Risk factors of unmet needs among women with breast cancer in the post‐treatment phase

Abstract

Objective Unmet health care needs require additional care resources to achieve optimal patient well‐being. In this nationwide study we examined associations between a number of risk factors and unmet needs after treatment among women with breast cancer, while taking into account their health care practices. We expected that more care use would be associated with lower levels of unmet needs. Methods A multicenter, prospective, observational design was employed. Women with primary breast cancer completed questionnaires 6 and 15 months post‐diagnosis. Medical data were retrieved from medical records. Direct and indirect associations between sociodemographic and clinical risk factors, distress, care use, and unmet needs were investigated with structural equation modeling. Results Seven hundred forty‐six participants completed both questionnaires (response rate 73.7%). The care services received were not negatively associated with the reported levels of unmet needs after treatment. Comorbidity was associated with higher physical and daily living needs. Higher age was associated with higher health system‐related and informational needs. Having had chemotherapy and a mastectomy were associated with higher sexuality needs and breast cancer‐specific issues, respectively. A higher level of distress was associated with higher levels of unmet need in all domains. Conclusions Clinicians may use these results to timely identify which women are at risk of developing specific unmet needs after treatment. Evidence‐based, cost‐effective (online) interventions that target distress, the most influential risk factor, should be further implemented and disseminated among patients and clinicians.

Design of a randomized controlled trial of a partnership-based, needs-tailored self-management support intervention for post-treatment breast cancer survivors

“…Second, EM-POWER is needs-tailored. Although substantial BCS have unmet needs after cancer treatment [40,41], there is a lack of interventions that meet their supportive care needs in a personalized manner. We believe that EM-POWER's Part 2 intervention (4-week SM skill training for participant's chosen topic) will work as a needsbased tailored intervention.…”

Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes

“…Out of 250 patients, 98 were scheduled for an appointment with the geneticist, 14 were referred for fertility counseling, and an appointment with a geriatrician was arranged for 34 elderly patients. Less attention has been devoted to addressing the specific "unmet needs" that patients may experience during treatment [5]. The benefits of a multimodal prehabilitation model are still emerging in recent studies, particularly during the preoperative period.…”

“…Specific evidence-based guidelines have been released to ensure that each patient treated in the neoadjuvant setting may receive the most effective, evidence-based chemotherapy regimen, in a personalized, multidisciplinary setting (Figure 2). Less attention has been devoted to addressing the specific "unmet needs" that patients may experience during treatment [5]. The benefits of a multimodal prehabilitation model are still emerging in recent studies, particularly during the preoperative period.…”

“…Less attention has been devoted to addressing the specific “unmet needs” that patients may experience during treatment [ 5 ]. The benefits of a multimodal prehabilitation model are still emerging in recent studies, particularly during the preoperative period.…”

Evaluation of the Pathways for Survivors program to address breast cancer survivorship associated distress

“…[1] Transitioning from cancer patient to survivor is challenging, and many breast cancer patients have unmet physical and emotional needs. [2][3][4][5] Studies have found increased rates of anxiety and depression among breast cancer survivors both short and long term, and these problems appear more prominent in younger survivors and those with pre-existing psychological symptoms. [4,6,7] Many studies also identify fear of cancer recurrence (FCR) and di culty in returning to "normalcy" as potential sources of distress in this population.…”