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Bore MG, Dadi AF, Ahmed KY, Hassen TA, Kibret GD, Kassa ZY, Amsalu E, Ketema DB, Perry L, Alemu AA, Shifa JE, Alebel A, Leshargie CT, Bizuayehu HM. Unmet Supportive Care Needs Among Cancer Patients in Sub-Saharan African Countries: A Mixed Method Systematic Review and Meta-Analysis. J Pain Symptom Manage 2024; 67:e211-e227. [PMID: 38043746 DOI: 10.1016/j.jpainsymman.2023.11.023] [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] [Received: 08/21/2023] [Revised: 10/13/2023] [Accepted: 11/19/2023] [Indexed: 12/05/2023]
Abstract
INTRODUCTION Supportive cancer care is vital to reducing the current disparities in cancer outcomes in Sub-Saharan Africa (SSA), including poor survival and low quality of life, and ultimately achieving equity in cancer care. This is the first review aimed to evaluate the extent of unmet supportive care needs and identify their contributing factors among patients with cancer in SSA. METHODS Six electronic databases (CINAHL, Embase, Medline [Ovid], PsycINFO, PubMed, and Cochrane Library of Databases] were systematically searched. Studies that addressed one or more domains of unmet supportive cancer care needs were included. Findings were analyzed using narrative analysis and meta-analysis, as appropriate. RESULT Eleven articles out of 2732 were retained in the review. The pooled prevalence of perceived unmet need for cancer care in SSA was 63% (95% CI: 45, 81) for physical, 59% (95% CI: 45, 72) for health information and system, 58% (95% CI: 42, 74) for psychological, 44% (95% CI: 29, 59) for patient care and support, and 43% (95% CI: 23, 63) for sexual. Older age, female sex, rural residence, advanced cancer stage, and low access to health information were related to high rates of multiple unmet needs within supportive care domains. CONCLUSION In SSA, optimal cancer care provision was low, up to two-thirds of patients reported unmet needs for one or more domains. Strengthening efforts to develop comprehensive and integrated systems for supportive care services are keys to improving the clinical outcome, survival, and quality of life of cancer patients in SSA.
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Affiliation(s)
- Meless Gebrie Bore
- School of Nursing and Midwifery (M.G.B., Z.Y.K.), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; School of Nursing (M.G.B.), College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
| | - Abel Fekadu Dadi
- Menzies School of Health Research (A.F.D.), Charles Darwin University, Northern Territory, Australia; Addis Continental Institute of Public Health (A.F.D.), Addis Ababa, Ethiopia.
| | - Kedir Yimam Ahmed
- Rural Health Research Institute (K.Y.A.), Charles Sturt University, Orange, New South Wales, Australia.
| | - Tahir Ahmed Hassen
- Center for Women's Health Research (T.A.H.), College of Health, Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia.
| | - Getiye Dejenu Kibret
- School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; Save Sight Institute (G.D.K.), The University of Sydney, New South Wales, Australia
| | - Zemenu Yohannes Kassa
- School of Nursing and Midwifery (M.G.B., Z.Y.K.), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia; Department of Midwifery (Z.Y.K.), College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Erkihun Amsalu
- Sydney Medical School (E.A.), Faculty of Medicine and Health, University of Sydney, New South Wales, Australia; St. Paul Hospital Millennium Medical College (E.A.), Addis Ababa, Ethiopia
| | - Daniel Bekele Ketema
- School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; The George Institute for Global Health (D.B.K.), University of New South Wales (UNSW), Sydney, Australia.
| | - Lin Perry
- Faculty of Health, University of Technology Sydney (L.P.), Ultimo, Australia; Prince of Wales Hospital (L.P.), Randwick, New South Wales, Australia.
| | - Addisu Alehegn Alemu
- School of Women's and Children's Health (A.A.A.), University of New South Wales, Sydney, Australia; College of Medicine and Health Science (A.A.A.), Debre Markos University, Debre Markos, Ethiopia.
| | - Jemal Ebrahim Shifa
- School of Public Health, Faculty of Health (J.E.S., A.A., C.T.L.), University of Technology Sydney, Ultimo, New South Wales, Australia.
| | - Animut Alebel
- School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; School of Public Health, Faculty of Health (J.E.S., A.A., C.T.L.), University of Technology Sydney, Ultimo, New South Wales, Australia.
| | - Cheru Tesema Leshargie
- School of Public Health (G.D.K., D.B.K., A.A., C.T.L.), College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia; School of Public Health, Faculty of Health (J.E.S., A.A., C.T.L.), University of Technology Sydney, Ultimo, New South Wales, Australia.
| | - Habtamu Mellie Bizuayehu
- First Nations Cancer and Wellbeing (FNCW) Research Program (H.M.B.), School of Public Health, The University of Queensland, Australia.
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Lyu MM, Siah RCJ, Zhao J, Cheng KKF. Supportive care needs of breast cancer survivors with different levels of fear of cancer recurrence: A cross-sectional survey study. Eur J Oncol Nurs 2023; 66:102360. [PMID: 37499406 DOI: 10.1016/j.ejon.2023.102360] [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: 02/13/2023] [Revised: 05/20/2023] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE To examine the supportive care needs of breast cancer survivors with nonclinical, subclinical, or clinical fear of cancer recurrence. METHODS In this cross-sectional study, 385 breast cancer survivors consented and completed a set of online questionnaires. Supportive care needs were assessed by using the 34-item Supportive Care Needs Survey. Fear of cancer recurrence was assessed by using the Fear of Cancer Recurrence Inventory. RESULTS One hundred eighty-four (47.8%) participants reported nonclinical fear of cancer recurrence, 147 (38.2%) reported subclinical fear of cancer recurrence, and 54 (14.0%) reported clinical fear of cancer recurrence. Higher levels of fear of cancer recurrence were associated with higher levels of supportive care needs in five domains (β = 0.30-0.60, P < 0.001) after adjusting for places of residence, education, motherhood, and time since diagnosis. Among participants with nonclinical fears of cancer recurrence, the most common needs were in the 'Health care system/Information' domain (50.5%). Among participants with subclinical or clinical fear of cancer recurrence, the most common needs were in the 'Psychological' domain (85.7% and 96.3%, respectively). CONCLUSION Fear of cancer recurrence was associated with supportive care needs. The most common needs among participants with subclinical or clinical fears of cancer recurrence were psychological needs.
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Affiliation(s)
- Meng-Meng Lyu
- National University of Singapore, Singapore, Singapore.
| | | | - Jia Zhao
- The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Karis Kin Fong Cheng
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Japan
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