Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia

Is There a Difference in Unmet Supportive Care Needs Between Older and Younger Outpatients Receiving Chemotherapy?

Objective: This study investigated whether there was a difference in unmet supportive care needs between older and younger cancer patients who receive chemotherapy. Background: Physiological, physical, cognitive, and social functions, which play a key role in coping with cancer, are impaired due to aging. Age-related physiological changes and psychosocial factors and comorbid medical conditions make some of the needs of older cancer patients unique and complex. At the heart of meeting these needs lies the concept of supportive care. First step of meeting their needs is to determine these needs. Study Design and Methods: The study was conducted in the Daytime Treatment Unit of the oncology hospital of a university in Ankara, Turkey. The study sample consisted of 93 patients aged 65 years or older and 93 patients under 65 years of age. Both groups were similar in terms of sex, cancer type, and chemotherapy protocols. Data were collected using a Patient Information Form and Supportive Care Needs Scale-Short Turkish Version and analyzed using descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and Bonferroni correction. Results: Participants had a median total score of 1.92. Their "daily life needs" and "sexuality needs" subscale scores were highest and lowest, respectively. Older patients had lower median total scores than younger patients. Younger patients had higher median "health care and information needs" and "sexuality needs" subscale scores than older patients. Conclusion: Elderly patients reported fewer unmet needs than younger patients. This may be due to age-related cultural factors as they may have difficulty expressing their needs. Implications: Results suggest to focus on the fact that patients' needs change with age and that they have difficulty expressing their needs.

Prospective cohort study of unmet supportive care needs, post-traumatic growth, coping strategy and social supports among patients with breast cancer: The PenBCNeeds study

PURPOSE

While the unmet healthcare needs are still being improved upon, the wellbeing of cancer patients has increasingly become a prime concern in Malaysia. The objective of this study is to ascertain the trend of unmet supportive care needs, post-traumatic growth (P T G), coping strategies, and social supports among patients with breast cancer over the three time points of treatment: T1 at early diagnosis, T2 for three months after diagnosis, and T3 for six months after diagnosis.

METHODS

A total of 240 cancer patients participated in this prospective cohort study, with follow-up visits from October 2019 until July 2021. Data were collected using several instruments: Brief COP E, the Source of Social Support Scale (SSSS), the Post-Traumatic Growth Inventory - Short Form (P T GI-SF), and a Malay version of the 34-Item Shortform Supportive Care Need Survey (SCNS-SF34).

RESULTS

The results indicated a significant change from T1 to T3 for all domains of the unmet needs (p-value < 0.001), except for the sexual domain. A lower SCNS-SF34 score resulted from more unfavorable social support. The P T GI-SF results indicated a trend toward meeting the unmet needs, and a higher SCNS-SF-34 score predicted a considerably higher P T GI-SF score.

CONCLUSIONS

Our study findings suggest that majority of the factors evaluated in terms of unmet needs among cancer patients have undergone considerable changes.

Factors influencing the supportive care needs of female patients with genital cancer in South Korea

Genital cancers are particularly important compared to other cancers because of the psychological impact they have on the individual. This study investigated the complexity in illness and quality of life among female genital cancer patients and determined the effects of these factors on supportive care needs to provide evidential data for the development of nursing intervention strategies to reduce supportive care needs in female genital cancer patients. This cross-sectional study collected data from July 22 to August 17, 2021. The study subjects were 103 female outpatients and inpatients aged 19 years or older who were treated for cervical cancer, endometrial cancer, ovarian cancer, or other female genital cancers such as vulvar cancer and vaginal cancer in a university hospital in Korea. The data were analyzed with t-tests and Scheffé's test using SPSS 26.0. The factors affecting supportive care needs were examined using hierarchical regression. The average age of the subjects was 56.41 (±9.91) years. Cervical cancer was the most common diagnosis at 42.7%, followed by ovarian cancer at 34.0%, and endometrial cancer at 21.4%. The factors affecting supportive care needs included a middle school education or below (β = 0.21, P = .028), unemployment (β = 0.23, P = .018), complexity in illness (β = 0.32, P < .001), and quality of life (β = -0.68, P < .001). Developing a strategy for managing the complexity in illness and quality of life caused by various variables including disease stage and type of treatment is necessary to reduce the supportive care needs of female genital cancer patients. Improving their quality of life through effective communication with healthcare providers is essential.

A Longitudinal Evaluation of the Preferences of Patients With Advanced Cancer for Quality of Life and Survival in Malaysia: A Discrete Choice Experiment

OBJECTIVES

This study aims to quantify the preferences of patients with advanced cancer for quality of life (QoL) outcomes versus survival extension in Malaysia. The secondary aim of this study is to explore the change in preferences over time.

METHODS

A discrete choice experiment was developed to include 7 attributes valued in cancer management: physical, psychological and social functioning, pain control, survival, place of death, and cost. Patients were recruited via convenience sampling from 2 Malaysian public hospitals. The survey questionnaire was administered to patients within 6 months of their cancer diagnosis with a follow-up 3 months later. Conditional logit regression was used to estimate the preference weight, relative attribute importance, and willingness to pay.

RESULTS

One hundred valid responses were collected at baseline and 45 at follow-up. Respondents placed higher values on QoL improvements from severe to moderate or mild levels and to achieve home death over survival extension from 6 to 18 months. However, additional improvements (from moderate to mild) in some of the QoL outcomes were not valued as highly as life extension from 12 to 18 months, showing that it was vital for patients to avoid being in "severe" health dysfunction. Improving physical dysfunction from severe to mild yielded 3 times as much value as additional 1-year survival. After 3 months, the respondents' preferences changed significantly, with increased relative attribute importance of physical functioning, pain control, and cost.

CONCLUSIONS

As QoL outcomes are valued more than survival, palliative care should be introduced as early as possible to alleviate suffering related to advanced cancer.

A comparative study on the effects of Mitchell and Benson relaxation techniques on quality of life of the old people in nursing homes: a quasi- experimental study

BACKGROUND

There is slight evidence on the effectiveness of relaxation techniques to improve quality of life of the old people, and no comparative studies have particularly investigated this population. Hence, the present study was conducted to examine the effect of Mitchell relaxation versus Benson relaxation technique to improve quality of life of the old people.

METHODS

In the present quasi-experimental study, 96 eligible old people in a nursing home were selected by available sampling method. Afterwards, they were assigned to three groups: Mitchell's Relaxation Technique, Benson Relaxation Technique, and control (each of 32 participants) using the random block sampling method. The intervention groups received relaxation for 8 weeks and 3 sessions of 20 min each week. However, the control group did not receive any relaxation. Data was gathered by questionnaires (SF-36) and (CASP-19) before (week 0) and after the intervention (week 8) and were analyzed using the SPSS software version 26.

RESULTS

The results indicated that both Benson and Mitchell relaxation had improved the quality of life (SF-36) and (CASP-19) and their sub-scales in the participants compare to the control group (P < 0.001). Accordingly, the median (quartile 25, 75) of the specific quality of life of the participants before the intervention was 21 (18.25, 25.75) in the Benson group, 20.5 (16, 24) in the Michel group, and 21 (16.25, 24) in the control group. However, after the intervention they reached 35(26.25, 38.75), 34.5(26.75, 42.25), and 17 (14, 21) respectively. There was no statistically significant difference between the Benson and Michel relaxation groups.

CONCLUSIONS

Based on the results, Benson and Mitchell relaxation techniques improve the quality of life of the old people. If the results be confirmed in other studies, the education of each of them, especially for the old people living in nursing homes and their caregivers, is suggested as routine care.

Depression and anxiety among patients treated for bladder cancer: examining clinical, demographic, and psychosocial predictors

INTRODUCTION AND OBJECTIVE

The significant impact of bladder cancer and treatment on patient health related quality of life (HRQoL) and emotional wellbeing has been documented. Increasing evidence from cancer research emphasizes the importance of examining patients supportive care needs and received social support as factors that could influence their emotional adjustment. The purpose of the study was to assess the demographic and clinical predictors of depression and anxiety among bladder cancer patients and its associations with patient reported supportive care needs and perceived availability of social support.

METHODS

A cross-sectional design was used to investigate the study questions. Bladder cancer patients were recruited from the Bladder Cancer Advocacy Network (BCAN) to complete a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), bladder cancer patient need survey (BCNAS-32), and the social provisions scale (SPS). The inclusion criteria restricted our sample to include bladder cancer patients who were English speakers, aged 18-85 years, and were able and willing to provide informed consent. Patients who had metastatic disease, cancer recurrence, or other primary cancers at the time of assessment were excluded from the study.

RESULTS

Participants included 159 bladder cancer patients. The mean age was 62±9.4 years and 51% were male. Almost two-thirds (62%) of patients reported a diagnosis of muscle invasive bladder cancer (MIBC), 25% patient reported clinically significant levels of anxiety, 17% reported clinically significant levels of depression, and 13% and 17% reported abnormal borderline abnormal levels for anxiety and depression, respectively. Univariate regression analyses revealed significant associations between HADS total score, HADS depression and anxiety subscales, patient age, physical functioning/daily living needs, sexuality needs, and perceived social support with higher total scores, anxiety, and depression scores associated with younger age, higher unmet needs, and lower levels of social support. Multivariate regression analyses, showed similar findings confirming the associations depicted by the univariate regression analyses.

CONCLUSIONS

Bladder cancer patients experience significant levels of depression and anxiety and these levels are associated with patient age, supportive care unmet needs and lack of social support. Patient focused interventions could be tailored to address these issues with the goal to improve patient HRQoL and emotional adjustment.

Determinants of unmet physical and psychological supportive care needs among adult cancer patients in Southern Ethiopia

OBJECTIVE

The main objective of this study was to assess the prevalence of unmet physical and psychological supportive care needs and associated factors among adult patients with cancer in Southern Ethiopia.

METHODS

A cross-sectional study was conducted among 321 patients with cancer from 20 June 2022 to 5 August 2022 at Hawassa University Comprehensive Specialized Hospital oncology centre. Simple random sampling technique was used to recruit participants. Data were entered into Epi-Data V.4.6 and were exported to SPSS V.26 for analysis. Logistic regression model was used to describe the association between dependent and independent variables.

RESULT

The mean age of the study participants was 45±14.27. The prevalence of unmet physical and psychological supportive care needs was 47.3% and 71.1%, respectively. Rural residence ((adjusted OR, AOR 2.73; 95% CI (1.27 to 5.83)) and late-stage cancer ((AOR 2.95; 95% CI 1.02 to 8.52) were factors significantly associated with unmet physical supportive care need. Coexisting illness was associated with both unmet physical and psychological supportive care needs (AOR 2.73; 95% CI 1.27 to 5.83) and (AOR 2.71; 95% CI 1.16 to 6.33), respectively.

CONCLUSION

Nearly half of the study participants had an unmet physical supportive care need while greater than two-thirds had unmet psychological supportive care need. Residence and late-stage cancer were factors significantly associated with physical unmet supportive care need while coexisting illness was associated with both unmet physical and psychological supportive care needs. Hence, supportive care for patients with cancer should be given an emphasis and incorporated into the cancer treatment protocol.

Time-Related Characteristics of Medical and Psychosocial Decisions in Japanese Women with Breast Cancer: Results of a Web-Based Open-Ended Response

BACKGROUND

This study aimed to articulate chronological characteristics of decisions made by Japanese women with breast cancer (BC) since their diagnosis.

METHODS

Open-ended questions were asked using an Internet-based cross-sectional survey method. Qualitative content analysis was performed on 1,158 free descriptive responses obtained from 549 participants, which were categorized according to the content of decisions. Furthermore, 994 text data from 433 respondents to the quantitative questions were categorized according to the decisions' timing and examined in relation to medical and sociodemographic factors.

RESULTS

Whereas more than 60% of medical decisions, except chemotherapy, were made before initial treatment, approximately more than one-third of sociopsychological decisions were made only after the initial treatment. In decisions regarding medical care, only surgical decisions showed an association between timing and the participants' decision-making style. Meanwhile, in decisions regarding sociopsychological matters, socioeconomic status at the time of diagnosis, such as marital and employment status, along with the perceived importance of what was to be determined, were associated with the timing of decision-making related to employment, attitudes toward life with BC, family matters and financial affairs.

CONCLUSION

Women make various decisions depending on the amount of time since the diagnosis of BC. Generally, medical decisions are made prior to initial treatment, while these temporal characteristics are not observed for decisions relating to sociopsychological matters. Furthermore, socioeconomic status influences the timing of decision-making regarding sociopsychological matters. This finding can illustrate the manner in which to go through life with BC, and thus, help women who are unexpectedly diagnosed with BC to be more prepared.

Supportive Care Needs (SCN) of Cancer Patients Referred to the Medical Centers in Iran

OBJECTIVE

The aim of this study was to evaluate the Supportive Care Needs s of cancer patients in Iran.

METHODS

This descriptive-analytical, cross-sectional study was conducted on cancer patients referred to public and private medical centers in Gorgan (Northern Iran) in 2020. Cancer patients refered to private medical ccentes were recruited into the study using the convenience sampling method. The reliable and valid "Supportive Care Needs Survey-Short Form" (SCNS-SF) with 34 items in five domains of need (physical and daily living, psychological, sexuality, patient care and support, health system, and information) was used to collect data.

RESULTS

Out of 247 patients, 54.7% were females with a mean age of 46.15± 9.36. The most common site of involvement was breast (25.1%), and the duration of involvement was 7.51±6.79 months. The total mean of SCNs was 68.80±18.5 so that the highest (73.68±15.03) and lowest (60.42±27.19) SCNs were related to physical and daily living as well as sexual domains, respectively. The highest frequency (62.3%) of SCNs was related to "fatigue/lack of energy".

CONCLUSION

This study showed that cancer patients experienced many unmet needs in various dimensions. Therefore, it is necessary to address these needs simultaneously treating the disease and developing and implementing a care plan based on patients' priorities.

The experience of a program combining two complementary therapies for women with breast cancer: An IPSE qualitative study

INTRODUCTION

The use of complementary therapies within oncology is a clinical issue, and their evaluation a methodological challenge. This paper reports the findings of a qualitative study exploring the lived experience of a French program of complementary therapies combining structured physical activity and MBSR among women with breast cancer.

METHODS

This French exploratory qualitative study followed the five stages of the Inductive Process to analyze the Structure of lived Experience (IPSE) approach. Data was collected from February to April 2021 through semi structured interviews. Participants, purposively selected until data saturation. Inclusion criteria were: being an adult woman with breast cancer whatever the stage who had completed their treatment and were part of the program of complementary therapies.

RESULTS

29 participants were included. Data analysis produced a structure of experience based on two central axes: 1) the experience these women hoped for, with two principal expectations, that is to take care of their bodies and themselves, and to become actors in their own care; and 2) an experience of discovery, first of themselves and also in their relationship with the exterior, whether with others, or in society, and in the relationships with health-care providers.

CONCLUSIONS

Our results from this French study reinforce the data described in other western countries about the needs of women receiving care in oncology departments for breast cancer: they need to be informed of the existence of supportive care in cancer by the health-care professionals themselves, to be listened to, and to receive support care. A systematic work of reflexivity about this redundancy in our results and in the qualitative literature, led us to question what impeded the exploration of more complex aspects of the experience of this women-the inherently emotional and anxiety-inducing experience of cancer, especially anxiety about its recurrence and of death-and to suggest new research perspectives to overcome these methodological and theoretical obstacles.

Assessment of supportive care needs among cervical cancer patients under treatment in Nepal: a cross-sectional study

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.

Unmet supportive care needs of breast cancer survivors: a systematic scoping review

BACKGROUND

Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs.

METHODS

This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews.

RESULTS

A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors.

CONCLUSION

BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.

A qualitative study of lived experiences and needs of advanced cancer patients in Malaysia: Gaps and steps forward

PURPOSE

Due to the high burden of cancer-related suffering, it is paramount to understand the gaps in cancer care that lead to suffering. Advanced cancer patients have unmet needs and challenges that differ from those with early-stage cancer due to the rapid disease progression. By exploring advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects, this study aims to identify gaps in the Malaysian health system and propose contextualised measures to improve cancer care.

METHODS

Semi-structured, in-depth interviews were conducted to explore advanced cancer patients' lived experiences and needs from the physical, psychological, social, and spiritual aspects. The interviews were then transcribed and coded. Themes were developed from the codes using iterative thematic approach.

RESULTS

The lived experiences and needs of nineteen patients converged into four major themes: disruption to daily lives, psychosocial and spiritual support system, information needs, and financial needs. This study described predominantly how cancer impacted patients' lives and livelihood, how patients coped with their psychological conditions after diagnosis, the need for effective communication and trust in a multicultural society, and how finance affected access to and experience of cancer care.

CONCLUSION

Advanced cancer patients had different needs beyond receiving medical treatments. A concerted effort is required from clinicians, allied health professionals, social workers, support groups, and family members to understand and fulfil these needs.

Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine

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.

Perceived needs and health-related quality of life in women with breast cancer undergoing chemotherapy: a cross-sectional study

OBJECTIVES

Women with breast cancer have different needs that are various in perceived importance and satisfaction. This study aimed to examine the relationship among perceived needs satisfaction, perceived needs importance with health-related quality of life (HRQoL) in women with breast cancer and determine the intermediary role of perceived needs importance in the relationship between perceived needs satisfaction and HRQoL.

DESIGN

Cross-sectional design.

SETTING

Two tertiary level hospitals in Shaanxi Province, China.

PARTICIPANTS

Women newly diagnosed with breast cancer were recruited.

OUTCOME MEASURES

The Needs Self-Rating Questionnaire for Breast Cancer and the Medical Outcomes Study 36-item Short-Form Health Survey V. 2.0 were used for data collection regarding perceived needs satisfaction, perceived needs importance and HRQoL.

RESULTS

A total of 359 valid questionnaires were collected. The perceived needs importance was negatively associated with physical component summary (PCS) (b=-0.067, p=0.024) and mental component summary (MCS) (b=-0.185, p&lt;0.001). On the contrary, perceived needs satisfaction was positively associated with PCS (c'=0.005, p=0.843), although not statistically significant. Perceived needs satisfaction was positively associated with MCS (c'=0.194, p&lt;0.001) and perceived needs importance (a=0.458, p&lt;0.001). Furthermore, the perceived needs importance suppressed the relationship between perceived needs satisfaction and PCS (a*b=-0.031; 95% CI -0.058 to -0.004) and the relationship between perceived needs satisfaction and MCS (a*b=-0.085; 95% CI -0.138 to -0.043).

CONCLUSION

For women with breast cancer, higher perceived needs satisfaction is associated with higher HRQoL. However, higher perceived needs importance would be conversely associated with lower HRQoL by suppressing the positive association of perceived needs satisfaction with HRQoL. Healthcare providers should pay more attention to those who have high perceived needs importance but low perceived needs satisfaction and fulfil the important needs.

Prevalence of psychological distress among cancer patients in Southeast Asian countries: A systematic review

Psychological distress (including depression and anxiety) is common in the first years of cancer diagnosis but can differ by country and region. The aim of the present paper was to review the prevalence of psychological distress among cancer patients in the Southeast Asia (SEA) region. A systematic literature search was carried out using several databases (i.e., PubMed, PsychARTICLES, Embase, CINAHI, Web of Sciences, Plus, Scopus, and AHMED). Papers originally published in English language were taken into consideration if they (i) were published from 2010 to 2021 and (ii) reported the prevalence of psychological distress among patients with different types of cancer. A total of 23 studies met the inclusion criteria. The most frequently employed psychometric instrument for anxiety and depression screening was the Hospital Anxiety and Depression Scale (HADS). The prevalence of anxiety (ranging from 7% to 88%) was wider than that of depression (ranging from 3% to 65.5%) among patients with different types of cancer and living in various countries in the SEA region. The overall prevalence rate of psychological distress among cancer patients from the SEA region was not fundamentally very different from that of general populations. These findings provide useful information for health professionals and cancer patients to understand the negative role of psychological distress in quality of life and health. The research findings demonstrate the importance of counselling for psychological distress among cancer patients as means of effectively resolving their psychological problems and ultimately improving the quality of oncology medical care. Clinical recommendations for cancer management should incorporate the early identification of (and therapy for) psychological distress, as well as their monitoring during treatment.

Assessment of Health-Related Quality of Life and Distress in an Asian Community-Based Cancer Rehabilitation Program

Cancer survivors have reduced health-related quality of life (HRQOL) and high levels of distress during and after active treatment, due to physical, psychological, and social problems. Understanding the prevalence and associations of HRQOL and distress in a patient population in the community is important when designing rehabilitation programs. This was a cross-sectional observational study conducted at a community-based cancer rehabilitation center, with the aim of investigating the prevalence and associations of HRQOL and distress in cancer patients. There were 304 patients who were recruited. We found low levels of HRQOL and high levels of distress in patients, with a mean FACT-G7 total score of 11.68, and a mean distress thermometer score of 3.51. In the multivariate regression model, significant factors for low HRQOL were metastatic disease (p = 0.025) and Malay ethnicity (p < 0.001). Regression analyses also found that significant distress was associated with family health issues (p = 0.003), depression (p = 0.001), worry (p = 0.005), breathing (p = 0.007), getting around (p = 0.012) and indigestion (p = 0.039). A high prevalence of impaired HRQOL and distress was reported in cancer survivors even in a community rehabilitation setting. The physical and psychosocial well-being of cancer survivors should be monitored and managed as part of community-based cancer rehabilitation.

Unmet needs of the Iranian mothers of the children with cancer and the identification of the related factors: A descriptive-correlational study

Introduction

Parents' caring responsibilities lead to imbalances in roles, functions, and emotions, confronting them with new needs that, if left unaddressed, have adverse consequences for the lives of all family members. Therefore, this study aimed to identify the significant unmet needs of the mothers of the children with cancer.

Materials and methods

This descriptive cross-sectional study was conducted in Tehran in 2019-2020 on 215 mothers of the children with cancer visiting the hospitals affiliated with medical universities. The study population was selected through convenience sampling method and according to the inclusion criteria. The FIN questionnaire consisting of two subscales, FIN-Import and FIN-Fulfillment, with 40 items, was used to collect data.

Results

The mean age of the mothers participating in the study was 34.77 ± 7.91 years, and the mean age of the children with cancer was 9.77 ± 14.37 years. The mean scores of FIN-Import and FIN-Fulfillment were 92.88 ± 7.97 and 70.82 ± 17.89, respectively. The phrase "To know the facts concerning my child's prognosis" with 23%, and the phrase "To be told about the people who could help with problems" with 22.8% were the most common unmet needs reported by the parents.

Conclusion

The present study indicated that caring for a child with cancer had confronted mothers with new needs to be met; however, not all of these needs had been satisfied. Awareness about the unmet needs of these mothers and planning to manage those needs can lay the groundwork to improve their health.

Predictors of unmet supportive care needs of adult cancer patients in Ethiopia

OBJECTIVE

Cancer is a global public health issue that continues to increase because of aging and adoption of cancer-causing behaviours. In Ethiopia, cancer belongs to the second most common non-communicable disease. Cancer patients face a range of unmet needs in multiple aspects of their lives. Supportive care is defined as essential care that helps patients to cope with cancer. This study aims to assess the predictors of unmet supportive care needs in adult cancer patients in Ethiopia.

METHODS

Institution-based cross-sectional study was done from February to March 2019 in adult cancer patients. Three hundred seventy-one patients were interviewed using convenience sampling. Supportive care needs were used as outcome variables, dichotomized as 'no need' and 'unmet needs'. Variables with a p-value of <0.2 were candidates for multivariable logistic regression.

RESULTS

From 371 patients, 69.8% were females with a mean age of 47 years; the commonest type of cancer was gynaecological cancer. Information about diagnosis, stage of cancer, time since diagnosis, age, wealth index, employment status, gender, type of treatment, history of recurrence, type of cancer and information about diagnosis modified by the source of information were predictors of unmet supportive care needs.

CONCLUSIONS

The study emphasised the importance of considering sociodemographic, clinical and information-related factors when dealing with cancer patients. Programmes, guidelines and services that focus on supportive care needs should be established and/or implemented.

Care Needs and Symptoms Burden of Breast Cancer Patients in Jordan: A Cross-Sectional Study

Breast cancer is the most common malignancy in Jordan. Rigorous needs assessment for breast cancer patients can prioritize both cancer care and palliative care to propose the appropriate services effectively. We conducted a cross-sectional study of breast cancer patients in a cancer center in Jordan. We assessed symptom burden, comorbidities, and performance using the Edmonton Symptom Assessment System (ESAS), the Charlson Comorbidity Index (CCI), and the Australia-modified Karnofsky performance scale (AKPS). Descriptive analysis and regression models to predict the highest symptom burden were used. A total of 233 participants were enrolled: curative vs. palliative intent groups (147 (63%) vs. 86 (37%) patients), respectively. Tiredness was the most reported symptom in 189 patients (81%), while nausea was the least in 61 patients (26.2%). A relationship between the AKPS score and total ESAS was seen (correlation coefficient of -0.487; p < 0.0001). The prevalence of anxiety (p = 0.014), lack of appetite (p = 0.002), poor well-being (p < 0.001), and sleep disorder (p = 0.035) was higher in the palliative care intent group than in the curative one. We identified unmet needs in breast cancer patients. Both groups showed a prevalence of distressing symptoms suggesting that even those with non-palliative intent have high needs and should receive integrated palliative care.

Breast cancer patients' experiences on their individual care pathway: A qualitative study

INTRODUCTION

Radiographers must be aware of the needs and expectations of women to be able to involve them in the decision making on their own care pathway. The purpose of the study is to describe experiences of women with breast cancer in their individual care pathway.

METHODS

Data was collected with qualitative open-ended online questionnaires via national breast cancer patient organizations in four countries. The subjects were women who had completed their breast cancer treatments at a maximum of six months before responding. Data was analysed using thematic analysis.

RESULTS

Women responding to the survey questionnaire (N = 14) reported 11 main meaningful events in their care pathways. According to respondents, being well informed about the treatment process, a smooth flow of the care process, being treated individually and having a properly organized follow-up were the most important aspects for the optimal breast cancer care pathway.

CONCLUSIONS

The subjects perceived their breast cancer care pathways somewhat differently from the way the pathways are usually described from the health care organizations' viewpoint. In different stages of their individual breast cancer care pathway, positive and less positive experiences of women were somewhat similar, yet contrasting.

IMPLICATIONS FOR PRACTICE

In addition to general forms of support, targeted interventions should be planned to improve the quality of breast cancer care specific to different stages of the treatment process. The findings can be used to promote education for radiographers and other cancer care staff, as well as to develop patient-centred breast cancer care.

Analysis of the unmet needs of Palestinian advanced cancer patients and their relationship to emotional distress: results from a cross-sectional study

Background

Although several studies assessing the needs of advanced cancer patients have been conducted globally, most have focused on a specific type of cancer such as lung or breast cancer. The variation across studies has also created difficulties in generalizing the results and applying the findings in other countries. The aim of this study was to provide comprehensive information on the needs of Palestinian advanced cancer patients. The quality of life (QOL), distress levels, depression, anxiety, and spiritual well-being of the patients were also assessed.

Methods

A hospital-based study with a cross-sectional design was conducted on a convenience sample of patients aged 18 or above who had been diagnosed with advanced-stage cancer. The unmet needs of the patients were assessed using the Short form of the Supportive Care Needs Survey (SCNS-SF34). Four instruments were utilized to examine their distress, anxiety, depression, QOL, and spirituality. A modified Supportive Care Framework was adopted to guide the design of this study. Descriptive statistics and hierarchical linear regression were utilized to analyse the data.

Results

Of the 404 cancer patients invited to the study, 379 patients consented to participate and complete the questionnaire. Of them 96.8% stated that they had at least one ‘moderate to high’ level unmet need. The most frequent unmet needs were those in the physical aspects of daily living (Mean 58.94; SD ± 20.93) and psychological (Mean 58.84; SD ± 19.49) domains. Most of the patients (91%) were physically ill and reported experiencing physical symptoms. About 78.1% had a high level of distress. Almost 90% reported signs of depression and anxiety. Although they felt that their spiritual well-being was good, their QOL was poor. Hierarchical linear regression analyses confirmed that educational level, age, gender, marital status, cancer stage, cancer type, physical symptoms, depression, anxiety, distress, QOL, and spirituality were independently associated with unmet supportive care needs.

Conclusion

Palestinian advanced cancer patients exhibit a significantly higher prevalence of unmet needs than those in other countries, indicating a need to develop a palliative care programme within the healthcare system. They have a great need for physical, emotional/psychosocial, self-management and other services, which should be made available to them, particularly in the routine delivery of cancer care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-00959-8.

Translation and psychometric testing of the Thai version of Cancer Survivors’ Unmet Needs measure among cancer survivors

Objective

To evaluate the psychometric properties of the Thai version of the Cancer Survivors’ Unmet needs (CaSUN-TH) scale among Thai cancer survivors after completion of primary treatment.

Methods

Standardized translation procedures developed the Cancer Survivors’ Unmet Needs into a Thai version (CaSUN-TH). Face validity was evaluated by a group of experts, and a pilot test on 10 cancer patients was conducted to evaluate its readability. A total of 236 cancer survivors who were attending follow-up visits at a cancer hospital in Thailand completed the CaSUN-TH. The internal consistency of the instrument was examined using Cronbach’s α. The association of the CaSUN-TH and its subscales with physical symptoms, QoL, age, gender, and type of cancer were examined for criterion validity and known-group validity. Construct validity was evaluated using confirmatory factor analysis.

Results

The CaSUN-TH showed good readability and high content validity for use as an instrument to assess unmet needs among Thai cancer survivors. Cronbach’s α for the entire scale was 0.95. Confirmatory factor analysis indicated that the five-factor structure of the CaSUN-TH was good fit to the data (CFI ​= ​0.901, SRMR ​= ​0.074, RMSEA ​= ​0.076 [90% confidence interval, 0.066–0.085]). In terms of construct validity, CaSUN-TH scores significantly correlated to other variables hypothesized to influence the level of need, including higher physical symptoms prevalence was related to poor quality of life, and poorer QOL and younger age were associated with a higher level of unmet needs. In addition, the scale was able to differentiate scores between groups, including gender, age, and type of primary cancer, with theoretically hypothesized differences.

Conclusions

The CaSUN-TH demonstrated appropriate psychometric properties for assessing unmet needs in different cancer survivor groups in Thailand. Using the CaSUN-TH can help health professionals in targeting individual survivor needs, bridging the gap between patients’ experiences and their expectations, and improving the quality of cancer survivorship care.

Quality of Life Post Breast Cancer Surgery: Comparison of Breast Conservation Surgery versus Modified Radical Mastectomy in a Developing Country

Introduction  Breast cancer survivors are the largest group of female cancer survivors. Oncologic breast surgery can have a profound impact on a woman's body image and sense of self that can significantly affect their quality of life (QOL). The paucity of data about the effect of type of surgery on QOL of Indian breast cancer survivors has led to this study. Materials and Methods  This prospective study included consecutive female early breast cancer patients who underwent primary surgery, that is, breast conservation surgery (BCS) or modified radical mastectomy (MRM) from January 1, 2015 to December 31, 2015. The primary objective was the comparison of QOL using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and EORTC QLQ-BR 23 between the two groups at 6 months and 1 year postsurgery with the baseline. Results  One hundred and thirty-eight patients were included of which 62 underwent BCS and 76 underwent MRM. BCS patients fared better with respect to physical functioning, dyspnea, fatigue, appetite loss, and body image at 6 months ( p  < 0.05) as compared with MRM. At 1 year postsurgery, BCS patients fared better with respect to physical functioning, role functioning, global health status, body image, sexual enjoyment, and dyspnea, while MRM patients fared better in emotional functioning and future prospectives ( p  < 0.05). Conclusion  Patients undergoing BCS have a better QOL with respect to various functional and symptom scales at 6 months and 1 year. However, patients undergoing MRM perform better in terms of future perspective and emotional functioning at 1 year.

Psychometric Properties of the Persian Version of the Short-Form Survivor Unmet Needs Survey (SF-SUNS) among Cancer Patients

Objective

Accurate identification of the unmet needs of patients with cancer and with a valid and reliable scale leads to the improvement of planning and implementation of nursing care. Thus, this study aims to translate the Short-Form Survivor Unmet Needs Survey (SF-SUNS) into Persian and to assess the psychometric properties of the Persian version among patients with cancer in Iran.

Methods

This study was conducted by methodological design. The translation of SF-SUNS was performed by translation protocol of the Quality of Life Assessment. Qualitative assessment of the face validity was conducted through cognitive interview and content validity was assessed through expert panel. This study used a convenience sampling method for 757 patients with cancer referring to Omid and Imam Reza hospitals in Mashhad, Iran. To determine the construct validity, confirmatory factor analysis and convergent validity were employed. Cronbach's alpha and intraclass correlation coefficient were calculated for reliability.

Results

Total score of unmet needs was 2.20 ​± ​0.73, which indicates the average level of unmet needs in patients with cancer. Content validity ratio and content validity index scores were 0.88 and 0.91, respectively, Cronbach's alpha coefficient was 0.89, and intraclass correlation coefficient was 0.91. Based on confirmatory factor analysis, goodness-of-fit indices confirmed the model fit (χ²/df ​= ​4.43, GFI ​= ​0.90, TLI/NNFI ​= ​0.91, CFI ​= ​0.90, RMSEA ​= ​0.067). In the subscale of unmet work and financial needs, 4 items had a factor loading lower than 0.4, which were omitted from the Persian version. The results revealed a significant difference in the unmet needs and quality of life of patients with cancer (P ​< ​0.001).

Conclusions

The Persian version of SF-SUNS has desirable psychometric properties. It can be used to design and assess interventions to improve the quality of caring, cancer management, and as well as interaction between patients and healthcare providers.

Supportive Care Needs Assessment for Cancer Survivors at a Comprehensive Cancer Center in the Middle East: Mending the Gap

Simple Summary

There are knowledge gaps regarding supportive care needs of cancer survivors in Jordan and the Arab region. Assessing unmet needs is crucial to achieving quality cancer care and patient satisfaction. In this study, we aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, explore predictors of unmet needs and assess the relationship between unmet supportive care needs and quality of life of adult cancer survivors. We confirmed the presence of several unmet needs in this population of cancer survivors that were evident in many domains. Late-stage diagnosis and quality of life as reported by study participants provided additional and independent information for unmet needs in several domains. Overall, this needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population and understanding these findings highlights opportunities for intervention to address gaps in care.

Abstract

Background: Cancer survivors are often underprepared for what to expect post-treatment, and there are knowledge gaps regarding cancer survivors’ supportive care needs in Jordan and neighboring Arab countries. This study aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, and explore predictors of unmet needs. Methods: This was an observational cross-sectional study using a modified version of the Supportive Care Needs Survey 34 item short form (SCNS-SF34). Results: Two hundred and forty adult cancer survivors completed the study questionnaire. The assessed needs were highest in the financial domain, including covering living expenses, managing cancer treatment adverse effects and co-morbidities. The least prevalent reported needs were in sexuality and reproductive consultations. Late-stage diagnosis was independently associated with higher physical, psychological, health system/information, financial and overall need scores, with p-values of 0.032, 0.027, 0.052, 0.002 and 0.024, respectively. The overall quality of life score was independently and inversely associated with physical, psychological, health system/information, financial and overall need domains, with p-values of 0.015, <0.0001, 0.015, 0.004 and 0.0003, respectively. Conclusions: This needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population, and understanding these findings highlights opportunities for intervention to address gaps in care.

Psychosocial outcome and health behaviour intent of breast cancer patients with BRCA1/2 and PALB2 pathogenic variants unselected by a priori risk

There is an increasing number of cancer patients undertaking treatment-focused genetic testing despite not having a strong family history or high a priori risk of being carriers because of the decreasing cost of genetic testing and development of new therapies. There are limited studies on the psychosocial outcome of a positive result among breast cancer patients who are at low a priori risk, particularly in women of Asian descent. Breast cancer patients enrolled under the Malaysian Breast Cancer Genetic Study between October 2002 and February 2018 were tested for BRCA1, BRCA2 and PALB2 genes. All 104 carriers identified were invited by a research genetic counsellor for result disclosure. Of the 104 carriers, 64% (N = 66) had low a priori risk as determined by PENN II scores. Psychosocial, risk perception and health behaviour measures survey were conducted at baseline (pre-result disclosure), and at two to six weeks after result disclosure. At baseline, younger carriers with high a priori risk had higher Cancer Worry Scale scores than those with low a priori risk but all scores were within acceptable range. Around 75% and 55% of high a priori risk carriers as well as 80% and 67% of low a priori risk carriers had problems in the "living with cancer" and "children" psychosocial domains respectively. All carriers regardless of their a priori risk demonstrated an improved risk perception that also positively influenced their intent to undergo risk management procedures. This study has shown that with sufficient counselling and support, low a priori risk carriers are able to cope psychologically, have improved perceived risk and increased intent for positive health behaviour despite having less anticipation from a family history prior to knowing their germline carrier status.

Factors associated with unmet supportive care needs of oncology patients at Dessie Referral Hospital, 2020

BACKGROUND

Assessment of supportive care needs for cancer patients and identifying factors affecting these needs is important for the implementation of supportive care programmes, as the burden of cancer is increasing in Ethiopia.

OBJECTIVE

To determine the prevalence and associated factors of unmet supportive care needs of cancer patients at Dessie Referral Hospital, Dessie, South Wollo, North East Ethiopia, 2020.

METHODS

A cross-sectional study design was implemented among 405 cancer patients from February to 30 July 2020, at Dessie Referral Hospital. The data were collected using a validated supportive care needs survey questionnaire through face to face interview and data extraction tools. Both descriptive and inferential statistics were used and bi-variable and multivariable logistic regressions were used to describe the association between dependent and independent variables. Thus, a p-value of less than 0.05 was considered statistically significant.

RESULT

From the total 405 participants, 275 (67.5%) were females with a mean age of (mean ± standard deviation) 48.6 ± 15.4 years. Unmet supportive care needs were higher among psychological needs (81.0%, 95% (confidence interval) CI = 77.0-84.9) and physical needs (74.6%, 95% CI = 70.1-79.0). Old age was associated with unmet physical and psychological needs domain than young age (adjusted odds ratio (AOR) = 1.03; 95% CI: 1.01-1.06), (AOR = 1.06; 95% CI: 1.03-1.09), respectively. High household income was significantly associated with health information needs (AOR = 2.22; 95% CI: 1.33-13.93), remission status (AOR = 0.37; 95% CI: 0.22-0.62) was associated with patient/supportive care needs, late stage cancer was also significantly associated with physical, psychological and health information needs of patients (AOR = 2.19; 95% CI: 1.18-4.06), (AOR = 2.3; 95% CI: 1.18-4.57) and (AOR = 2:95%; CI: 1.03-3.86), respectively. Besides, source of information had a statistically significant association with psychological, health information and patient care needs domain (AOR = 2.61; 95% CI: 1.15-5.93), (AOR = 3.1; 95% CI: 1.65-5.82) and (AOR = 2.2; 95% CI: 1.25-3.87), respectively.

CONCLUSION AND RECOMMENDATION

This study shows that the prevalence of unmet supportive care needs in cancer patients is high in each domain. Age, income, cancer stage, cancer site, treatment option, time since diagnosis and sources of information were associated across one or more unmet supportive care needs domains. Therefore, the government and health professionals should work together to improve the unmet needs of cancer patients.

The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions

PURPOSE

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed.

DESIGN/METHODOLOGY/APPROACH

This is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and p-values.

FINDINGS

The authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (p-value < 0.01 using t-test for two independent samples). The data showed an increasing trend of "satisfied" responses as the household income increased.

RESEARCH LIMITATIONS/IMPLICATIONS

A comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care.

PRACTICAL IMPLICATIONS

Assessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability.

SOCIAL IMPLICATIONS

After being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life.

ORIGINALITY/VALUE

Cancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.

Psychometric Properties of the 34-Item Short-Form Supportive Care Need Survey (SCNS-SF34) Scale in the Malaysian Cancer Healthcare Context

(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.

Supportive care needs of patients living with an extremely rare and unpredictable cancer: The Epithelioid Haemangioendothelioma patient experience

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.

Coping Strategies for Sexual Problems and Sexual Dysfunction Amongst Malay Women With Breast Cancer. A Qualitative Study

Introduction

Women’ sexuality becomes complex after breast cancer diagnosis and sexual health is highly neglected in the management of the illness.

Aims

To explore the coping and strategies to overcome sexuality problems and sexual dysfunction among women with breast cancer.

Material and Methods

Using the in-depth and photo-elicitation interview methods, this qualitative study following phenomenological analysis was conducted on fourteen married female respondents with breast cancer and had the positive result for female sexual dysfunction (FSD) screened by Female Sexual Function Index (FSFI-6 items) from Kelantan, Malaysia. The interviews data were audio-recorded, transcribed verbatim and managed in analytic computer software NVivo11 Pro. The transcriptions were analyzed using thematic analysis by referring to the meaning-making theory.

Main Outcome Measures

We identified overlapping themes of coping and strategies among women with breast cancer to overcome sexual problems and sexual dysfunction which correspond with meaning-making theory.

Results

Three themes have emerged. Women with breast cancer that developed sexuality problem and sexual dysfunction strived to accept the illness using religious belief and conform by altering sexual practices. These individuals positively look for a solution by seeking formal healthcare advice, modify their physical appearance, active discussion with the husband and support from other survivors. A few of them passively struggle with the subject by averting the intimacy and receptive toward polygamy.

Conclusion

This study highlighted the various mechanisms that emphasized the pivotal role of religious belief and relationship context as key factors in the coping strategies among women with breast cancer in Malaysia. The finding may not be generalized to other countries.

Che Ya SN, Muhamad R, Zain NM, et al. Coping Strategies for Sexual Problems and Sexual Dysfunction Amongst Malay Women With Breast Cancer. A Qualitative Study. Sex Med 2021;9:100336.

Can tele-nursing affect the supportive care needs of patients with cancer undergoing chemotherapy? A randomized controlled trial follow-up study

Purpose

In some countries, telephone-based support is one of the key services used for supporting patients with cancer. However, there is a lack of research on the efficacy of this method in Iran. This study aimed to evaluate the effects of tele-nursing on supportive care needs (SCNs) of patients with cancer undergoing chemotherapy.

Methods

This randomized controlled trial was conducted on 60 patients with cancer undergoing chemotherapy who were randomly assigned and allocated to two groups, an intervention group and a control group. Patients’ SCNs were assessed in the baseline, and 1 and 2 months after commencement of the intervention using the SCNs Survey -Short Form 34. The data were analyzed through descriptive statistics, t-test, and repeated measure test, by SPSS version 16.

Results

There were no significant statistical differences in the mean score of dimensions and total SCNs between the two groups in baseline (p˃0.05). However, the results showed that the mean score of dimensions and total SCNs in the intervention group were significantly less than the control group, after the intervention (p˂0.05).

Conclusions

Telephone-based support is an effective method to address and reduce SCNs of patients with cancer undergoing chemotherapy through increasing access to support for this population especially who may be in rural and remote settings. During the COVID_19 pandemic and given the vulnerability of patients with cancer, telephone support can be used to avoid unnecessary visits to hospitals and reduced the risk of transmitting the virus to the patients.

Trial registration number

IRCT20170404033216N1

Multicentre prospective cohort study of unmet supportive care needs among patients with breast cancer throughout their cancer treatment trajectory in Penang: a PenBCNeeds Study protocol

INTRODUCTION

Proper assessment of unmet supportive care needs of patients with breast cancer and its influencing factors at different treatment intervals will improve the rehabilitation of patients with breast cancer. Therefore, this study aims to determine the prevalence of unmet supportive care needs, changes of needs over time and associated factors during the treatment period.

METHODS AND ANALYSIS

This multicentre, prospective cohort study will be conducted in three governmental hospitals and one tertiary cancer institute in Penang, Malaysia. Adult women diagnosed with primary or recurrent tumour, node, metastases stage I-IV breast cancer based on pathological biopsy will be eligible for this study. At least 281 samples are required for this study. Participants will undergo follow-up at three time intervals: T1 at breast cancer diagnosis; T2 at 3 months after diagnosis and T3 at 6 months after diagnosis. Patients will complete a set of questionnaires at each time. The primary outcome of this study includes the changes in supportive care needs over three time points, followed by the secondary outcome examining patients' characteristics, coping behaviours and positive psychological components as they affect changes in unmet supportive care needs over time.

ETHICS AND DISSEMINATION

The study has received ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-19-268-45809 IIR) and the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/17100443). The results of the prospective study will be submitted for publication in a peer-reviewed journal.

Unmet supportive care needs of survival patients with breast cancer in different cancer stages and treatment phases

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.

Translation and Validation of the Arabic Version of the Cancer Needs Questionnaire-Short Form

Objective:

Care needs among Arabic cancer patients have not been assessed previously due to the lack of translated instrument that can determine the care needs among the cancer patients in Arab countries. The aim of this study was to translate and validate an Arabic version of the Cancer Needs Questionnaire-Short Form (CNQ-SF).

Methods:

A cross-cultural adaptation and psychometric testing was used. Brislin's model of translation was used to translate the CNQ-SF from English to Arabic. A cross-cultural adaptation and psychometric testing was used. A sample of 113 participants with different types of cancer completed the study surveys including the CNQ-SF (Arabic version) and Functional Assessment of Cancer Therapy-General (FACT-G). Descriptive, bivariate statistics and exploratory factor analysis (EFA) were performed.

Results:

Content validity was evaluated by a panel of experts and 20 participants and showed that translated scale was clear, understandable, and logical in order. Reliability analysis of CNQ-SF domains ranged from 0.85 to 0.93 and 0.94 for the total Arabic version of CNQ-SF. Convergent analysis showed a significant relationship between CNQ-SF (Arabic version) and FACT-G. Results of EFA indicated that the CNQ-SF scale has 32-items. It consists of five domains, the results indicated that Kaiser–Meyer–Olkin was 0.851, and Bartlett's Test of Sphericity was significant (significant (P < 0.001).

Conclusions:

The current study indicates that the Arabic version of CNQ-SF is valid, reliable, and applicable. It can be used by researchers, clinical practitioners, and health educators in Arab countries.

The psychosocial determinants of quality of life in breast cancer survivors: a scoping review

Background

Breast cancer care today involves state-of-the-art biomedical treatment but can fail to address the broader psychosocial and quality-of-life (QoL) issues associated with the transition to breast cancer survivorship. This scoping review examines the evidence on the influence of psychosocial determinants on QoL in breast cancer survivors.

Methods

Scoping review methodology was used to: (1) identify the research question(s); (2) identify relevant studies; (3) undertake study selection; (4) extract data; (5) collate, summarise and report the results.

Results

A total of 33 studies met the inclusion criteria. The majority of studies were conducted in the US (n = 22, 67%) and were mainly cross-sectional (n = 26, 79%). Sixteen psychosocial determinants of QoL were identified. Social support (n = 14, 42%), depression (n = 7, 21%) and future appraisal and perspective (n = 7, 21%) were the most frequently investigated determinants. Twelve different QoL measures were used. A range of different measurement tools were also used per psychosocial determinant (weighted average = 6). The 14 studies that measured the influence of social support on QoL employed 10 different measures of social support and 7 different measures of QoL. In general, across all 33 studies, a higher level of a positive influence and a lower level of a negative influence of a psychosocial determinant was associated with a better QoL e.g. higher social support and lower levels of depression were associated with a higher/better QoL. For some determinants such as spirituality and coping skills the influence on QoL varied, but these determinants were less commonly investigated.

Conclusion

Consensus around measures of QoL and psychological determinants would be valuable and would enable research to determine the influence of psychosocial determinants on QoL adequately. Research in other healthcare settings beyond the US is required, in order to understand the influence of organisation and follow-up clinical and supportive care on psychosocial determinants and QoL and to improve the quality of care in breast cancer survivors.

Factors influencing quality of life of Asian breast cancer patients and their caregivers at diagnosis: perceived medical and psychosocial needs

INTRODUCTION

We aimed to examine the relative importance of medical and psychosocial needs of Asian breast cancer patients and their caregivers, and to identify the determinants of quality of life (QoL) at the time of diagnosis.

METHODS

This is a prospective observational study of the perceived needs and QoL of 99 dyads of breast cancer patients and their caregivers at diagnosis. A self-administered questionnaire was used to measure the perceived importance of medical and psychosocial support needs. Short Form-36 health survey (SF-36) version 2 was used to measure QoL. We also collected patient and caregiver demographic profiles and disease-specific information. Descriptive analysis of perceived needs was performed. SF-36 scores for eight domains and composite scores were calculated. Bivariate analysis and linear regression were performed to identify significant independent predictors of QoL of patients and caregivers.

RESULTS

The mean ages of the patients and caregivers were 56.5 years and 51.7 years, respectively. To have family around (73%), prompt information about treatment and treatment options, including side effects (71%), and prompt treatment for side effects (71%) were the top three needs among patients and their caregivers. Supportive nurses and prompt treatment for side effects positively improved patients' social functioning and bodily pain scores. Stage of disease, age, education and ethnicity also influenced QoL. Only the presence of chronic disease influenced caregivers' physical functioning and role-physical scores.

CONCLUSION

Patients and caregivers have similar perceptions of needs at diagnosis. A supportive healthcare team can positively influence patients' QoL, highlighting the importance of tailoring support according to needs.

Impact of Psycho-Social Factors on Fatigue among Breast Cancer Patients Who Are Currently Undergoing Radiotherapy

Fatigue in breast cancer patients undergoing radiotherapy has been studied less comprehensively than fatigue from chemotherapy. The aim of this study was to test the impact of psycho-social factors on the fatigue among breast cancer patients undergoing radiotherapy. This was a cross-sectional correlational study and participants were 210 breast cancer patients currently undergoing radiotherapy in an outpatient setting in Korea. Data collection was carried out from 22 July to 30 September 2019. The results of this study showed that symptom assessment, anxiety and depression, uncertainty, and perceived stress had a direct effect on the fatigue of breast cancer patients receiving radiotherapy, while social support had an indirect effect. These factors explained 67.2% of the fatigue among the participants. This study confirmed that various interventions for symptom assessment, anxiety and depression, uncertainty, and stress reduction need to be developed to reduce fatigue of breast cancer patients receiving radiotherapy. The present results form the basis for developing such interventions.

Quality of life of women with locally advanced or metastatic breast cancer

OBJECTIVES

To identify the main affected domains of quality of life of hospitalized women with locally advanced or metastatic breast cancer; and to analyze the association between the level of quality of life and stage of cancer.

METHOD

This was a cross-sectional quantitative, study conducted in Rio de Janeiro, Brazil, between March and July 2017. Interviews were performed with 199 women. The researchers administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, with analysis using the Statistical Package for the Social Sciences software and the Kruskal-Wallis test.

RESULTS

Mean global health status was 32.04. On the functional scales, cognitive functioning scored the highest (60.47), while role functioning scored the lowest (12.48). Fatigue presented the highest mean (69.57). The scores for global health status and the functional scales (with the exception of the social functioning) decreased as staging progressed.

CONCLUSION

The stage of cancer affects the quality of life of the studied sample of women.

Body image mediates the relationship between post-surgery needs and health-related quality of life among women with breast cancer: a cross-sectional study

Background

Although body image (BI) disturbance is a common problem that often contributes to poor health-related quality of life (HRQoL) among women with breast cancer following surgery, the mediating role of BI (as a self-perceptive factor) in the relationship between needs and HRQoL after controlling for socio-demographic factors remains unclear. The purpose of this study was to identify the mediating role of BI between post-surgery needs and HRQoL after controlling for socio-demographic factors among women with breast cancer.

Methods

In this cross-sectional study, the primary outcome was HRQoL (as measured with the 36-item Short-Form Health Survey version 2 [SF-36v2] and Functional Assessment of Cancer Therapy-Breast version 4.0 [FACT-Bv4.0]). The secondary outcomes included needs (measured in terms of needs importance [NI] and needs satisfaction [NS]) and BI. Structural equation modeling was used to identify the mediating role of BI between needs and HRQoL while considering socio-demographics.

Results

The 406 eligible patients reported poor HRQoL, and approximately half reported important unmet needs and poor BI. NI, NS, and socio-demographics had differing direct effects on BI and HRQoL, and contrasting indirect effects on HRQoL via BI. NI, NS, surgery type, presence of chronic disease, and BI explained 4% of the variance in the SF-36v2 physical component summary score; NI, NS, surgery type, residence, and BI explained 20% of the variance in the mental component summary score; and NI, NS, marital status, employment status, radiotherapy, and BI explained 33% of the variance in the FACT-Bv4.0 total score.

Conclusions

After surgery, women with breast cancer have poor HRQoL and BI, and important unmet needs. BI mediates the relationship between needs and HRQoL after controlling for socio-demographics. The present findings provide information for developing comprehensive BI-based needs interventions and preparing targeted health-management programs for patients with breast cancer.

Unmet Supportive Care Needs of Survival Patients with Nasopharyngeal Carcinoma

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.

The Needs Self-Rating Questionnaire for Breast Cancer (NSQ-BC): Development of a tool for the needs assessment of women with breast cancer in mainland China

RATIONALE, AIMS, AND OBJECTIVES

A needs assessment tool considering the cultural background of mainland China has not been reported. This study developed a Needs Self-rating Questionnaire for Breast Cancer (NSQ-BC) based on Maslow's hierarchy of needs for mainland Chinese patients.

METHODS

The Delphi technique and pilot cross-sectional surveys (two rounds) were performed for item selection. In the Delphi technique, items were selected according to the experts' perspective on the item's significance (ie, 1-5 Likert-scale ratings of importance; mean > 4.0 and coefficients of variation <0.25). In the pilot cross-sectional surveys, items were selected according to internal consistency reliability (Cronbach's α ≥ 0.70), discriminant validity (stronger correlations of the item with the hypothesized subscale than for other subscales), and convergent validity (hypothesized item-subscale correlations ≥0.40). All decisions were made based on the results of statistical analyses, recommendations of the experts, and in-depth discussion among research team members.

RESULTS

Following the two evaluation rounds, the revised NSQ-BC comprised 26 items across five subscales of needs: physical, psychological, respect/self-esteem, information, and rehabilitation. Item ratings from the expert panellists met the aforementioned criteria (ie, Kendall's W = 0.329, P < 0.001). Except for the "respect/self-esteem needs" subscale, Cronbach's α for all subscales exceeded 0.70. All items had acceptable discriminant and convergent validity. Additionally, two new items-good environment/facilities and economic support-were added to the NSQ-BC, as recommended by the experts.

CONCLUSIONS

The NSQ-BC was developed fully via the comprehensive use of Delphi technique and pilot cross-sectional surveys. It provides evidence of a proper instrument for needs assessment and evaluation among women with breast cancer in mainland China.

Unmet needs in the physical and daily living domain mediates the influence of symptom experience on the quality of life of gastric cancer patients

PURPOSE

Gastric cancer patients are expected to have considerable supportive care needs; however, few studies have been conducted. This study aimed to understand the unmet needs of gastric cancer patients at different phases of the cancer journey, identify factors contributing to their unmet needs and quality of life (QOL) and explore the relationships among unmet needs, symptom experience, anxiety, depression, and QOL.

METHODS

A correlational study was conducted using data from 223 gastric cancer patients. The instruments include the SCNS-SF 34, HADS, MDASI, and EORTC QLQ-C 30 (Korean version). Descriptive statistics, t test/ANOVA, Pearson's correlation, multiple regression, and path analyses were used to analyze the data.

RESULTS

Unmet needs in the health system and information domain were the highest. The phase of the cancer journey had a significant association only with physical and daily living unmet needs (p = 0.027). Physical and daily living unmet needs, symptom severity, symptom interference, and depression demonstrated direct effects on QOL. The physical and daily living unmet needs mediated the association between symptom experience (symptom severity and interference with daily living caused by symptoms) and QOL. The overall paths explained 51.6% of the variance in the QOL of gastric cancer patients (p < 0.001).

CONCLUSION

The health system and information unmet needs of gastric cancer patients should be fulfilled by reinforcing the continuity of care, professional counseling, and self-care education. Unmet needs in the physical and daily living domain have to be appraised to facilitate improved symptom management to minimize the negative influence on QOL. Factors contributing to the unmet needs and QOL of gastric cancer patients need to be reflected in supportive care planning.

Prevalence and Correlates of Unmet Supportive Needs of Nigerian Patients With Cancer

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.