Factors associated with a high level of unmet needs and their prevalence in the breast cancer survivors 1–5 years after post local treatment and (neo)adjuvant chemotherapy during the COVID-19: A cross-sectional study

Abstract

ObjectiveTo assess the prevalence of unmet needs in post-treatment breast cancer survivors and identify sociodemographic, clinical, and psychosocial variables associated with reported unmet needs during the COVID-19 pandemic.Materials and methodsIn this cross-sectional study, 430 post-treatment breast cancer survivors, ranging between 1 and 5 years after the procedure, completed the Cancer Survivors’ Unmet Needs (CaSUN) questionnaire from September 2021 and January 2022. The multivariate logistic analysis identified factors associated with at least one reported unmet need in the total CaSUN scale and specific domains.ResultsA total of 67% of survivors reported at least one unmet need. The most frequently reported unmet needs were the lack of accessible hospital parking (43%) and recurrence concerns (39.5%). The majority of reported unmet needs relate to comprehensive care (44%), followed by the psychological and emotional support domain (35.3%). Younger age (OR = 0.95, 95% CI = 0.92–0.99; p < 0.001), three or more comorbidities (OR = 0.27, 95% CI = 0.11–0.71, p < 0.01), a lower quality of life (OR = 0.06, 95% CI = 0.01–0.47, p < 0.01) and low resilience (OR = 0.95, 95% CI = 0.93–0.99) were associated with a high level of unmet needs in the multivariate regression model. Results are presented for factors associated with a high level of unmet needs for comprehensive cancer care and psychological and emotional support domain.ConclusionA high prevalence found in our study could be attributed to the COVID-19 pandemic, where patients may have missed adequate follow-up care, although comparing to studies done in non-pandemic time is difficult. Family physicians should be more attentive toward younger cancer survivors and those with more comorbidities as both characteristics can be easily recognized in the family practice.

Lessons learned from COVID-19: improving breast cancer care post-pandemic from the patient perspective

“…Unmet supportive care needs were common for all BC patients throughout the pandemic, including physical and psychological needs, communication with clinicians, health system information needs, and other financial and social needs [ 30 ]. A previous quantitative study conducted during the pandemic found that unmet needs for BC survivors can be addressed with either comprehensive care or psychological and emotional support and women who reported more unmet needs also reported a significantly lower quality of life [ 15 ]. The results of our study found that women of low SES experienced greater disruption to routine care and increased financial difficulties specific to BC, which is consistent with research conducted prior to the pandemic [ 31 ].…”

“…A failure to address unmet needs can have a negative impact on an individual’s quality of life and other health outcomes [ 14 ]. Previous research conducted during the pandemic identified unmet needs for individuals living with a diagnosis of BC such as psychological and emotional support, management of side effects, complementary therapy, communication among healthcare providers, local health care services, and transportation [ 15 ]. However, similar research has not been conducted qualitatively post-pandemic to identify lasting unmet needs.…”

Symptoms of Anxiety and Depression Among Slovenian Breast Cancer Survivors Post-Treatment During the COVID-19 Pandemic: A Cross-Sectional Study

“…All eligible female BC survivors attending hospital followup appointments during this period were invited to participate. The detailed inclusion and exclusion criteria for this cross-sectional study have already been described in another publication ( 22 ). Prior to participation, all individuals were informed about the purpose of the study and gave informed consent.…”

“…In this study, we collected socio-demographic, clinical and patient-reported data. Comprehensive descriptions of these measures with validation reports can be found in the original study ( 22 ).…”

“…The methodology for sample size calculation, responder/ non-responder analysis, and handling missing data was detailed elsewhere ( 22 ). Here, we performed two stepwise multivariate linear regression analyses using IBM® SPSS® Statistics Version 27, focusing on anxiety and depression as primary outcomes.…”