Physicians' Awareness of the Breast Cancer Survivors' Unmet Needs in Korea

Effects of stigma on quality of life of cancer survivors: Preliminary evidence from a survivorship programme in Kenya

Globally, cancer is a major public health problem. There is a paucity of information regarding stigma and how it affects the cancer survivors' quality of life (QoL) in Kenya. In a recent report by Globocan, 42,116 new cases and 27,072 fatalities related to cancer were documented in Kenya in 2020. Cancer survivors are more likely to suffer physical and psychological disorders as a result of their poor QoL. The purpose of this study was to evaluate the knowledge, attitudes, and beliefs regarding the stigma associated with the disease as well as how it affects their QoL among a cohort of cancer survivors supported by the KILELE Health Association.

Methods

This research used a cross-sectional design with both quantitative and qualitative methods. The study enrolled 45 cancer survivors from a cohort participating in the KILELE Health Association (KHA) survivors' program. The quantitative data were coded and analyzed using the 26th version of the Statistical Package for Social Sciences (SPSS). Utilizing content analysis, qualitative data was thematically evaluated. In accordance with the study's goals and key measures, the generated transcripts were organized into themes and sub-themes.

Results

Participants' mean age was 44.55 ± 9.89 years. Forty-two of the participants completed the survey and were thus included in the analysis. Cancer survivors reported experiencing low levels of stigma across the following dimensions: awkwardness (2.51 ± 0.75), severity (3.22 ± 1.29), financial discrimination (2.77 ± 1.17), personal responsibility (1.9 ± 1.38), avoidance (1.38 ± 0.68), and policy level stigmatization (5.09 ± 1.70). Awareness raising (97.62%), using communication channels (95.24%), advocacy, and lobbying (92.86%) were the most commonly stated strategies to change people's attitudes in terms of interventions to reduce stigma and improve QoL.

Conclusion

Respondents in this study showed low levels of stigma, which may be due to the support they receive from the KILELE Health Association. Strategic steps in advocacy, publicity, and education are required to end stigmatization to promote awareness and pique people's interest in cancer survivorship. Further research with a larger sample size of cancer survivors from various settings is warranted.

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.

Breast cancer survivors-supportive care needs: systematic review

OBJECTIVES

To achieve optimal survival care outcomes, all healthcare services must be tailored to patients' specific needs, preferences and concerns throughout the survival period. This study aimed to identify supportive care needs from the point of view of breast cancer survivors.

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews, a comprehensive search of PubMed, Web of Science and Scopus was performed. The inclusion criteria were studies published from inception to the end of January 2022, covering all stages of breast cancer. The exclusion criteria were mixed-type studies relating to cancer, such as case reports, commentaries, editorials and systematic reviews, as well as studies that assessed patients' needs during cancer treatment. Two quality assessment tools were used for the qualitative and quantitative studies.

RESULTS

Of the 13 095 records retrieved, 40 studies, including 20 qualitative and 20 quantitative studies, were retained for this review. Survivors' supportive care needs were classified into 10 dimensions and 40 subdimensions. The most frequently mentioned supportive care needs of survivors were psychological/emotional needs (N=32), health system/informational needs (N=30), physical and daily activities (N=19), and interpersonal/intimacy needs (N=19).

CONCLUSIONS

This systematic review highlights several essential needs for breast cancer survivors. Supportive programmes should be designed in order to take into consideration all aspects of these needs, particularly psychological, emotional and informational needs.

Information needs and research priorities in long-term survivorship of breast cancer: Patients and health professionals' perspectives

OBJECTIVE

The objective of this work is to identify unmet information needs of long-term-survivors of breast cancer (BC) and future research needs from the perspectives of patients and health care professionals.

METHODS

Two online Delphi surveys were conducted. Participants in Survey 1 were patients. Participants in Survey 2 were health care professionals from both primary and secondary care involved in BC care. Both surveys included three successive rounds. The first round aimed to identify research and information needs; the second round aimed to rank the relative importance of those needs; the third round aimed to find consensus.

RESULTS

The most important information needs were self-management recommendations of common health problems after treatment and complications of breast reconstruction after 5 years. The most important research priorities were related to interventions and tools to increase information provision by professionals about certain tests, diet, and coordinated action between primary and specialised care during follow-up, and indications and safety issues of pregnancy in survivors.

CONCLUSIONS

Two fundamental ideas were identified: (1) Patients request information about self-management common health problems after treatment and breast reconstruction complications. (2) Health care professionals emphasise the need for a standardised approach based on protocols, recommendations, and coordinated actions in the provision of information.

IMPLICATIONS FOR CANCER SURVIVORS

Given the increasing number of BC survivors, it is essential to identify information and research needs to improve their care and health outcomes.