Breast cancer survivors’ supportive care needs 2–10 years after diagnosis

Hodgkinson, Katharine; Butow, Phyllis; Hunt, Glenn E.; Pendlebury, Susan; Hobbs, Kim; Wain, Gerard

doi:10.1007/s00520-006-0170-2

Cited by 265 publications

(290 citation statements)

References 66 publications

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“…For instance, psychological factors such as depression, anxiety and distress have been linked previously to patients reporting unmet needs [13,16] and the present study extends these findings by identifying which needs domains are predicted by psychological factors. Specifically, greater depression and greater distress at time 1 was associated with patients reporting unmet needs in the physical/daily living domain at six months follow-up.…”

Section: Discussionsupporting

confidence: 76%

“…However, while these predictors provide some insight into the patients at risk of higher unmet supportive care needs, many of these factors are not amenable to change and so cannot be targeted by support interventions. There is some evidence that depression, anxiety and psychological distress are associated with patients reporting greater unmet needs [13,16]. However, it is not clear how these factors relate to different needs domains.…”

mentioning

confidence: 99%

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Predictors of change in unmet supportive care needs in cancer

et al. 2010

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Objective: Patient Reported Outcome (PRO) assessments can assist health professionals to tailor their health practices to the individual needs of patients and improve patient care over time. The present study assessed prospective predictors of unmet supportive care needs in cancer patients over a six-month period.Methods: Participants were recruited from a regional cancer treatment centre in Australia and completed the Supportive Care Needs Survey (SCNS) at recruitment (n 5 439; 61.4% response rate) and six months follow-up (n 5 396). Hierarchical logistic regression was used to identify predictors of change in unmet needs across each supportive care domain. Predictor variables were socio-demographic, treatment and psychosocial factors including depression, anxiety, social support, and patient satisfaction.Results: Unmet needs were reported by approximately two-thirds of patients at baseline and half of patients at six months follow-up. Having unmet needs at baseline was the strongest predictor of unmet needs at six months. Longer time since diagnosis was a consistent predictor of greater unmet needs, associated with change in physical/daily living, psychological and health system and information unmet needs over time. By contrast, a complex relationship was found in that patient satisfaction, psychosocial and treatment characteristics predicted higher needs in some domains and lower needs in others.Conclusions: Unmet supportive care needs persist over time and psychological needs may emerge later in the illness continuum. Interventions to meet the needs of longer term cancer survivors are needed and should closely articulate with reported supportive care needs.

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Section: Discussionsupporting

confidence: 76%

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confidence: 99%

Predictors of change in unmet supportive care needs in cancer

et al. 2010

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“…Cancer survivors can experience physical and psychosocial problems, which are most prevalent during the first year after cancer treatment completion, but may endure for many subsequent years (Andrykowski, Lykins, & Floyd, 2008; Duijts et al., 2014; Hodgkinson, Butow, Fuchs, et al., 2007; Hodgkinson, Butow, Hunt, et al., 2007; Mehnert & Koch, 2008). Many cancer survivors also report having unmet information and support needs in dealing with these issues (Geller, Vacek, Flynn, Lord, & Cranmer, 2014; Hodgkinson, Butow, Fuchs, et al., 2007; Hodgkinson, Butow, Hunt, et al., 2007; Willems et al., 2016a).…”

Section: Introductionmentioning

confidence: 99%

“…Many cancer survivors also report having unmet information and support needs in dealing with these issues (Geller, Vacek, Flynn, Lord, & Cranmer, 2014; Hodgkinson, Butow, Fuchs, et al., 2007; Hodgkinson, Butow, Hunt, et al., 2007; Willems et al., 2016a). The greater the number of unmet information and support needs, the greater the depressive feelings, fear of recurrence and distress, and the lower the quality of life of cancer survivors (Smith et al., 2013).…”

Section: Introductionmentioning

confidence: 99%

“…For our two studies (Kanera, Bolman, Mesters, et al., 2016; Willems et al., 2016a), the validated CaSUN was regarded as the most appropriate general questionnaire to specifically investigate the unmet needs of cancer survivors (Bender et al., 2012; Brennan, Butow, Spillane, & Boyle, 2016; Geller et al., 2014; Harrison et al., 2011; Hodgkinson, Butow, Fuchs, et al., 2007; Hodgkinson, Butow, Hunt, et al., 2007; Rowlands, Janda, McKinnon, Webb, & Beesley, 2015; Smith et al., 2013; Urbaniec, Collins, Denson, & Whitford, 2011). Therefore, the CaSUN was translated into Dutch.…”

Section: Introductionmentioning

confidence: 99%

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Psychometric properties of the Dutch extended Cancer Survivors’ Unmet Needs measure (CaSUN-NL)

et al. 2018

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Information and support needs increase emotional distress and can impede cancer survivors’ adjustment. To investigate the information and support needs of Dutch cancer survivors, the Cancer Survivors’ Unmet Needs measure (CaSUN) was translated into Dutch and applied in two Dutch studies with cancer survivors (N = 255; N = 467). The CaSUN‐NL entailed the original five CaSUN scales, extended with respectively a returning to work and lifestyle scale. This study aimed to determine the psychometric properties of the CaSUN‐NL. To assess validity, a maximum likelihood factor analysis was employed. Construct validity was analysed using Pearson's and Spearman's correlation coefficients. To assess reliability, test–retest (Kappa coefficient) and internal consistency (Cronbach's alpha) values were determined. Factor analysis revealed the original five factors. Test–retest reliability was low (r ≤ .15, 93% retest response). Internal consistency values were high (Cronbach's alpha = 0.92–0.94), except for lifestyle. Significant correlations were found between total number of unmet needs with anxiety (r = .55), depression (r = .49), negative adjustment (r = .50), quality of life (r = −.52) and age (r = −.24). The CaSUN‐NL is valid and reliable to investigate the unmet information and support needs of Dutch cancer survivors.

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Factors Associated With Unmet Supportive Care Needs and Emergency Department Visits and Hospitalizations in Ambulatory Oncology

et al. 2023

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ImportancePatients with cancer experience multiple supportive care needs (eg, coping and financial counseling) that, if not addressed, may result in poor clinical outcomes. Limited work has assessed the factors associated with unmet needs in large and diverse samples of ambulatory oncology patients.ObjectiveTo characterize the factors associated with unmet supportive care needs among ambulatory oncology patients and to assess whether such needs were associated with emergency department (ED) visits and hospitalizations.Design, Setting, and ParticipantsBetween October 1, 2019, and June 30, 2022, cross-sectional retrospective analyses were performed in a large and diverse ambulatory cancer population via My Wellness Check, an electronic health record (EHR)–based supportive care needs and patient-reported outcomes (PROs) screening and referral program.Main Outcomes and MeasuresDemographic characteristics, clinical characteristics, and clinical outcomes were extracted from EHRs. Data on PROs (ie, anxiety, depression, fatigue, pain, and physical function), health-related quality of life (HRQOL), and supportive care needs were also collected. Logistic regressions examined factors associated with unmet needs. Cumulative incidence of ED visits and hospitalizations were assessed by Cox proportional hazards regression models adjusting for covariates.ResultsThe 5236 patients in the study had a mean (SD) age of 62.6 (13.1) years and included 2949 women (56.3%), 2506 Hispanic or Latino patients (47.9%), and 4618 White patients (88.2%); 1370 patients (26.2%) indicated Spanish as their preferred language, according to their EHR. A total of 940 patients (18.0%) reported 1 or more unmet needs. Black race (adjusted odds ratio [AOR], 1.97 [95% CI, 1.49-2.60]), Hispanic ethnicity (AOR, 1.31 [95% CI, 1.10-1.55]), 1 to 5 years after diagnosis (AOR, 0.64 [95% CI, 0.54-0.77]), more than 5 years after diagnosis (AOR, 0.60 [95% CI, 0.48-0.76]), anxiety (AOR, 2.25 [95% CI, 1.71-2.95]), depression (AOR, 2.07 [95% CI, 1.58-2.70]), poor physical function (AOR, 1.38 [95% CI, 1.07-1.79]), and low HRQOL scores (AOR, 1.89 [95% CI, 1.50-2.39]) were associated with greater unmet needs. Patients with unmet needs had a significantly higher risk of ED visits (adjusted hazard ratio [AHR], 1.45 [95% CI, 1.20-1.74]) and hospitalizations (AHR, 1.36 [95% CI, 1.13-1.63]) relative to patients without unmet needs.Conclusions and RelevanceIn this cohort study of ambulatory oncology patients, unmet supportive care needs were associated with worse clinical outcomes. Patients from racial and ethnic minority groups and those with greater emotional or physical burden were more likely to have 1 or more unmet needs. Results suggest that addressing unmet supportive care needs may be crucial for improving clinical outcomes, and targeted efforts should focus on specific populations.

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Breast cancer survivors’ supportive care needs 2–10 years after diagnosis

Abstract: The findings have direct clinical relevance: irrespective of years since diagnosis, comprehensive and extended supportive care services are required to identify breast cancer survivors in need of supportive care interventions and remediate high levels of anxiety.

Cited by 265 publications

References 66 publications

Predictors of change in unmet supportive care needs in cancer

Predictors of change in unmet supportive care needs in cancer

Psychometric properties of the Dutch extended Cancer Survivors’ Unmet Needs measure (CaSUN-NL)

Factors Associated With Unmet Supportive Care Needs and Emergency Department Visits and Hospitalizations in Ambulatory Oncology

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