Non-clinical needs of cancer patients in Spain under different perspectives: A comparative study

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Background: Patients with cancer and their caregivers express unmet needs beyond the clinical approach to cancer. The ECO Foundation (Quality and Excellence in Oncology) and the Spanish Association Against Cancer (AECC) have promoted a qualitative research study with the objective to compare the perceptions of newly diagnosed and 2-3 years after diagnosis cancer patients, caregivers, oncologists, nurses and social workers in relation to a set of non-clinical needs expressed by cancer patients and caregivers, and to obtain concrete and feasible proposals for improvement aimed at satisfying these needs. Methods: A multidisciplinary group of experts developed a questionnaire containing information processes for cancer patients and caregivers, shared decision-making, healthcare circuits, the architecture of consultations, psychological support, support of associations and hospital social workers. Fourteen Medical Oncology Services of Spanish hospitals have participated in this study collecting 310 forms. Data were statistically analyzed using Fisher's exact test. Results: Information processes. The opportunity to have a second opinion is positively valuated for 72.6% of patients and 70.2% of caregivers. However, although 62.5% of oncologists referred to offer this option to their patients, only 10.9% of patients reported having received it. Shared decision-making. For 58% of oncologists, patients are sufficiently trained to share decision-making, but only 24.6% of newly diagnosed patients consider being prepared. In addition, although 95.8% of oncologists report offering the participation of their patients in decision-making, only 45.8% of newly diagnosed patients and 64.4% of 2-3 years after diagnosis patients, consider having received this opportunity. Psychological support. Psychological assistance was considered positive for 94.2% of the patients, 97.4% of the caregivers, 85.4% of the oncologists and 97.1% of the nurses. However, only 21.3% of oncologists and 31.4% of nurses recognize offering such proffessional care given by psychologists to patients. Conclusions: Knowing the non-clinical needs, not only of patients and caregivers, but also from the health care professionals, is essential when designing health strategies that should align the perceptions of patients and health care professionals.