings support the growing emphasis on Acceptance and Commitment based interventions for cancer patients.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

Swash

Bramwell

Hulbert‐Williams

2017

Journal of Contextual Behavioral Science

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“…Furthermore, a study conducted by Morrison et al (2012) to explore the unmet needs of cancer patients showed that informational needs about cancer, its treatment and side effects, topped the list of unmet needs. Thus, there is a need for additional studies to explain the reasons for these unmet needs and how patients meet them (Al Qadire, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…It has been demonstrated that, compared to informed patients, uninformed patients are less likely to use preventive services and manage their own cares (Vernon, Trujillo, Rosenbaum, & DeBuono, 2007). Many studies have showed that patients need to know about their disease, diagnosis, prognosis and treatment (Browall, Carlsson, & Horvath, 2004;Morrison, Henderson, Zinovieff et al, 2012;Tsuchiya & Horn, 2009). The most frequently expressed information needs were related to cancer treatment, followed by information related to specific cancer type (Rutten, Arora, Bakos, Aziz, & Rowland, 2005).…”

Section: Introductionmentioning

confidence: 99%

What Are the Unmet Information Needs of Cancer Patients? A Qualitative Study

Yatim¹,

Cristofalo²,

Minvielle³

2017

GJHS

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Objective: Identify the unmet information needs of cancer patients and understand the causes of patients' dissatisfaction Methods: A qualitative method using interviews with cancer patients attending a Meeting and Information Area (ERI) at Gustave Roussy cancer center (France), and focus groups with the ERI professionals. The data were analysed using vertical and horizontal open coding.Results: Firstly, the needs for medical information are important, but there are other types of information that patients need (e.g. organizational information). Secondly, patients' dissatisfaction is not linked only to the lack of medical information; it also reflects other needs, which are not taken into account (e.g. accompanying information to make it understandable and useful). Thirdly, the relationships established over time between patients and professionals make possible the emergence of latent needs (ranging from basic information needs to requests for psychological support). Conclusion:Information must be considered in an integrated and holistic approach to facilitate patients' navigation and improve their health literacy.Practice Implications: The training of healthcare professionals is crucial, but this is not enough. The introduction of other, non-carers professionals is necessary to address a broad range of patients' needs in a more effective and cost-efficient way.

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Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer

Binkley

Harris

Levangie

et al. 2012

Cancer

178

135

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Women's experience of breast cancer is complex, affecting all aspects of life during and after treatment. Patients' perspectives about common impairments and functional limitations secondary to breast cancer treatment, including upper extremity motion restriction, lymphedema, fatigue, weight gain, pain, and chemotherapy-induced peripheral neuropathy, are addressed. Women often report being uninformed regarding these side effects and surprised that they do not always disappear after treatment, but remain part of their lives. Breast cancer patients express strong, unmet needs for education, information, and intervention for these side effects. Evidence suggests that rehabilitation and exercise are effective in preventing and managing many physical side effects of breast cancer treatment. Nevertheless, few women are referred to rehabilitation during or after treatment, and fewer receive baseline assessments of impairment and function to facilitate early detection of impairment and functional limitations. The prospective surveillance model of rehabilitation will serve the needs of women with breast cancer by providing education and information about treatment side effects, reducing the incidence and burden of side effects through early identification and treatment, and enhancing access to timely rehabilitation. Integration of exercise as a component of the model benefits patients at every phase of survivorship, by addressing individual concerns about exercise during and after treatment and highlighting the important contribution of exercise to overall health and survival. The prospective surveillance model of rehabilitation can meet the evident and often expressed needs of survivors for information, guidance, and intervention-thus addressing, and potentially improving, overall quality of life for individuals diagnosed with and treated for breast cancer. Women's experience of breast cancer is complex, affecting all aspects of their lives during and after treatment. Although each woman's experience with breast cancer is unique, they share common perspectives related to the physical and functional side effects of breast cancer treatment. Activity limitation, upper extremity motion restriction, lymphedema, fatigue, pain, and chemotherapy-induced peripheral neuropathy (CIPN) are well-documented concerns of breast cancer survivors.1-5 Impairments such as limited range of motion, pain, and fatigue appear to be inter-related, and may have an additive effect. Women note that upper extremity issues, fatigue, pain, depression, and body image disturbance tend to compound each other and impact quality of life.6-9 Less information is available about women's concerns regarding other treatment side effects addressed in this supplement (eg, arthralgias, osteoporosis, and cardiotoxicity). This may be because of lack of awareness of these potential long-term side effects, as research about their prevalence and time course is more recent. Cumulatively, these observations provide strong evidence of an unmet need for cancer patients gene...

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Common, important, and unmet needs of cancer outpatients

Cited by 66 publications

References 27 publications

Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility

What Are the Unmet Information Needs of Cancer Patients? A Qualitative Study

Patient perspectives on breast cancer treatment side effects and the prospective surveillance model for physical rehabilitation for women with breast cancer

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