Supportive care of rural women with breast cancer in Tasmania, Australia: changing needs over time

Abstract

Providing for patients' psychosocial needs is a potential means of minimising cancer morbidity. Needs assessments can guide responsive patient-centred care. A longitudinal survey of women with early breast cancer consulting a breast nurse in a primarily rural state of Australia was undertaken to measure unmet supportive care needs, identify changes in unmet needs across time and compare results with previous studies. Needs assessments were completed with the Supportive Care Needs Survey (SCNS) at 1 month (n = 74) and 3 months (n = 83) post-diagnosis. Access to services was also examined. High levels of psychological and health system and information needs were identified at 1 month post-diagnosis, but these decreased significantly at 3 months post-diagnosis. Sexuality domain needs increased significantly during the same time. Compared to a previous SCNS study of rural women with breast cancer, unmet supportive care needs in this study were significantly lower than previously reported, although assistance with energy levels (i.e. fatigue) continues to be an unmet need for women with breast cancer. Results suggest there have been positive cultural changes within healthcare systems, specifically in better informing patients and providing support. Although services appear to be more responsive to breast cancer patients, significant unmet needs still exist.

The needs of patients with advanced, incurable cancer

“…This result is not surprising given the nature of this patient population's prognosis. The results are similar to those in literature using the Supportive Care Needs Survey, examining, in general, the needs of cancer patients, those with brain tumours, those with melanoma and those with breast cancer (Bonevski et al, 1999;Sanson-Fisher et al, 2000;Janda et al, 2008;Minstrell et al, 2008).…”

Psychosocial well-being and supportive care needs of cancer patients living in urban and rural/regional areas: a systematic review

“…The possibility for bias in the recruitment process was noted in many studies [e.g. 35,40]. Almost all the studies (including population based studies with a control group) used a cross sectional design, leading to a lack of measurement of long term outcomes and an inability to explore causality.…”

“…The single longitudinal study, with a sample of 89 Australian women with breast cancer [35], reported that most needs decreased significantly between 1 and 3 months post diagnosis, although sexuality needs increased over this timeframe. The most common reported needs at one month post diagnosis were psychological: worries for those closest to you, fears about the cancer spreading, fears about the cancer returning and anxiety about having treatment.…”

“…There were 14 quantitative studies without a control group, three on emotional aspects, three on travel issues and eight on needs and quality of life, all in the active phase of treatment [9,11,[26][27][28][29][30][31][32][33][34][35][36][37]. Only one study [35] was longitudinal.…”

Unmet psychosocial needs in haematological cancer: a systematic review

“…Clinically, those requiring more intensive treatment and those diagnosed at a more advanced stage are also known to report greater need, with further variance observed across time from diagnosis to follow-up care [11].…”