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Çelik H, Aslan H. The Relationship Between Cancer Patients' Supportive Care Needs and Their Attitudes Toward Complementary and Alternative Medicine. Niger J Clin Pract 2024; 27:415-423. [PMID: 38679761 DOI: 10.4103/njcp.njcp_377_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/01/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Cancer patients have high supportive care needs related to the nature of the disease and treatment methods. To meet these needs or reduce symptoms, patients can be expected to resort to alternative treatment methods. AIM To examine the relationship between the supportive care needs of cancer patients and their attitudes toward complementary and alternative medicine (CAM). METHODS This was a cross-sectional study involving 289 cancer patients at the Oncology Hospital in east of Turkey. Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF 29) and Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were standard instruments used for data collection. The association between supportive care needs and attitude toward CAM was determined. RESULTS The mean age of the study participants was 56.7 ± 12.7 years. There were 180 females (62.3%) and 109 males (37.7%). The mean score of the SCNS-SF 29 of the study participant was 101.19 ± 33.97. It was found that the patients' psychological needs were the highest, followed by health services and information, daily life, and sexuality needs, respectively. The mean score of the HCAMQ was 27.16 ± 9.54. There was a weak, significant negative correlation between HCAM and psychological supportive care needs (r: -0.240, P: 0.003). However, there was no significant relationship between needs related to health services information, daily life sexuality, and attitudes toward CAM. CONCLUSIONS Cancer patients have high supportive care requirements. Those with high psychological needs have a positive attitude toward HCAM. Incorporation of HCAM in the care of cancer patients may improve their quality of care.
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Affiliation(s)
- H Çelik
- Department of Fundamentals of Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
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Chen F, Ou M, Xia W, Xu X. Psychological adjustment to death anxiety: a qualitative study of Chinese patients with advanced cancer. BMJ Open 2024; 14:e080220. [PMID: 38458799 DOI: 10.1136/bmjopen-2023-080220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES Death anxiety (DA) refers to the negative emotions experienced when a person reflects on the inevitability of their own death, which is common among patients with cancer. It is crucial to understand the causes, coping styles and adjustment processes related to DA. The purpose of this qualitative study is to explore the adaptation process and outcome of patients with advanced cancer with DA and to provide evidence-based support for the development of targeted intervention measures to improve the mental health of such patients. DESIGN This cross-sectional qualitative study sampled patients with advanced cancer (n=20). Grounded theory procedures were used to analyse transcripts and a theoretical model generated. SETTING All interviewees in this study were from a tertiary oncology hospital in Hunan Province, China. The data analysis followed the constructive grounded theory method, involving constant comparison and memo writing. PARTICIPANTS A purposive and theoretical sampling approach was used to recruit 20 patients with advanced cancer with diverse characteristics. RESULTS A total of 20 participants were included in the study. Four stages of DA in patients with advanced cancer were extracted from the interview data: (1) death reminder and prominence; (2) perception and association; (3) defence and control; (4) transformation and Acceptance. CONCLUSIONS This study highlights the psychological status and coping strategies of dynamic nature of patients with advanced cancer when confronted with negative emotions associated with death. It emphasises the importance of timely identification of DA in psychological nursing for patients with advanced cancer and the need for targeted psychological interventions based on their specific psychological processes. IMPLICATIONS Knowing interventions that aim to promote the integration of internal and external resources, enhance self-esteem and facilitate a calm and accepting attitude towards death could ultimately reduce the overall DA of patients with advanced cancer.
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Affiliation(s)
- Furong Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
- University of South China School of Nursing, Hengyang, China
| | - Meijun Ou
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Wanting Xia
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
- Central South University Xiangya School of Nursing, Changsha, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
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Mendes-Santos C, Nóbrega C, Quinta-Gomes AL, Weiderpass E, Santana R, Andersson G. Validation of the Portuguese version of the supportive care needs survey short-form questionnaire (SCNS-SF34-Pt) and the breast cancer supplementary module (SCNS-BR8-Pt). J Psychosoc Oncol 2023; 42:486-505. [PMID: 37975563 DOI: 10.1080/07347332.2023.2282015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE This study aimed to test the psychometric properties of the Portuguese Supportive Care Needs Survey-Short Form-34 (SCNS-SF34-Pt) and its breast cancer-specific complementary module (SCNS-BR8-Pt). A further aim was to characterize Portuguese Breast Cancer Survivors' (BCS) unmet supportive care needs, using these measures. METHODS A convenient sample of BCS was recruited from five hospitals in Portugal and invited to complete SCNS-SF34-Pt and SCNS-BR8-Pt, EORTCQLQC30 and QLQBR23, the Generalized Anxiety Disorder, and the Patient Health-Questionnaire. The validity (i.e. convergent, discriminant and convergent validity) and reliability of SCNS-SF34-Pt and SCNS-BR8-Pt were statistically evaluated. BCS' unmet supportive care needs were descriptively assessed. FINDINGS 336 BCS participated in the study. A four-factor solution was produced for SCNS-SF34-Pt. This solution included the Physical and daily living needs, Psychological needs, Sexuality needs, and Health system, information, and patient support needs dimensions (73% of the total variance; Cronbach's alpha=.82 to .97). SCNS-SF34-Pt demonstrated good convergent validity. It could also discriminate between known-groups regarding age, disease staging, treatment performed, and ECOG performance status. SCNS-BR8-Pt revealed a single-factor structure (62% of the total variance; Cronbach's alpha=.91).Portuguese BCS' most prevalent unmet supportive care needs were associated with the Psychological, and Physical and daily living domains. Fear of cancer spreading, the inability to do things as usual, and lack of energy/tiredness were perceived as issues requiring further supportive care. CONCLUSIONS SCNS-SF34-Pt and the SCNS-BR8-Pt are valid and reliable tools to assess Portuguese BCS' unmet supportive care needs. Fear of cancer spreading and lack of energy/tiredness concerns should be a target of supportive care services.
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Affiliation(s)
| | - Catarina Nóbrega
- Center for Psychology at the University of Porto, Porto, Portugal
| | | | | | - Rui Santana
- NOVA National School of Public Health, Public Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden
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Kusakabe A, Mawatari H, Hirano K, Ohta M, Inamori M, Morita T. Identifying the unmet physical and psychological intimacy and sexual needs of partners of patients with terminal cancer. J Sex Med 2023; 20:1312-1318. [PMID: 37750582 DOI: 10.1093/jsxmed/qdad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/27/2023] [Accepted: 08/12/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Palliative care aims to improve the quality of life of patients who are terminally ill, but support for the sexuality of these patients is often inadequate. AIM To identify factors related to the unmet needs of bereaved partners whose significant others died of cancer during hospitalization. METHODS Bereaved individuals in Japan aged >50 years who had lost their partners to cancer in a hospital in the last 5 years answered a questionnaire on the support desired for "time to nurture love with your partner." OUTCOMES We used 3 sexual questions in the 34-item Supportive Care Needs Survey-Short Form (SCNS-SF34) and measured the unmet needs of partners of patients with terminal cancer. RESULTS We obtained 290 responses (equal number of males and females). Respondents' age distribution was as follows: 50 to 59 years, 34.8%; 60 to 69 years, 44.5%; 70 to 79 years, 19.3%; ≥80 years, 1.4%. In total, 81% had children. Most partners died in the general ward (59.3%). Frequency of time to nurture love with one's partner before the illness was as follows: none at all, 44 (15.2%); very little, 84 (29.0%); once in a while, 76 (26.2%); occasionally, 45 (15.5%); and often, 41 (14.1%). Roughly 20% of participants reported experiencing unmet sexual needs across all 3 selected questions in the SCNS-SF34. Multivariate analysis showed that younger age (P = .00097) and a higher frequency of time to nurture love with one's partner before illness (P = .004) were positively associated with unmet needs for sexuality during hospitalization. CLINICAL IMPLICATIONS The study may help health care workers identify patients who are seeking sexual support. STRENGTHS AND LIMITATIONS This study identified the unmet needs and underlying factors regarding sexuality during hospitalization for partners of patients with terminal cancer. However, differences by cancer type could not be analyzed. Additionally, the modified version of the supportive care needs measure used in this study (SCNS-SF34) may have decreased validity owing to the alterations made for its use. CONCLUSION Some hospitalized patients with terminal cancer could need support for time to nurture love with their partners. Health care providers can play a crucial role by anticipating the needs of patients, preparing them mentally, and offering counseling and information to help them maintain an intimate connection with their loved ones.
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Affiliation(s)
- Akihiko Kusakabe
- Department of General Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Hironori Mawatari
- Department of Palliative and Supportive Care, Yokohama Minami Kyousai Hospital, Yokohama, Kanagawa 236-0004, Japan
| | - Kazue Hirano
- Yokohama Ekisaikai Hospital, Naka-ku, Yokohama 231-0036, Japan
| | - Mitsuyasu Ohta
- Department of General Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Masahiko Inamori
- Department of Medical Education, Yokohama City University Hospital Yokohama City University School of Medicine, Kanazawa-ku, Yokohama 236-0004, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara Hospital, Kita, Hamamatsu 433-8558, Japan
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Dhakal K, Wang P, Mboineki JF, Getu MA, Chen C. Assessment of supportive care needs among cervical cancer patients under treatment in Nepal: a cross-sectional study. BMC Womens Health 2023; 23:407. [PMID: 37537619 PMCID: PMC10401776 DOI: 10.1186/s12905-023-02484-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 06/14/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUNDS The perceived supportive care needs (SCNs) of cancer patients are essential components of a care program. The first step in planning and intervening for supportive care is the proper identification of the SCNs of cancer patients. Cervical cancer (CC) is the most prevalent cancer among Nepali women. The authors assess SCNs and their predictors among CC patients under treatment by using a validated Nepali version supportive care need survey short form (SCNS- SF 34 N). METHODS This descriptive cross-sectional study was conducted in 5 cancer treatment hospitals in Nepal. A culturally adapted and psychometrically validated Nepali version SCNS -SF- 34 N was completed by a convenience sample of 218 CC patients. Data were analyzed by using descriptive (frequency, percentage, mean, median) and inferential (Chi-square P-value and binary logistic regression analysis) statistics. RESULTS The study showed that 99% of the respondents were in need of some level (low, moderate, high) of supportive care. The psychological domain, physical daily living, health system information, patient care support and sexuality domain ranked from first to fifth for SCNs with mean and standard deviations 70.29 ± 18.84, 63.25 ± 23.15, 57.90 ± 21.11, 56.46 ± 21.92 and 46.06 ± 34.16, respectively. Binary logistic regression found causal association between SCNs and variables "occupation (p-value = 0.007), and type of hospital (p-value = 0.000)" at a 95% confidence level. CONCLUSION Nepali CC patients perceive and experience many unmet SCNs, with psychological SCNs being the first priority. It is essential that the SCNs of patients may need to be known by their close family members, care providers, CC related program. so that they can offer intervention as per patients' needs.
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Affiliation(s)
- Kamala Dhakal
- Nursing Department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
- Maharjgunj Nursing Campus, Maharajgunj, Kathmandu, Nepal
- Institute for Hospital Management of Henan, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China
| | - Panpan Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | | | - Mikiyas Amare Getu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changying Chen
- Nursing Department, The first affiliated hospital of Zhengzhou University, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China.
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, China.
- Institute for Hospital Management of Henan, Jianshe Dong Lu, Henan Province, Zhengzhou, Henan, 450000, China.
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Tsuchiya M, Tazaki M, Fujita R, Kodama S, Takata Y. A mixed-method systematic review of unmet care and support needs among Japanese cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01439-5. [PMID: 37531042 DOI: 10.1007/s11764-023-01439-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE To synthesize published studies regarding Japanese cancer survivors' needs/unmet needs of care/support, change of unmet needs over time, and preferred care/support providers. METHODS A mixed-method systematic review was conducted. MEDLINE, PsycINFO, CINAHL, and Ichu-shi were searched from inception to May 2022. Quantitative and qualitative studies were separately analyzed using narrative synthesis and meta-ethnography. Each finding was synthesized using a line of argument. RESULTS Twenty-four studies (13 quantitative and 11 qualitative studies) were included. Six quantitative studies reported unmet needs in survivors of adolescent and young adult (n=1) and adulthood (n=5) cancer. No longitudinal studies regarding changes in unmet needs were identified. One study reported that adults preferred care/support providers. The quantitative studies identified more help in physical (48.2-51.0%, n=2) and psychological issues (17.4-78.8%, n=5), information (27.9-58.0%, n=3), and healthcare services (25.3-67.1%, n=2) among adults. The qualitative studies emphasized more tailor-made information about life events for young cancer survivors. More empathic and trustworthy interactions with surrounding people, including healthcare professionals, were demanded, regardless of age. A line of argument illustrated that cancer survivors had insufficient resources for activities and empowerment to face life with cancer at all phases. CONCLUSIONS Japanese cancer survivors' unmet needs are diverse. More information and resources for psychological care/support and local healthcare services post-treatment are needed, which may hinder the optimal transition to survivorship. IMPLICATIONS FOR CANCER SURVIVORS The synthesized evidence should be utilized to implement a comprehensive care/support system in practice and educate people surrounding cancer survivors, regardless of age.
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Affiliation(s)
- Miyako Tsuchiya
- Research Institute of Nursing, Musashino University, 3-3-3, Ariake, Koto-ku, Tokyo, 135-8181, Japan.
- Former Division of Healthcare Delivery, Survivorship and Policy Research, Institute of Cancer Control, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Makiko Tazaki
- Former Division of Healthcare Delivery, Survivorship and Policy Research, Institute of Cancer Control, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Graduate School of Nursing, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8672, Japan
| | - Risako Fujita
- Former Division of Healthcare Delivery, Survivorship and Policy Research, Institute of Cancer Control, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
- Shirokanetakanawa Clinic, 1-13-11, Shirokane, Minato-ku, Tokyo, 108-0072, Japan
| | - Shoko Kodama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Yoshinori Takata
- Department of Nursing, Japanese Red Cross College of Nursing, 4-1-3 Hiroo, Shibuya City, Tokyo, 150-0012, Japan
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Elsous A, Radwan M, Najjar S, Masad A, Abu Rayya M. Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine. Acta Oncol 2023; 62:194-209. [PMID: 36802358 DOI: 10.1080/0284186x.2023.2180326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Cancer, especially breast cancer, remains a public health problem because of its negative consequences, which require long-term programs to alleviate its devastating effects. This study aimed to examine unmet supportive care needs and health-related quality of life of females with breast cancer. METHODS A cross-sectional study with a mixed-method design was employed. A simple, randomly selected sample of 352 females attending Al-Rantisi and Al-Amal hospitals was included in this study. A validated Arabic version of the Supportive Care Needs Survey (34 items) and The European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C15-PAL) were used. Moreover, twenty-five semi-structured interviews were performed (13 females, eight husbands, and four healthcare workers). Quantitative data were analysed using descriptive and inferential analysis, whereas thematic analysis was used for qualitative data to highlight main themes. RESULTS The highest unmet need reported by females with breast cancer was psychological needs (63%), followed by health-related systems and information (62%) and physical and daily life (61%). Pain and fatigue were the most reported symptoms (65.8% and 62.5%, respectively), followed by emotional distress, physical function, and physical symptoms; 55.8%, 54.3%, and 51.5%, respectively. These unmet needs and health-related quality of life-related dimensions were highlighted and elicited by qualitative data analysis. Unmet needs are high among married females, on conservative treatments, young females (< 40 years old), and females in the first year of diagnosis. The presence of chronic diseases did not increase needs. However, health-related quality of life was affected. Six themes are subtracted: availability of anticancer therapy, affordability of healthcare, family and social support, psychological support, health education, and self-image & intimate relationship. CONCLUSION Many needs are unmet. Caring for females with breast cancer should be comprehensive to fill gaps, including psychological care, health information and education, physical care and support, and medical care.
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Affiliation(s)
- Aymen Elsous
- Faculty of Medical Sciences, Israa University -Gaza, Gaza strip, Palestine.,Department of Planning, Unit of Planning and Institutional Development Performance, Ministry of Health, Gaza strip, Palestine
| | - Mahmoud Radwan
- Department of Foreign Relations, General Directorate of International Cooperation, Ministry of Health, Gaza strip, Palestine
| | - Shahenaz Najjar
- Health Policy and Health Informatics, Arab American University of Palestine, Palestine.,Leuven Institute for Healthcare Policy, Pillar Quality and Safety, Department of Public Health and Primary Care, KU Leuven
| | - Atef Masad
- Department of Medical Laboratories, Faculty of Medical Sciences, Israa University -Gaza, Gaza strip, Palestine
| | - Mohammed Abu Rayya
- Public Health Consultant, Aid and Hope Program for Cancer Patients Care, Gaza strip, Palestine
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Moreno PI, Esquives BN, Thomas JL, Horner FS, Torzewski JB, Gradishar W, Victorson D, Penedo FJ. Characterizing unique supportive care needs among women living with metastatic breast cancer: A qualitative study. JOURNAL OF PSYCHOSOCIAL ONCOLOGY RESEARCH AND PRACTICE 2023; 5:10.1097/or9.0000000000000093. [PMID: 37383566 PMCID: PMC10299747 DOI: 10.1097/or9.0000000000000093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Background Women with metastatic breast cancer face unique challenges as they cope with life-limiting prognoses and arduous treatments. However, the vast majority of research has focused on optimizing quality of life in women with early-stage, non-metastatic breast cancer and little is known about supportive care needs among women living with metastatic cancer. As part of a larger project that sought to inform the development of a psychosocial intervention, the aim of this study was to characterize supportive care needs among women with metastatic breast cancer and elucidate challenges unique to living with a life-limiting prognosis. Methods Four, two-hour focus groups with 22 women were audio-recorded, transcribed verbatim, and analyzed in Dedoose using a general inductive approach to code categories and extract themes. Results A total of 16 codes emerged from 201 participant comments regarding supportive care needs. Codes were collapsed into four supportive care need domains: 1. psychosocial, 2. physical and functional, 3. health system and information, and 4. sexuality and fertility needs. The most prevalent needs were breast cancer-related symptom burden (17.4%), lack of social support (14.9%), uncertainty (10.0%), stress management (9.0%), patient-centered care (7.5%), and sexual functioning (7.5%). More than half of needs (56.2%) were in the psychosocial domain and more than two-thirds of needs (76.8%) were in the psychosocial and physical and functional domains. Supportive care needs unique to living with metastatic breast cancer included the cumulative effects of continuously undergoing cancer treatment on symptom burden, worry from scan-to-scan regarding response to cancer treatments, diagnosis-related stigma and social isolation, end-of-life concerns, and misconceptions regarding metastatic breast cancer. Conclusions Findings suggest that women with metastatic breast cancer have unique supportive care needs compared to women with early-stage breast cancer that are specific to living with a life-limiting prognosis and are not typically captured in existing self-report measures of supportive care needs. Results also highlight the importance of addressing psychosocial concerns and breast cancer-related symptoms. Women with metastatic breast cancer may benefit from early access to evidence-based interventions and resources that specifically address their supportive care needs and optimize quality of life and wellbeing.
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Affiliation(s)
- Patricia I. Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Blanca Noriega Esquives
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Jessica L. Thomas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Fiona S. Horner
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Joanna B. Torzewski
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - William Gradishar
- Department of Medicine, Division of Hematology and Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Frank J. Penedo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
- Department of Psychology, University of Miami, Coral Gables, FL
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
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Drury A, Dowling M, Diez de Los Rios de la Serna C, Erdem S, Aroyo V, Wiseman T, Bağçivan G. Advanced breast cancer education for cancer nurses: A systematic review. NURSE EDUCATION TODAY 2022; 117:105477. [PMID: 35908406 DOI: 10.1016/j.nedt.2022.105477] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/23/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Access to comprehensive, integrated, multidisciplinary care is one of the most urgent and actionable recommendations of the Advanced Breast Cancer Global Alliance. However, access to specialist breast care units, and specialist breast cancer nurses is variable, influenced by access to specialist education and role recognition. To date, there has not been a synthesis of evidence regarding educational programmes related to advanced breast cancer education for nurses. OBJECTIVES The aim of this review was to determine the content, mode of delivery, assessment and outcomes of education programmes related to advanced breast cancer for nurses. REVIEW METHODS A systematic review was undertaken, according to the Joanna Briggs Institute's mixed methods review methodology. DATA SOURCES MEDLINE, PUBMED, CINAHL, Scopus, PsycInfo, Joanna Briggs Institute, Web of Science and grey literature sources were systematically searched. Eleven publications met the inclusion criteria. Data relating to programme content, mode of delivery, assessment and outcomes were extracted and analysed. RESULTS This review identifies a limited number of educational programmes within this specialist area of nursing practice. Shortcomings in the development, implementation and evaluation of advanced breast cancer education programmes included limited use of educational standards, theoretical frameworks and patient and public involvement to inform programme development. Evaluation of education programmes related to advanced breast cancer relied predominantly on self-reported learning, with limited consideration of the impacts of education on service delivery, patient experience or quality of care. CONCLUSIONS Future development of advanced breast cancer education programmes must consider the alignment of programme content and learning outcomes with existing educational and competency standards. Evaluation of educational programmes in this field must endeavour to enhance rigour of methods, incorporating standardised questionnaires, and multiple methods and sources of data to evaluate the broader impacts of advanced breast cancer education for nurses.
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Affiliation(s)
- Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Celia Diez de Los Rios de la Serna
- School of Nursing, Faculty of Medicine and Health Sciences, Bellvitge Campus, Barcelona University, Feixa Llarga, 08907-L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
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Akuoko CP, Chambers S, Yates P. Healthcare providers’ perspectives of the supportive care needs of women with advanced breast cancer in Ghana. BMC Womens Health 2022; 22:350. [PMID: 35982431 PMCID: PMC9389751 DOI: 10.1186/s12905-022-01931-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background The study sought to understand the supportive care needs of women with advanced breast cancer from the perspectives of healthcare professionals (HCPs) and key informants of charitable/non-governmental organisations (NGOs), that provide supportive care services to women with advanced breast cancer, in Ghana. Methods A qualitative descriptive approach was employed via one-to-one semi-structured interviews with 13 HCPs and key informants of charitable/NGOs in Ghana that provide supportive care services to women with advanced breast cancer. The study was underpinned by Bradshaw’s taxonomy of social needs and Fitch’s supportive care framework. The data were analysed using a deductive content analysis approach. Results Healthcare providers and key informants perceived that women with advanced breast cancer in Ghana have numerous and complex supportive care needs in key areas that align with Fitch’s supportive care framework, including informational, psychological, emotional, physical, practical, social, sexuality and spiritual needs. Conclusion Participants perceived that women who have advanced breast cancer in Ghana require ongoing information about their condition, treatments and related effects, as well as spiritual support and guidance particularly due to the fatalistic beliefs they often associate with the condition. Tailored supportive care interventions and services, which address the unique sociocultural circumstances for this cohort, are required. Additional research is needed to explore how multidisciplinary teams can work collaboratively to provide comprehensive support to women in addressing their needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01931-7.
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Akuoko CP, Chambers S, Yates P. Supportive care needs of women with advanced breast cancer in Ghana. Eur J Oncol Nurs 2022; 58:102142. [DOI: 10.1016/j.ejon.2022.102142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 04/09/2022] [Indexed: 01/03/2023]
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Hart NH, Crawford-Williams F, Crichton M, Yee J, Smith TJ, Koczwara B, Fitch MI, Crawford GB, Mukhopadhyay S, Mahony J, Cheah C, Townsend J, Cook O, Agar MR, Chan RJ. Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review. Crit Rev Oncol Hematol 2022; 176:103728. [PMID: 35662585 DOI: 10.1016/j.critrevonc.2022.103728] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023] Open
Abstract
Examining and addressing unmet care needs is integral to improving the provision and quality of cancer services. This review explored the prevalence of unmet supportive care needs, and factors associated with unmet need, in adults with advanced cancers (solid and hematological malignancies) and their caregivers. Electronic databases (PubMed, CINAHL, EMBASE) were searched, producing 85 papers representing 81 included studies. People with advanced cancer reported the highest unmet needs in financial, health system and information, psychological, and physical and daily living domains, whereas caregivers reported the highest unmet needs in psychological, and patient care and support domains. Distress, depression, and anxiety were associated with higher unmet needs across all unmet need domains for people with advanced cancer and their caregivers. Substantial heterogeneity in study populations and methods was observed. Findings from this review can inform targeted strategies and interventions to address these unmet needs in people with advanced cancer.
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Affiliation(s)
- Nicolas H Hart
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, WA, Australia.
| | - Fiona Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia; Nutrition and Dietetics Research Group, Bond University, QLD, Australia
| | - Jasmine Yee
- Centre for Medical Psychology and Evidence-Based Decision-Making, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Thomas J Smith
- Division of General Internal Medicine, John Hopkins Medical Institutions, Baltimore, MD, USA
| | - Bogda Koczwara
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, SA, Australia; Flinders Cancer and Innovation Centre, Flinders Medical Centre, SA, Australia
| | - Margaret I Fitch
- School of Graduate Studies, Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Gregory B Crawford
- Discipline of Medicine, University of Adelaide, SA, Australia; Northern Adelaide Local Health Network, SA, Australia
| | - Sandip Mukhopadhyay
- Burdwan Medical College, West Bengal, Kolkata, India; Indian Council of Medical Research, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Chan Cheah
- Internal Medicine, UWA Medical School, University of Western Australia, WA, Australia; Department of Haematology, Sir Charles Gairdner Hospital, WA, Australia; Department of Haematology, Hollywood Private Hospital, WA, Australia
| | | | - Olivia Cook
- McGrath Foundation, NSW, Australia; School of Nursing and Midwifery, Monash University, VIC, Australia
| | - Meera R Agar
- IMPACCT Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Science, Flinders University, SA, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, QLD, Australia
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13
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Bu X, Jin C, Fan R, Cheng ASK, Ng PHF, Xia Y, Liu X. Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer 2022; 22:135. [PMID: 35109799 PMCID: PMC8811964 DOI: 10.1186/s12885-022-09224-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Breast cancer survivors (BCSs) often have potential unmet needs. Identification of the specific needs of BCSs is very significant for medical service provision. This study aimed to (1) investigate the unmet needs and quality of life (QoL) of BCSs in China, (2) explore the diverse factors associated with their unmet needs, and (3) assess the association between their unmet needs and QoL. Methods A multicentre, cross-sectional survey was administered to 1210 Chinese BCSs. The Cancer Survivor Profile-Breast Cancer and the Functional Assessment of Cancer Therapy-Breast scale were administered to survivors who gave informed consent to participate. Data were analysed using t-test, ANOVA, multiple regression analysis, and Pearson correlations. Results The 1192 participants completed questionnaires (response rate 98.51%). Our study reveals that the most prevalent unmet needs were in the ‘symptom burden domain’. The unmet needs of BCSs depend on eleven factors; age, time since diagnosis, education level, occupation, payment, family income status, stage of cancer, treatment, family history of cancer, pain, and physical activities. To ensure the provision of high-quality survivorship care and a high satisfaction level, more attention should be paid to actively identifying and addressing the unmet needs of BCSs. The problem areas identified in the Cancer Survivor Profile for breast cancer were negatively associated with all subscales of QoL except the health behaviour domain, with the correlation coefficient ranging from − 0.815 to − 0.011. Conclusion Chinese BCSs exhibit a high demand for unmet needs in this study, and the most prevalent unmet needs were in the ‘symptom burden domain’. There was a significant association between patients’ unmet needs (as defined in the Cancer Survivor Profile for breast cancer) and QoL. Future research should focus on enhancements to survivorship or follow-up care to address unmet needs and further improve QoL.
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Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Xiangya School of Nursing, Central South University, Changsha, China
| | - Cai Jin
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Department of Nursing, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Rongrong Fan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Peter H F Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yimin Xia
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
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14
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A feasibility study of a peer discussion group intervention for patients with pancreatobiliary cancer and their caregivers. Palliat Support Care 2021; 20:527-534. [PMID: 34593073 DOI: 10.1017/s1478951521001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The purpose of this feasibility study was to examine the impacts of a peer discussion group intervention called "the pancreatobiliary cancer salon" on psychological distress among patients with pancreatobiliary cancer and their caregivers. METHODS We recruited patients with pancreatic or biliary tract cancer and their caregivers. We conducted a within-group pre-post comparison study. Participants were grouped by the type of cancer and treatment. Each group consisted of four to five patients or caregivers. Hospital staff members facilitated group discussions where participants freely talked for 1 h. We evaluated participants' psychological condition using the Profile of Mood States (POMS) and their impressions of the pancreatobiliary cancer salon. RESULTS We analyzed data from 42 patients and 27 caregivers who joined the salon for the first time. Thirty-five patients (83.3%) had pancreatic cancer. Thirty-one patients (71.4%) had unresectable pancreatobiliary cancer and 14 patients (33.3%) were being treated with second-line or third-line chemotherapy at the time of the survey. Twenty-two patients (52.4%) participated in the salon within 6 months after diagnosis. Most participating caregivers were the patient's spouse/partner (51.9%) or child (34.6%). Both patients and caregivers experienced high levels of satisfaction with the pancreatobiliary cancer salon. Both patients and caregivers had significantly lower psychological distress as assessed by POMS after the salon. SIGNIFICANCE OF RESULTS A peer discussion group intervention might be well-received and has potential to benefit for patients with pancreatobiliary cancer and their caregivers.
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15
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Azman N, Thien LM, Abdullah MFIL, Mohd Shariff N. Psychometric Properties of the 34-Item Short-Form Supportive Care Need Survey (SCNS-SF34) Scale in the Malaysian Cancer Healthcare Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179403. [PMID: 34501991 PMCID: PMC8431238 DOI: 10.3390/ijerph18179403] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 12/30/2022]
Abstract
(1) Background: This study aimed to assess the psychometric properties of the Malay version of SCNS-SF34 among Malaysian cancer patients. (2) Methods: This cross-sectional study involved 171 cancer patients. Data were collected using the structured five-factor survey via telephone call or face-to-face interviews. The internal reliability and the construct validity of SCNS-34M were analysed using principal component analysis with varimax rotation. (3) Results: The health system and information need (HSI) was the domain with the highest mean score (2.73 ± 0.88), followed by patient care and support needs (2.16 ± 0.90), as well as physical and daily living needs (1.99 ± 0.98). The confirmatory factor analysis indicated a moderate model fit for RMSEA with 0.070, TLI = 0.911 and CFI = 0.924. (4) Conclusions: The SCNS-SF34M was found to be a conceptually applicable and culturally appropriate scale in measuring the supportive care for cancer patients within the Malaysian context.
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Affiliation(s)
- Nizuwan Azman
- Unit of Biostatistics and Bioinformatics, Division of Research and Networking, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam 13200, Penang, Malaysia;
| | - Lei Mee Thien
- School of Educational Studies, Universiti Sains Malaysia, Minden 11700, Pulau Pinang, Malaysia;
| | | | - Noorsuzana Mohd Shariff
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam 13200, Penang, Malaysia;
- Correspondence: ; Tel.: +60-4562-2312
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16
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Okati-Aliabad H, Ansari-Moghadam A, Mohammadi M, Kargar S, Shahraki-Sanavi F. The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer. Support Care Cancer 2021; 30:703-710. [PMID: 34365523 DOI: 10.1007/s00520-021-06477-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/28/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE Diagnosis of breast cancer and its treatment dramatically affects women's psychological health. This study investigated the prevalence of depression and anxiety and their related factor in breast cancer women. METHODS We conducted a cross-sectional study with a sample of 120 women with breast cancer in Zahedan, Iran, 2020. Data were collected using instruments included: Hospital Anxiety and Depression Scale (HADS), Supportive Care Needs Survey (SCNS-SF34), Multidimensional Scale of Perceived Social Support (MSPSS), The adjustment to illness measurement inventory for Iranian women with breast cancer (AIMI-IBC). We analyzed the data using the ANOVA, independent sample t-test, Kruskal Wallis, Mann-Whitney U test, Pearson's and Spearman's correlation coefficients. RESULTS The prevalence of depression and anxiety in women with breast cancer was 66.6% and 60%, respectively. A significant positive correlation was found between anxiety and depression and unmet psychological needs, care/support needs, and emotional turmoil coping strategy, while reasonable efforts and avoidance coping strategies and adjusting to disease were negatively correlated with anxiety and depression. Also, linear regression results indicated unmet psychological needs, emotional turmoil coping strategy, and a high level of depression predicted a high anxiety level. A lower level of depression was indicated by reasonable efforts strategy and less level of anxiety. CONCLUSIONS Women with breast cancer reported a high level of depression and anxiety in Zahedan, and clinicians should pay more attention to these patients' psychological distress. Resolving the unmet need of patients, increasing social support, and using the right coping strategy have an essential role in breast cancer women's psychological distress control.
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Affiliation(s)
- Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shiva Kargar
- School of Health, Zahedan University of Medical Sciences, Zahedan, Iran.
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17
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Arnaud A, Grenier J, Boustany R, Kirscher S, Mege A, de Rauglaudre G, Vazquez L, Debourdeau P. Role of supportive care in improving the quality of life and reducing unscheduled hospital care in patients with metastatic breast cancer. Support Care Cancer 2021; 29:3735-3742. [PMID: 33205324 DOI: 10.1007/s00520-020-05877-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Metastatic breast cancer (MBC) patients experience long survival and report poorer quality of life than localized breast cancer patients. Comprehensive supportive care (CSC) has been shown to improve the quality of life (QoL) of MBC. The respective part of each support care has not been fully examined, and little is known about whether meeting patients' needs is accompanied by decreased unscheduled hospital care (UHC). METHODS This prospective monocentric study included women who started a new treatment line for MBC between January 2018 and December 2018. The endpoints were factors associated with UHC and QoL (SF36) at month 12. RESULTS 100 patients were offered CSC, 78 were included (21 refusals, 1 no MBC). CSC was provided to 60 patients: pain (43%), psychological (37%), kinesitherapy (30%), social assistance (22%), esthetic (18%), nutrition (18%), massage (13%), and none (10%). CSC rate was not statistically different among patients with (58%) and without UHD (49%). Factors associated with a decrease of UHC were age > 65 years (p = 0.01), no previous treatment for MBC (p = 0.0001) with a trend for the lack of CSC (p = 0.054). Among the 8 domains of the SF36 scale, only health change perception was improved (p = 0.01) and its predictive factors were treatment carried out as planned (p = 0.0004), pain care (p = 0.003), and lack of MBC progression (p = 0.0035). CONCLUSION CSC can improve QoL in MBC. Painful patients might benefit more from CSC. UHC did not decrease for patients receiving CSC as expected possibly because of their important needs for clinical care.
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Affiliation(s)
- Antoine Arnaud
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France
| | - Julien Grenier
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France
| | - Rania Boustany
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France
| | - Sylvie Kirscher
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France
| | - Alice Mege
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France
| | | | - Léa Vazquez
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France.
| | - Philippe Debourdeau
- Institut Sainte Catherine, 250 chemin de baigne-pieds, 84918, Avignon, France
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18
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Husson O, Weidema M, Leonard H, Hartle DeYoung L, van der Graaf W, van de Poll-Franse L. Supportive care needs of patients living with an extremely rare and unpredictable cancer: The Epithelioid Haemangioendothelioma patient experience. Eur J Cancer Care (Engl) 2021; 30:e13461. [PMID: 33989441 DOI: 10.1111/ecc.13461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/10/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Epithelioid haemangioendothelioma (EHE) is an ultrarare vascular sarcoma with an incidence of <1/million/year and a large clinical heterogeneity. Data on supportive care needs of rare cancer patients are scarce. This study aimed to investigate the level of supportive care needs of EHE patients and its association with sociodemographic, clinical and symptom burden characteristics. METHODS We present secondary data of a cross-sectional questionnaire study involving EHE patients recruited from the international EHE Facebook group. Data were collected using the web-based PROFILES registry. Unmet needs were measured with Supportive Care Needs Survey Short Form (SCNS-SF34). RESULTS 115 EHE patients from 20 countries completed the online questionnaire. Mean level of supportive care needs was 68.4 (range 34-170), with the highest mean score on the psychological domain. Supportive care needs were associated with age, disease stage, years since diagnosis and number of tumour locations. Highly symptomatic patients (33%) reported more supportive care needs than patients with low or intermediate symptom burden. CONCLUSION Supportive care needs were found in all domains, highest in the psychological domain, and were associated with sociodemographic, clinical and symptom burden characteristics. Adequate and tailored supportive care should be offered especially to highly symptomatic EHE patients.
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Affiliation(s)
- Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Marije Weidema
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Winette van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lonneke van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.,Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
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19
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Choi E, Kim SH, Lee YW, Kim H, Shim YM, Lee G, Volker DL. Supportive Care Needs and Health-Related Quality of Life of Esophageal Cancer Survivors. Asia Pac J Oncol Nurs 2021; 8:164-171. [PMID: 33688565 PMCID: PMC7934594 DOI: 10.4103/apjon.apjon_60_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/06/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: The aim of this study is (1) to describe the prevalence and correlates of unmet needs among esophageal cancer survivors (ECS) in Korea and (2) to identify the association between unmet needs and health-related quality of life (HRQOL). Methods: We used a cross-sectional descriptive study design. Participants were 118 ECS from a hospital in Korea who received surgery at least 12 months before participating. We collected data including the Supportive Care Needs Survey-short form 34 and to measure HRQOL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 with a self-report questionnaire. Results: Participants' mean age was 65.2 years, and 92.4% were male. Among five domains of supportive care needs, unmet need prevalence ranged from 0.8% to 50%. The most commonly reported domains of unmet needs were Health System and Information and Physical and Daily Living. Participants with unmet needs in Psychological Needs, Physical and Daily Living Needs, and Patient Care and Support Needs demonstrated significantly poorer HRQOL in almost all measured domains. Conclusions: Our finding suggests that Korean ECS had substantial unmet needs, especially in the Health System and Information domain. Psychological, Patient Care and Support, and Physical and Daily Living Needs were related to HRQOL. The study can advance understanding of priority issues in ECS.
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Affiliation(s)
- Eunju Choi
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Soo Hyun Kim
- Department of Nursing, College of Medicine, Inha University, Incheon, Korea
| | - Young Whee Lee
- Department of Nursing, College of Medicine, Inha University, Incheon, Korea
| | - Hwasoon Kim
- Department of Nursing, College of Medicine, Inha University, Incheon, Korea
| | - Young Mog Shim
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Genehee Lee
- Patients-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea
| | - Deborah L Volker
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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20
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Chou YH, Chia-Rong Hsieh V, Chen X, Huang TY, Shieh SH. Unmet supportive care needs of survival patients with breast cancer in different cancer stages and treatment phases. Taiwan J Obstet Gynecol 2020; 59:231-236. [PMID: 32127143 DOI: 10.1016/j.tjog.2020.01.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE This study aimed to examine the differences between patients with breast cancer (BC) at different cancer stages and treatment phases in terms of unmet supportive care needs as well as to predict the critical factors that influence the unmet needs of such patients. MATERIALS AND METHODS A retrospective study was conducted by collecting data from the case consultation and service records of a cancer center in central Taiwan. Information extracted from the case consultation and service records included patients' age, treatment phase, cancer stage, and unmet need domains. RESULTS AND CONCLUSION Overall, 1129 BC patients were recruited. In the prediction of critical factors influential to the health information needs of patients with BC, in-treatment patients, and those undergoing a follow-up were found to have significantly lower health information needs than patients newly diagnosed with BC. In-treatment and follow-up patients had significantly lower patient care needs than those newly diagnosed with BC. Stage II, III, and IV BC patients had significantly lower nutritional needs than stage I patients. In-treatment patients and those receiving follow-ups had significantly lower nutritional needs than patients newly diagnosed with BC. Relapse and terminal care patients had significantly higher psychosocial needs than patients newly diagnosed with BC. Thus, unmet needs of patients with cancer differ according to their age, cancer stage, and treatment phase. Appropriate and punctual tailored support provided by medical care personnel to address the unmet needs of patients can reduce the unmet supportive care needs in such patients and improve the quality of medical care services they are provided with. Ultimately, the overall quality of life of patients can be improved.
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Affiliation(s)
- Ying-Hsiang Chou
- Institute of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Vivian Chia-Rong Hsieh
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - XianXiu Chen
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan; Research Center for Chinese Herbal Medicine, China Medical University, Taichung, Taiwan
| | - Ting-Yi Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Shwn-Huey Shieh
- Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
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21
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Doubova SV, Pérez-Cuevas R. Association of supportive care needs and quality of patient-centered cancer care with depression in women with breast and cervical cancer in Mexico. Psychooncology 2020; 30:591-601. [PMID: 33247968 DOI: 10.1002/pon.5608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To compare the prevalence of depression, supportive care needs (SC-needs), and quality of patient-centered cancer care (PCC-quality) between women with breast cancer and women with cervical cancer and to assess the association of SC-needs and PCC-quality with depression. METHODS We conducted a cross-sectional survey in a public oncology hospital in Mexico City with 247 breast cancer and 165 cervical cancer ambulatory patients aged ≥18 years with at least one hospitalization and ≤5 years since diagnosis. Participants completed the short-form Supportive Care Needs Survey, the Patient-Centered Quality of Cancer Care Questionnaire, and the Hospital Anxiety and Depression Scale. We performed multiple logistic regression analyses to evaluate the association between SC-needs, PCC-quality, and probable presence of depression. RESULTS Nearly all women reported SC-needs-mainly health system and information needs, followed by physical and psychological needs. PCC-quality was substandard in both groups. PCC-quality was lowest when addressing biopsychosocial needs, followed by information for treatment decision-making needs. Cervical cancer patients had probable depression more often (41.2%) than those with breast cancer (29.5%). Having unmet psychological and care needs was associated with increased odds of probable depression, while high-quality timely care was associated with reduced odds of probable depression. CONCLUSION In Mexico, women with cervical and breast cancer face unmet SC-needs, probable depression, and substandard PCC-quality, pointing to priority areas for improvements in cancer care.
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Affiliation(s)
- Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Jamaica
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22
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A Framework for Assessing the Impact of Information-Seeking Behavior on Cancer Patients' Long-Term Prognosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020. [PMID: 32468307 DOI: 10.1007/978-3-030-32637-1_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Cancer is considered as one of the main challenges of modern healthcare systems. Cancer patients are obliged to cope with the uncertainty of disease progression. Their anxiety regarding said uncertainty is intensified because they need to constantly make decisions concerning the management of their disease. Information and communication are considered important in cancer management. As a result, the research associated with the impact of healthcare information-seeking behavior on numerous cancer management aspects has intensified and grown in astonishing rates. This work concentrates on the interplay of oncological patients' information-seeking behavior regarding their long-term prognosis. Therefore, a conceptual framework is proposed that identifies and associates several clinical, socio-demographic, psychological, and information-seeking behavioral factors that are likely to be linked with patients' health outcomes.
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Unmet Supportive Care Needs of Survival Patients with Nasopharyngeal Carcinoma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103519. [PMID: 32443492 PMCID: PMC7277141 DOI: 10.3390/ijerph17103519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/21/2022]
Abstract
This study examined unmet supportive care needs for nasopharyngeal carcinoma (NPC) patients by cancer stage and treatment phase, as well as the factors associated with these unmet needs. At a cancer center in central Taiwan, information on consultations and services patients received at the resource center was described in the service chart. We extracted data available for NPC patients to evaluate their unmet supportive care needs (health information, patient care, treatment, nutritional, psychosocial, and economic) and their association with sex, age, cancer stage, and treatment phase. The 145 NPC patients were 68.3% male, 60.0% less than 50 years old, and 83.5% diagnosed at stages III and IV. The most prevalent unmet need was nutritional (40.7%), followed by psychosocial and patient care, with economic unmet needs the least (4.8%). Women were more likely than men to have patient care unmet needs (32.6% vs. 15.2%). Nutritional unmet need was higher in older patients than in younger ones (83.3% vs. 35.6%), with an adjusted odds ratio (aOR) of 9.39 (95% confidence interval (CI) = 2.17–40.70). Psychosocial unmet needs were higher in younger patients than old patients (34.5% vs. 0%) and in patients interviewed during follow-up period than those at newly diagnosed (55.2% vs. 23.1%). In conclusion, the most commonly reported concern was nutritional unmet needs for NPC patients. Their unmet needs may vary by demographic and disease factors, including patient sex and age, cancer stage, and treatment phase.
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Beech E, Reynen H. Assessing the Awareness of Psychosocial Initiatives Available to Breast Cancer Patients Undergoing Radical Radiation Therapy. J Med Imaging Radiat Sci 2020; 51:324-330. [PMID: 32284237 DOI: 10.1016/j.jmir.2020.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/16/2020] [Accepted: 02/24/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The goal of this study is to determine if patients are aware of psychosocial initiatives available to them throughout their cancer journey and how they would prefer to learn about these initiatives. It has been proven that patients who participate in psychosocial programs throughout their treatment benefit emotionally by showing improved moods, less cancer-related anxiety and depression, increased knowledge of their illness, and better quality of life than those who do not. Studies have shown that lack of patient awareness is a potential barrier for patients not accessing psychosocial services and supports available to them. METHODS The data were collected using incidental sampling of breast cancer patients 18 years or older during their radiation treatments. This study assessed patients for how aware they are, how they learn, and how they would prefer to learn about different psychosocial initiatives available to them. RESULTS Overall, 76% of participants were very unaware of individual initiatives; 69% of participants said they heard of an initiative from at least 1 resource listed. Most learned about initiatives from a poster, pamphlet, or friend/family. Learning about initiatives from the health care team, information booklets, and pamphlets was preferred. Participants who learned about initiatives with posters tended to be the least aware of initiatives compared with those who learned about the initiatives from a pamphlet or family/friend. The largest barrier for not accessing an initiative is lack of awareness. Sixty five percent of participants want assistance in deciding what initiatives to access. Promotion of initiatives at cancers centres where patients begin their cancer journey and a centralized area to go were wanted by participants. DISCUSSION Patients who participated in the study were not very aware of initiatives offered to them and were learning about these initiatives mostly from posters, which was demonstrated as the least informational method. Trends showed that promotion through the method of pamphlets, a binder, or from a health care provider is most wanted and effective communication pathway. Results also indicated the want for a centralized area of promotion. CONCLUSION This study suggests the need for improvement in patient awareness and access to initiatives. Future research should consider similar methodologies to improve on current communication pathways for more effective patient use. Strengthened communication pathways can create a surplus of knowledge allowing patients to make informed decisions of participation in initiatives. More informed decisions on their own care has the potential to improve overall quality of life.
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Affiliation(s)
- Emily Beech
- Radiation Therapy, Laurentian University, The Michener Institute, Northeast Cancer Centre, Health Sciences North, Sudbury, Ontario, Canada.
| | - Heather Reynen
- Radiation Therapy, Northeast Cancer Centre, Health Sciences North, Sudbury, Ontario, Canada
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Watanabe K, Katayama K, Yoshioka T, Narimatsu H. Impact of individual background on the unmet needs of cancer survivors and caregivers - a mixed-methods analysis. BMC Cancer 2020; 20:263. [PMID: 32228490 PMCID: PMC7106842 DOI: 10.1186/s12885-020-06732-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/10/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cancer survivors and their caregivers may have various unmet needs that are medically difficult to solve. Previous studies have suggested the relations between individuals' backgrounds and their unmet needs. We conducted a large-scale analysis to clarify the influence of individuals' backgrounds, primarily cancer type, on specific types of unmet needs. METHODS Using a mixed-methods approach, we analyzed records of first-time callers to a cancer-focused telephone consultation service that was provided by the Kanagawa Cancer Clinical Research Information Organization from October 2006 to May 2014. The qualitative approach concerned extracting unmet needs mentioned in each consultation and classifying them into themes of specific needs, while the quantitative approach comprised multi-variated analysis of the relationships between the frequency by which the needs in each theme arose and the associated callers' backgrounds. RESULTS A total of 1938 consultation cases were analyzed. In the qualitative analysis, the needs were classified into 16 themes. The mean number of unmet needs for each caller was 1.58 (standard deviation = 0.86). In the multi-variated analysis, caregivers for colorectal cancer survivors had a lower frequency of "emotional/mental health" needs (OR: 0.31, 95%CI: 0.11-0.88, p = 0.028) than did caregivers for breast-cancer survivors. Nevertheless, this was the only significant difference in needs frequency among callers (including survivors and their caregivers) with specific cancer types. Meanwhile, there significant difference in the frequency of occurrence of each unmet need theme was found among items concerning other background elements. Among survivors, sex was related to the frequency of needs among "physical" and "resources" themes, and "emotions/mental health"; their age group with "employment"; treatment course with "physical" and "resources" themes and "cure"; residence with "physical" themes; presence of symptom with "physical," "education/information," "resources," "emotions/mental health," and "cure" themes. CONCLUSIONS This large-scale study suggests that cancer type is not a significant factor for specific unmet needs and that individuals' backgrounds and presence of symptoms play a more important role. Through this study, it was found that instruments to predict people's needs and a system to provide individualized cancer care across cancer types should be developed in the future.
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Affiliation(s)
- Kaname Watanabe
- Department of Clinical Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan.,Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center, Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Kayoko Katayama
- Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center, Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takashi Yoshioka
- Department of Clinical Oncology, Yamagata University, Faculty of Medicine, Yamagata, Japan
| | - Hiroto Narimatsu
- Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center, Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan. .,Graduate School of Health of Innovation, Kanagawa University of Human Services, Kawasaki, Kanagawa, Japan.
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Fatiregun O, Sowunmi AC, Habeebu M, Okediji P, Alabi A, Fatiregun O, Adeniji A, Awofeso O, Adegboyega B. Prevalence and Correlates of Unmet Supportive Needs of Nigerian Patients With Cancer. J Glob Oncol 2019; 5:1-9. [PMID: 31246552 PMCID: PMC6613661 DOI: 10.1200/jgo.19.00043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Diagnosis and treatment of cancer are associated with significant psychological distress, and patients face a broad range of challenges that create a vacuum of unmet needs felt by patients, such as a loss of personal control and frustration. The aim of the current study was to determine the magnitude, distribution, and correlates of unmet needs in Nigerian patients with cancer. PATIENTS AND METHODS Using a descriptive cross-sectional approach, we assessed 205 patients with cancer who attended oncology outpatient clinics at the Lagos University Teaching Hospital. Eligible patients were administered the Supportive Care Needs Survey (SCNS) –Short Form 34 with a focus on five domains of need: psychological, health system and information, physical and daily living, patient care and support, and sexuality. RESULTS Mean age was 47.4 ± 12.3 years and patients were predominantly female (96.6%). The most common diagnosis was breast cancer (92.2%), and mean duration since diagnosis was 20.9 ± 21.9 months for all patients. Mean SCNS score was 83.9 ± 24.8 and at least 46% of participants indicated unmet needs in 15 items of the SCNS. The most frequent unattended needs were related to the health information (53.4%), physical and daily living (49.4%), psychological (48.5%), sexuality, and patient care and support domains. None of the factors considered—age, sex marital status, family type, educational attainment, employment status, economic status, the presence of financial support, social support, and cancer type—was significantly predictive of unmet needs in these patients (P > .05). CONCLUSION Nigerian patients with cancer experience considerable levels of unmet needs. These needs require urgent and long-term interventions to help patients achieve increased care satisfaction and a better quality of life.
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Affiliation(s)
| | | | | | - Paul Okediji
- Solar Center for International Development and Research, Abuja, Nigeria
| | - Adewumi Alabi
- Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
| | | | | | - Opeyemi Awofeso
- Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
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Zhao XS, Wang HY, Zhang LL, Liu YH, Chen HY, Wang Y. Prevalence and risk factors associated with the comprehensive needs of cancer patients in China. Health Qual Life Outcomes 2019; 17:102. [PMID: 31196089 PMCID: PMC6567519 DOI: 10.1186/s12955-019-1171-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/03/2019] [Indexed: 01/09/2023] Open
Abstract
Background The incidence and mortality rates of cancer have been increasing in developing countries, particularly in Asia. Therefore to provide optimal comprehensive care to the cancer patients, the care plan must focus on the comprehensive needs of cancer patients. The purpose of this study was to investigate the comprehensive needs of cancer patients, and explore the associated factors. Methods In a cross-sectional questionnaire study, a total of 200 cancer patient-caregiver dyads were selected and interviewed in Mainland China by convenient sampling method. Patients’ comprehensive needs were assessed with Comprehensive Needs Assessment Tool in cancer for Patients (CNAT), including seven domains (Information, Psychological Problems, Health Care Staffs, Physical Symptoms, Hospital Facilities and Services, Social/Religious/Spiritual Support and Practical Support). Both cancer patients and caregivers completed the sociodemographic survey. The mean differences in domain scores for different characteristics groups were compared by one-way ANOVA or non-parametric analyses, and influencing factors defined with multivariate regression analysis. Results The cancer patients’ need for Health Care Staffs (78.35 ± 13.08) was the highest among the seven domains, followed by the need for Information (71.18 ± 17.39) and the need for Hospital Facilities and Services (52.65 ± 13.35). The lowest score was the need for Physical Symptoms (35.12 ± 16.68). Patients who were female, with low family monthly income, at their own expense, and with highly educated caregivers had higher score of CNAT. Also sociodemographic characteristics were associated with each domain need of cancer patients. Conclusion This study shows that cancer patients experience high levels of needs for health-care staff and information, and the different needs are closely related to their sociological characteristics. The provision of health care can be adapted to meet the different needs of cancer patients of different epidemiological characteristics at different times during the course of treatment.
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Affiliation(s)
- Xin-Shuang Zhao
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Hong-Yun Wang
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China.
| | - Luo-Ling Zhang
- The 1st Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Yan-Hua Liu
- The 1st Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Hai-Yan Chen
- College of Nursing, Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
| | - Ying Wang
- Henan University of Science and Technology, Luoyang, 471023, People's Republic of China
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Blaschke SM, Gough KC, Chua BH, Francis PA, Cockerell R, Drosdowsky AF, Sheeran L, Krishnasamy M. Implementation of a Multidisciplinary Model of Care for Women With Metastatic Breast Cancer: Challenges and Lessons Learned. Clin Breast Cancer 2018; 19:e327-e336. [PMID: 30661949 DOI: 10.1016/j.clbc.2018.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 12/10/2018] [Accepted: 12/15/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The present study examined the feasibility and effects of integrating a multidisciplinary team (MDT) model of care for women with metastatic breast cancer (MBC) into a large Australian cancer center. The challenges encountered and lessons learned are described. PATIENTS AND METHODS In the present prospective, longitudinal, mixed-methods implementation study, the MDT model included face-to-face consultations with a breast care nurse and social worker, followed by a MDT case discussion and face-to-face delivery of a personalized management plan. Data were collected to describe the cohort of women living with MBC who had attended a specialist breast cancer service and their supportive care needs. RESULTS A total of 62 women with median age of 60 years (interquartile range [IQR], 37-82 years) participated. The median interval from the first breast cancer diagnosis was 5.7 years (IQR, 2.0-11.6 years), and the median interval from the diagnosis of MBC was 2.0 years (IQR, 0.9-3.6 years). The MDT care model required new resources and cross-sector participation. However, the participants indicated a preference for personalized needs assessment and care planning at the diagnosis of MBC. CONCLUSIONS The results highlight the challenges of implementing and evaluating an MDT care model for women with MBC. The model coordinated MDT collaboration to strengthen the delivery of complex care plans. Investment in cross-sector partnerships to optimize care coordination for women with MBC was needed.
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Affiliation(s)
- Sarah-May Blaschke
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
| | - Karla C Gough
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Boon H Chua
- University of New South Wales, Sydney and Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Robyn Cockerell
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Allison F Drosdowsky
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Lisa Sheeran
- Breast Service, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Meinir Krishnasamy
- Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia; Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
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Raphael D, Frey R, Gott M. The nature and timing of distress among post-treatment haematological cancer survivors. Eur J Cancer Care (Engl) 2018; 28:e12951. [PMID: 30284333 DOI: 10.1111/ecc.12951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/19/2018] [Accepted: 09/12/2018] [Indexed: 11/26/2022]
Abstract
Many people with haematological cancers will not meet the diagnostic criteria for a psychological disorder, but will still suffer distress during treatment and beyond. The current study aimed to explore the nature and timing of psychosocial distress experienced by haematological cancer survivors. Twenty-three post-treatment haematological cancer survivors participated in a semi-structured interview. Data were analysed using thematic analysis which involved identifying, analysing and reporting themes. Four themes were identified: Apprehension about leaving the safety of the health care system comprises the struggles encountered when transitioning from patient to survivor, Uncertainty and life transitions in the post-treatment period encompasses the changes survivors face when attempting to re-enter their "normal" lives, Distress associated with ongoing physical problems or impairment describes issues associated with the ongoing physical sequelae, and Fear of recurrence encapsulates how the continuing threat of cancer recurrence impacted survivors. This study has found that distress is ongoing for many haematological cancer survivors in the post-treatment period. It is imperative that distress is identified and support offered to those in need to prevent further psychosocial issues. It is especially important to consider the psychosocial needs of survivors in the post-treatment stage who are discharged from the health system may be unsure where to seek help.
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Affiliation(s)
- Deborah Raphael
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rosemary Frey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Wang T, Molassiotis A, Chung BPM, Tan JY. Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review. BMC Palliat Care 2018; 17:96. [PMID: 30037346 PMCID: PMC6057056 DOI: 10.1186/s12904-018-0346-9] [Citation(s) in RCA: 352] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/25/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND This systematic review aimed to identify the unmet care needs and their associated variables in patients with advanced cancer and informal caregivers, alongside summarizing the tools used for needs assessment. METHODS Ten electronic databases were searched systematically from inception of each database to December 2016 to determine eligible studies. Studies that considered the unmet care needs of either adult patients with advanced cancer or informal caregivers, regardless of the study design, were included. The Mixed Methods Appraisal Tool was utilized for quality appraisal of the included studies. Content analysis was used to identify unmet needs, and descriptive analysis was adopted to synthesize other outcomes. RESULTS Fifty studies were included, and their methodological quality was generally robust. The prevalence of unmet needs varied across studies. Twelve unmet need domains were identified in patients with advanced cancer, and seven among informal caregivers. The three most commonly reported domains for patients were psychological, physical, and healthcare service and information. The most prominent unmet items of these domains were emotional support (10.1-84.4%), fatigue (18-76.3%), and "being informed about benefits and side-effects of treatment" (4-66.7%). The most commonly identified unmet needs for informal caregivers were information needs, including illness and treatment information (26-100%) and care-related information (21-100%). Unmet needs of patients with advanced cancer were associated with their physical symptoms, anxiety, and quality of life. The most commonly used instruments for needs assessment among patients with advanced cancer were the Supportive Care Needs Survey (N = 8) and Problems and Needs in Palliative Care questionnaire (N = 5). The majority of the included studies investigated unmet needs from the perspectives of either patients or caregivers with a cross-sectional study design using single time-point assessments. Moreover, significant heterogeneity, including differences in study contexts, assessment methods, instruments for measurement, need classifications, and reporting methods, were identified across studies. CONCLUSION Both advanced cancer patients and informal caregivers reported a wide range of context-bound unmet needs. Examining their unmet needs on the basis of viewing patients and their informal caregivers as a whole unit will be highly optimal. Unmet care needs should be comprehensively evaluated from the perspectives of all stakeholders and interpreted by using rigorously designed mixed methods research and longitudinal studies within a given context.
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Affiliation(s)
- Tao Wang
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Betty Pui Man Chung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
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Haynes-Lewis H, Clayton MF, Viswanathan S, Moadel-Robblee A, Clark L, Caserta M. Distress and Supportive Care Needs of Ethnically Diverse Older Adults With Advanced or Recurrent Cancer. Oncol Nurs Forum 2018; 45:496-507. [PMID: 29947356 DOI: 10.1188/18.onf.496-507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the prevalence of supportive care needs (SCNs) and distress and to describe relationships among these and patient characteristics for ethnically diverse older adults with advanced or recurrent cancer. SAMPLE & SETTING Cross-sectional survey in five outpatient oncology clinics in an urban academic medical center involving 100 participants receiving cancer care in an economically challenged community. METHODS & VARIABLES The supportive care framework for cancer care guided this study, and participants completed the SCN Survey Short Form 34 and the Distress Thermometer. Study variables are cancer diagnosis, gender, helping to raise children, number of comorbid diseases, race or ethnicity, treatment status, and zip code. RESULTS Clinically meaningful distress was found in about a third of patients. Distress was not affected by race or ethnicity. Many ethnically diverse older patients with advanced or recurrent cancer report distress and SCNs; those with high distress are more likely to report multiple SCNs. IMPLICATIONS FOR NURSING Nursing assessment of patient SCNs and distress is integral to establishing individualized patient-centered care plans and to delivering optimal care.
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Supportive care priorities of low-income Latina breast cancer survivors. Support Care Cancer 2018; 26:3851-3859. [DOI: 10.1007/s00520-018-4253-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 05/06/2018] [Indexed: 11/25/2022]
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McRoy S, Rastegar-Mojarad M, Wang Y, Ruddy KJ, Haddad TC, Liu H. Assessing Unmet Information Needs of Breast Cancer Survivors: Exploratory Study of Online Health Forums Using Text Classification and Retrieval. JMIR Cancer 2018; 4:e10. [PMID: 29764801 PMCID: PMC5974460 DOI: 10.2196/cancer.9050] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/23/2018] [Accepted: 04/22/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient education materials given to breast cancer survivors may not be a good fit for their information needs. Needs may change over time, be forgotten, or be misreported, for a variety of reasons. An automated content analysis of survivors' postings to online health forums can identify expressed information needs over a span of time and be repeated regularly at low cost. Identifying these unmet needs can guide improvements to existing education materials and the creation of new resources. OBJECTIVE The primary goals of this project are to assess the unmet information needs of breast cancer survivors from their own perspectives and to identify gaps between information needs and current education materials. METHODS This approach employs computational methods for content modeling and supervised text classification to data from online health forums to identify explicit and implicit requests for health-related information. Potential gaps between needs and education materials are identified using techniques from information retrieval. RESULTS We provide a new taxonomy for the classification of sentences in online health forum data. 260 postings from two online health forums were selected, yielding 4179 sentences for coding. After annotation of data and training alternative one-versus-others classifiers, a random forest-based approach achieved F1 scores from 66% (Other, dataset2) to 90% (Medical, dataset1) on the primary information types. 136 expressions of need were used to generate queries to indexed education materials. Upon examination of the best two pages retrieved for each query, 12% (17/136) of queries were found to have relevant content by all coders, and 33% (45/136) were judged to have relevant content by at least one. CONCLUSIONS Text from online health forums can be analyzed effectively using automated methods. Our analysis confirms that breast cancer survivors have many information needs that are not covered by the written documents they typically receive, as our results suggest that at most a third of breast cancer survivors' questions would be addressed by the materials currently provided to them.
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Affiliation(s)
- Susan McRoy
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Online information and support needs of women with advanced breast cancer: a qualitative analysis. Support Care Cancer 2018; 26:3489-3496. [PMID: 29693203 DOI: 10.1007/s00520-018-4206-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Women with advanced breast cancer (ABC) face significant adjustment challenges, yet few resources provide them with information and support, and attendance barriers can preclude access to face-to-face psychosocial support. This paper reports on two qualitative studies examining (i) whether information and support-seeking preferences of women with ABC could be addressed in an online intervention, and (ii) how an existing intervention for patients with early stage cancer could be adapted for women with ABC. METHODS Women with ABC participated in telephone interviews about their information and support-seeking preferences (N = 21) and evaluated an online intervention focused on early-stage cancer (N = 15). Interviews were transcribed and underwent thematic analysis using the framework method to identify salient themes. RESULTS Participants most commonly sought medical, lifestyle-related, and practical information/support; however, when presented with an online intervention, participants most commonly gave positive feedback on content on coping with emotional distress. Difficulty finding information and barriers to using common sources of information/support including health professionals, family and friends, and peers were reported; however, some women also reported not wanting information or support. All participants evaluating the existing intervention gave positive feedback on various components, with results suggesting an online intervention could be an effective means of providing information/support to women with ABC, given improved specificity/relevance to ABC and increased tailoring to individual circumstances and preferences. CONCLUSIONS Adaptation of an existing online intervention for early stage cancer appears to be a promising avenue to address the information and support needs of women with ABC.
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Sakamoto N, Takiguchi S, Komatsu H, Okuyama T, Nakaguchi T, Kubota Y, Ito Y, Sugano K, Wada M, Akechi T. Supportive care needs and psychological distress and/or quality of life in ambulatory advanced colorectal cancer patients receiving chemotherapy: a cross-sectional study. Jpn J Clin Oncol 2017; 47:1157-1161. [DOI: 10.1093/jjco/hyx152] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 09/28/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nobuhiro Sakamoto
- Division of Psycho-Oncology and Palliative Care, Nagoya City University Hospital
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School
| | - Shuji Takiguchi
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School
| | - Hirokazu Komatsu
- Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences
| | - Toru Okuyama
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences
| | - Tomohiro Nakaguchi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences
| | - Yosuke Kubota
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences
| | - Yoshinori Ito
- Division of Psycho-Oncology and Palliative Care, Nagoya City University Hospital
| | - Koji Sugano
- Division of Respiratory Medicine, Juntendo Tokyo Koto Geriatric Medical Center
| | - Makoto Wada
- Department of Psycho-Oncology and Palliative Medicine, Osaka International Cancer Institute, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences
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Yu FF, Bai YN, He H, Zhu L, Zhang RL, Jiao HX, Li QY, Fu JF. Identifying the unmet supportive care needs, with concomitant influencing factors, in adult acute leukemia patients in China. Eur J Oncol Nurs 2017; 30:67-74. [DOI: 10.1016/j.ejon.2017.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 02/17/2017] [Accepted: 07/03/2017] [Indexed: 12/26/2022]
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The influence of unmet supportive care needs on anxiety and depression during cancer treatment and beyond: a longitudinal study of survivors of haematological cancers. Support Care Cancer 2017; 25:3447-3456. [DOI: 10.1007/s00520-017-3766-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 05/29/2017] [Indexed: 11/25/2022]
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Özbayır T, Geçkil ÖS, Aslan A. An Adaptation of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF 34) into Turkish. Eur J Breast Health 2017; 13:183-188. [PMID: 29082375 DOI: 10.5152/tjbh.2017.3266] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/07/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In the study, Adaptation of The Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF 34) into Turkish, examination of its validity and reliability was aimed at. MATERIALS AND METHODS The study was carried out between May and July, 2016 with 170 patients. The socio-demographic and clinical status was analyzed by means of number averages and standard deviation. After language validity, the content validity index was calculated. The split-scale analyses, which are reliability internal consistency tests, were performed with the Cronbach α coefficient and total item correlation. For structure validity, exploratory factor analysis was used. RESULTS The average age of the patients is 55.53±11.43 years and average time since diagnosis is 5.69±5.06 years. The content validity index of the scale was calculated as 0.83. The Cronbach α coefficient is 0.93. In terms of the item total score correlation, all correlation coefficients except items 18 and 19 were between 0.36 and 0.81 and p<0.001. Items 18 and 19 were excluded. Following the exploratory factor analysis, items 13, 17 and 32 were excluded as their two detected high weight values were below 0.10. The descriptive factor analysis of item 29, four factors with eigenvalues over one and the total variance described by these four values was 68.83%. The factors were determined to be healthcare service and informing, psychology, sexuality and daily life. CONCLUSION It was confirmed that the SCNS-SF 29Tr is a valid and reliable means for the Turkish society for the determination of the supportive care needs of breast cancer patients.
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Affiliation(s)
- Türkan Özbayır
- Department of Surgical Disease Nursing, Ege University School of Nursing, İzmir, Turkey
| | - Özlem Soyer Geçkil
- Department of Surgical Disease Nursing, Ege University School of Nursing, İzmir, Turkey
| | - Arzu Aslan
- Department of Surgical Disease Nursing, Ege University School of Nursing, İzmir, Turkey
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Swash B, Bramwell R, Hulbert-Williams NJ. Unmet psychosocial supportive care needs and psychological distress in haematological cancer survivors: The moderating role of psychological flexibility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2017.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Schmidt AL, Lorenz RA, Buchanan PM, McLaughlin L. Evaluating the Needs of Patients Living With Solid Tumor Cancer: A Survey Design. J Holist Nurs 2016; 36:15-22. [PMID: 27872340 DOI: 10.1177/0898010116677146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe the unmet needs of adult patients living with solid tumor cancer. DESIGN Survey design. METHOD Adult patients living with solid tumor cancer from two outpatient clinics were mailed the Sheffield Profile for Assessment and Referral to Care, a holistic screening questionnaire for assessing palliative care needs, and a demographics questionnaire. One hundred fifteen patients returned the instruments, corresponding to a 62% response rate. FINDINGS There were no significant differences by cancer type (breast, non-breast) or gender. However, Caucasians reported significantly more psychological issues, such as anxiety, than non-Caucasians ([ n = 101 (87.8%)] and [ n = 14 (12.2%)], respectively, p = .032). Older patients reported more concerns about loss of independence/activity ( p = .012) compared with younger age groups. Patients living with Stage III/IV cancer reported more distressed about independence/activity ( p = .034), family/social issues ( p = .007), and treatment side effects ( p = .027) than patients living with Stage I/II cancer. CONCLUSION Patients living with solid tumor cancer have a myriad of unmet needs regardless of age, gender, cancer type, or cancer stage. There appears to be important differences by cancer stage. The Sheffield Profile for Assessment and Referral to Care questionnaire provides a holistic approach for nurses to identify unmet needs and concerns. Future research should explore the preferred methods of receiving support and information.
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Hasegawa T, Goto N, Matsumoto N, Sasaki Y, Ishiguro T, Kuzuya N, Sugiyama Y. Prevalence of unmet needs and correlated factors in advanced-stage cancer patients receiving rehabilitation. Support Care Cancer 2016; 24:4761-7. [PMID: 27344328 DOI: 10.1007/s00520-016-3327-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Although rehabilitation for patients with cancer is currently being provided throughout all phases of the disease, including the advanced stage, much remains unknown about the needs of such patients. The aims of this study were to identify the supportive care and unmet needs of cancer patients receiving rehabilitation interventions and to investigate the factors associated with those unmet needs. METHODS A total of 45 patients with cancer receiving rehabilitation interventions participated in this study between June 2013 and December 2015. Measures included the Japanese version of the Short-Form Supportive Care Needs Survey Questionnaire (SCNS-SF34), the Functional Independence Measure (FIM), the Hospital Anxiety and Depression Scale (HADS), and various other medico-social factors. RESULTS The mean age of the cancer patients was 66.6 years, the mean (±standard deviation) FIM score was 111.8 (±16.1), and the mean HADS score was 13.9 (±8.2). The patients had a mean of 17.4 (±10.3) unmet needs. The top ten unmet needs related to rehabilitation intervention included seven psychological needs, two health system and information needs, and one physical and daily living need. Multiple regression analysis revealed that psychological distress (HADS ≥11), marital status, and sex were significantly associated with physical and daily living needs. CONCLUSIONS These results suggest that psychosocial factors are important in understanding the supportive care and unmet needs of cancer patients receiving rehabilitation interventions.
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Affiliation(s)
- Takaaki Hasegawa
- Department of Respiratory Medicine and Medical Oncology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan. .,Palliative Care Center, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan.
| | - Naoya Goto
- Department of Rehabilitation, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan
| | - Naoto Matsumoto
- Department of Rehabilitation, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan
| | - Yusuke Sasaki
- Department of Rehabilitation, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan
| | - Takashi Ishiguro
- Department of Respiratory Medicine and Medical Oncology, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan.,Palliative Care Center, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan
| | - Nanori Kuzuya
- Palliative Care Center, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan
| | - Yasuyuki Sugiyama
- Palliative Care Center, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu City, Gifu, 500-8513, Japan
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Moghaddam N, Coxon H, Nabarro S, Hardy B, Cox K. Unmet care needs in people living with advanced cancer: a systematic review. Support Care Cancer 2016; 24:3609-22. [PMID: 27137214 DOI: 10.1007/s00520-016-3221-3] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/17/2016] [Indexed: 02/05/2023]
Abstract
PURPOSE The support needs of cancer patients vary according to the phase of their cancer journey. Recent developments in healthcare are such that the advanced cancer phase is increasingly experienced as a chronic illness phase, with consequent changes in patient support needs. Understanding these needs, and identifying areas of unmet need, can enable us to develop services that are more adequate to the task of supporting this population. METHODS We conducted a systematic search of four electronic databases to identify studies examining the unmet needs of people living with advanced cancer. Relevant data were extracted and synthesised; meta-analyses were conducted to obtain pooled estimates for prevalence of needs. RESULTS We identified 23 studies (4 qualitative) for inclusion. Unmet needs were identified across a broad range of domains, with greatest prevalence in informational (30-55 %), psychological (18-42 %), physical (17-48 %), and functional (17-37 %) domains. There was considerable heterogeneity amongst studies in terms of methods of assessment, coding and reporting of needs, respondent characteristics, and appraised study quality. CONCLUSIONS Heterogeneity made it difficult to compare across studies and inflated confidence intervals for pooled estimates of prevalence-we need standardised and comprehensive approaches to assessment and reporting of unmet needs to further our understanding. Nonetheless, the review identified prominent needs across a range of (interacting) experiential domains. Moreover, by focussing on unmet needs for support, we were able to extrapolate potential implications for service development.
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Affiliation(s)
- Nima Moghaddam
- College of Social Sciences, University of Lincoln, Brayford Pool, Lincoln, UK.
| | | | | | - Beth Hardy
- Department of Health Sciences, University of York, York, UK
| | - Karen Cox
- School of Health Sciences, University of Nottingham, Nottingham, UK
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Kim SH, Lee S, Kim SH, Ok ON, Kim IR, Choi E, Kang YK, Kim SJ, Lee MH. Unmet needs of non-Hodgkin lymphoma survivors in Korea: prevalence, correlates, and associations with health-related quality of life. Psychooncology 2016; 26:330-336. [PMID: 27073128 DOI: 10.1002/pon.4136] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/17/2016] [Accepted: 03/22/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVE We aimed to describe the prevalence and correlates of unmet needs among non-Hodgkin lymphoma (NHL) survivors in Korea and to identify their association with health-related quality of life (HRQOL). METHODS Participants were 826 NHL survivors from three hospitals in South Korea diagnosed at least 24 months prior to participating (mean, 6.3 years; range, 2.1-20.9 years). We used self-reported questionnaires, including the Need Scale for Cancer Patients Undergoing Follow-up Care (NS-C) developed in Korea and the EORTC QLQ-C30. We defined an unmet need as a moderate to high level of unmet need in the NS-C response scale. RESULTS Among six domains, unmet need prevalence ranged from 1.7% to 38.3%. Most commonly reported domains with unmet needs were 'treatment and prognosis' (38.3%) and 'keeping mind under control' (30.5%). The three most frequently reported individual unmet needs were 'being informed about prevention of recurrence' (50.7%), 'being informed about prevention of metastasis' (49.7%), and 'having self-confidence of overcoming cancer' (42.7%). Multivariate logistic analyses revealed that younger age, being unmarried, and low monthly income were associated with unmet needs of multiple domains. Participants with unmet needs demonstrated significantly poorer HRQOL, and the most clinically meaningful differences were found in social function and emotional function. CONCLUSIONS Korean NHL survivors have substantial unmet needs, especially those who are younger, unmarried, and have a lower income. Initiating supportive care programs for meeting unmet needs may enhance their HRQOL. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, South Korea
| | - Suyeon Lee
- Department of Oncology, Asan Medical Center, Seoul, South Korea
| | - So Hee Kim
- Cancer Edu-Info Center, Asan Medical Center, Seoul, South Korea
| | - Oh Nam Ok
- Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
| | - Im-Ryung Kim
- Cancer Education Center, Samsung Medical Center, Seoul, South Korea
| | - Eunju Choi
- Department of Nursing, Inha University, Incheon, South Korea
| | - Yoon-Koo Kang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seok Jin Kim
- Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Moon Hee Lee
- Division of Hematology-Oncology, Inha University Hospital and College of Medicine, Incheon, South Korea
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Abdollahzadeh F, Moradi N, Pakpour V, Rahmani A, Zamanzadeh V, Mohammadpoorasl A, Howard F. Un-met supportive care needs of Iranian breast cancer patients. Asian Pac J Cancer Prev 2016; 15:3933-8. [PMID: 24935576 DOI: 10.7314/apjcp.2014.15.9.3933] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. MATERIALS AND METHODS A descriptive- correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. RESULTS Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. CONCLUSIONS The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.
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Affiliation(s)
- Farahnaz Abdollahzadeh
- Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran E-mail :
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Edib Z, Kumarasamy V, Binti Abdullah N, Rizal AM, Al-Dubai SAR. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Health Qual Life Outcomes 2016; 14:26. [PMID: 26898558 PMCID: PMC4762172 DOI: 10.1186/s12955-016-0428-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 02/12/2016] [Indexed: 12/16/2022] Open
Abstract
Background Addressing breast cancer patients’ unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients’ characteristics, and their unmet supportive care needs. Methods A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants’ socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Results The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Conclusion Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.
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Affiliation(s)
- Zobaida Edib
- Department of Community Medicine, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Verasingam Kumarasamy
- Department of Community Medicine, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Norlia Binti Abdullah
- Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia.
| | - A M Rizal
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia.
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Park JH, Chun M, Jung YS, Jung YM. Changes of Supportive Care Needs and Quality of Life in Patients with Breast Cancer. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.4.217] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jin-Hee Park
- College of Nursing · The Institute of Nursing Science, Ajou University, Suwon, Korea
| | - Mison Chun
- School of Medicine, Department of Radiation Oncology, Ajou University, Suwon, Korea
| | - Yong-Sik Jung
- School of Medicine, Department of Surgery, Ajou University, Suwon, Korea
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Miyashita M, Ohno S, Kataoka A, Tokunaga E, Masuda N, Shien T, Kawabata K, Takahashi M. Unmet Information Needs and Quality of Life in Young Breast Cancer Survivors in Japan. Cancer Nurs 2015; 38:E1-11. [PMID: 25254410 PMCID: PMC4612149 DOI: 10.1097/ncc.0000000000000201] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND Young breast cancer survivors have specific needs related to age. Clarifying the relationships between unmet information needs and quality of life (QOL) in young breast cancer survivors can contribute to constructing a support system to enhance QOL in patients. OBJECTIVE This study aimed to identify the unmet information needs and examine the relationships between unmet information needs and QOL in young breast cancer survivors in Japan. METHODS Participants completed an information needs questionnaire containing 26 items, the World Health Organization Quality of Life Instrument-Short Form (WHOQOL-BREF), and a demographic and medical information questionnaire. RESULTS Fifty participants (30.7%) were unsatisfied with "overall communication with medical professionals." The mean scores on all subscales of the WHOQOL-BREF of the participants who were satisfied with "overall communication with medical professionals" were significantly higher than those of the unsatisfied group. "follow-up tests," "treatment for recurrence of breast cancer," "strategies about communication with medical staff," and "nutrition" were significantly related with all subscales in the WHOQOL-BREF. "Secondary menopause caused by hormonal therapy" was significantly related with physical and psychological health. CONCLUSIONS Japanese young breast cancer survivors have unmet information needs, including age-specific issues. These unmet information needs are related to QOL. In particular, "overall communication with medical professionals," which is the most unmet information need, is related to QOL. IMPLICATIONS FOR PRACTICE Oncology nurses should teach patients communication skills, provide adequate information, and provide education and emotional support to medical professionals to improve QOL in young breast cancer survivors.
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Affiliation(s)
- Mika Miyashita
- Author Affiliations: Division of Nursing Science, Graduate School of Biomedical and Health Sciences, Hiroshima University (Dr Miyashita); Clinical Cancer Institute, National Hospital Organization Kyushu Cancer Center, Fukuoka (Dr Ohno); Department of Breast and Endocrine Surgery, Toho University Omori Medical Center, Tokyo (Dr Kataoka); Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Dr Tokunaga); Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital (Dr Masuda); Department of Breast and Endocrine Surgery, Okayama University Hospital (Dr Shien); Department of Nursing School of Health and Social Services, Saitama Prefectural University, Koshigaya (Dr Kawabata); and Cancer Survivorship Research Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo (Dr Takahashi), Japan
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Lam WWT, Law WL, Poon JTC, Fong D, Girgis A, Fielding R. A longitudinal study of supportive care needs among Chinese patients awaiting colorectal cancer surgery. Psychooncology 2015; 25:496-505. [DOI: 10.1002/pon.3946] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 05/18/2015] [Accepted: 07/28/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Wendy W. T. Lam
- School of Public Health; The University of Hong Kong; Pok Fu Lam Hong Kong
| | - Wai-Lun Law
- Department of Surgery; The University of Hong Kong; Pok Fu Lam Hong Kong
| | - Jensen T. C. Poon
- Department of Surgery; The University of Hong Kong; Pok Fu Lam Hong Kong
| | - Daniel Fong
- School of Nursing; The University of Hong Kong; Pok Fu Lam Hong Kong
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research; South Western Sydney Clinical School, UNSW Medicine; University of New South Wales; Sydney New South Wales Australia
| | - Richard Fielding
- School of Public Health; The University of Hong Kong; Pok Fu Lam Hong Kong
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Schmitz C, Ansmann L, Ernstmann N. Psychosocial Information Requirements for Multimorbid Breast Cancer Patients in Breast Centres in North Rhine Westphalia. Geburtshilfe Frauenheilkd 2015; 75:702-709. [PMID: 26257407 DOI: 10.1055/s-0035-1546271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/06/2015] [Accepted: 06/15/2015] [Indexed: 10/23/2022] Open
Abstract
Introduction: The importance of breast cancer patients (BPs) being supplied with sufficient information is well known. This study investigated the unfulfilled psychosocial information requirements of multimorbid BPs. Methods: This study records the unfulfilled psychosocial information requirements of 4166 patients, who were treated at one of the fifty breast centres in North Rhine Westphalia. The Cologne patient questionnaire for breast cancer 2.0 included in the postal survey following hospital stays records the information requirements using an adapted version of the "Cancer patient information needs" scale. Through a univariate analysis using the χ2 test, it was investigated whether multimorbid BPs had significantly different psychosocial information requirements than BPs without further concomitant illnesses. Results: In general, it transpired that BPs had relatively low unfulfilled information requirements regarding work (20.7 %), everyday life (26.8 %), illness (27.4 %) and treatment (35.7 %), though such requirements were higher when it came to health-related behaviour (54.2 %). Multimorbid BPs had significantly lower unfulfilled information requirements regarding work and significantly larger ones regarding treatment in comparison to BPs without concomitant illnesses. Renal diseases and concomitant mental illnesses were associated with particularly high information requirements (p < 0.05). Conclusion: The results of our study should clarify the complexity and heterogeneity of information requirements of breast cancer patients in oncological care and should help to design the supply of information to be more patient-oriented.
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Affiliation(s)
- C Schmitz
- IMVR - Institute of Medical Sociology, Health Services and Rehabilitation Science, University of Cologne, Cologne
| | - L Ansmann
- IMVR - Institute of Medical Sociology, Health Services and Rehabilitation Science, University of Cologne, Cologne
| | - N Ernstmann
- IMVR - Institute of Medical Sociology, Health Services and Rehabilitation Science, University of Cologne, Cologne
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