Predictors of change in unmet supportive care needs in cancer

Abstract

Objective: Patient Reported Outcome (PRO) assessments can assist health professionals to tailor their health practices to the individual needs of patients and improve patient care over time. The present study assessed prospective predictors of unmet supportive care needs in cancer patients over a six-month period.Methods: Participants were recruited from a regional cancer treatment centre in Australia and completed the Supportive Care Needs Survey (SCNS) at recruitment (n 5 439; 61.4% response rate) and six months follow-up (n 5 396). Hierarchical logistic regression was used to identify predictors of change in unmet needs across each supportive care domain. Predictor variables were socio-demographic, treatment and psychosocial factors including depression, anxiety, social support, and patient satisfaction.Results: Unmet needs were reported by approximately two-thirds of patients at baseline and half of patients at six months follow-up. Having unmet needs at baseline was the strongest predictor of unmet needs at six months. Longer time since diagnosis was a consistent predictor of greater unmet needs, associated with change in physical/daily living, psychological and health system and information unmet needs over time. By contrast, a complex relationship was found in that patient satisfaction, psychosocial and treatment characteristics predicted higher needs in some domains and lower needs in others.Conclusions: Unmet supportive care needs persist over time and psychological needs may emerge later in the illness continuum. Interventions to meet the needs of longer term cancer survivors are needed and should closely articulate with reported supportive care needs.

Self-Disclosure of Breast Cancer Diagnosis by Iranian Women to Friends and Colleagues

“…The ability of patients with BC to return to work after diagnosis and treatment is an important survivorship issue because it may have consequences related to quality of life and income (McDowell et al, 2010).The impact of support on work outcomes is important in BC survivors, but social support in the context of BC diagnosis may be complicated by potential negative outcomes of disclosure of diagnosis (Frazier et al, 2009). Fears of being stigmatised and being dismissed from work following discovery of an individual's BC diagnosis are a few reasons why disclosure may not occur.…”

Associations between neighbourhood support and financial burden with unmet needs of head and neck cancer survivors

“…In their paper on supportive care needs of cancer patients in the immediate post treatment phase, Armes suggests that factors such as specific coping style and perceived social support may be influential in determining supportive care need [9]. McDowell et al [10] also found that a lower level of social support predicted unmet supportive care needs in the sexuality domain for patients/survivors with a variety of cancers and treatments. We postulated that a deficit in social support is associated with increased unmet needs in head and neck cancer survivors.…”

Desarrollo del cuestionario español para medir necesidades no cubiertas de supervivientes de cáncer (CESC)

“…Entre los aportes del presente estudio se quiere destacar que se trata de un estudio pionero para esta población. Además, las características de la muestra han puesto en evidencia las necesidades de los supervivientes de edad menor de 40 años, menos estudiada y más propensa a presentar necesidades no cubiertas (28,29,31) . Además, la mayoría de los encuestados presenta problemas a nivel de la reinserción laboral y que ninguno de los encuestados recibió asistencia para poder resolver estos problemas, cuestión que resulta de interés y estudio a nivel internacional (32)(33) .…”