Factors Associated with Meeting the Psychosocial Needs of Cancer Survivors in Nova Scotia, Canada

Abstract

Purpose: The purpose of this study is to describe the psychosocial needs of cancer survivors and examine whether sociodemographic factors and health care providers accessed are associated with needs being met. Methods: All Nova Scotia survivors meeting specific inclusion and exclusion criteria are identified from the Nova Scotia Cancer Registry and sent an 83-item survey to assess psychosocial concerns and whether and how their needs were met. Descriptive statistics (frequencies, percentages) and Chi-square analyses are used to examine associations between sociodemographic and provider factors and outcomes. Results: Anxiety and fear of recurrence, depression, and changes in sexual intimacy are major areas of concern for survivors. Various sociodemographic factors, such as immigration status, education, employment, and internet use, are associated with reported psychosocial health and having one’s needs met. Having both a specialist and primary care provider in charge of follow-up care is associated with a significantly (p < 0.05) higher degree of psychosocial and informational needs met compared to only one physician or no follow-up physician in charge. Accessing a patient navigator also is significantly associated with a higher degree of needs met. Conclusions: Our study identifies the most prevalent psychosocial needs of cancer survivors and the factors associated with having a higher degree of needs met, including certain sociodemographic factors, follow-up care by both a primary care practitioner and specialist, and accessing a patient navigator.

What Matters in Cancer Survivorship Research? A Suite of Stakeholder-Relevant Outcomes

“…The most prevalent physical needs were fatigue, changes in sexual function, and changes in memory/concentration; the most prevalent emotional needs were anxiety and worry about cancer recurrence, followed by changes in sexual intimacy and depression; and the most prevalent practical/economic needs were returning to work/school, getting to/from appointments, and paying for health care. Thus, the findings from our qualitative study largely align with the most prevalent needs of cancer survivors in Canada [7][8][9][10]20] and elsewhere [21,22], and provide targetable outcomes in future research. Indeed, with the exception of sexual health, the psychosocial and physical outcomes identified in this study were also prioritized by cancer survivors and health care providers in Australia to develop a core set of patient-reported outcomes for cancer survivorship research [23].…”

“…Since the IOM report, many interventions have been tested, in both research and practice settings, to improve the survivors' outcomes during follow-up care. However, the reality is that many studies lead to null or mixed results [4][5][6], and survivors continue to lack access to timely information and support during the follow-up period, have high anxiety and fear after treatment, experience poor coordination across health sectors, and feel unprepared for follow-up including the physical, psychological, and practical effects of cancer and its treatment [7][8][9][10][11]. Importantly, studies of follow-up care interventions have typically assessed clinical endpoints, patient/provider satisfaction, and quality of life.…”

Relationships between Canadian adult cancer survivors’ annual household income and emotional/practical concerns, help‐seeking and unmet needs

“…The greatest levels of concerns were found for anxiety, stress and worry about cancer returning, depression and sadness, changes in sexual intimacy and changes in body image. These are issues often reported by cancer survivors (Chahine et al., 2021; Lerro et al., 2012; Molassiotis et al., 2017; Recklitist & Syrajola, 2017) and are the focus of interventions by psychosocial practitioners (Canadian Association of Psychosocial Oncology Standards of Practice, 2010). Interventions exist which are known to be effective in assisting with these concerns (Berman et al., 2020).…”

“…For survivors who have completed treatment, evidence regarding unmet needs concerning emotional and practical issues has been growing. Major areas of concern are reported including fear of cancer recurrence, anxiety, depression, difficulties with sexual intimacy, return to work and finances (Chahine et al., 2021; Recklitist & Syrajola, 2017). Samples in studies of cancer survivors vary widely in terms of time since diagnosis making it difficult to compare across studies (Harrison et al., 2009).…”

“…Samples in studies of cancer survivors vary widely in terms of time since diagnosis making it difficult to compare across studies (Harrison et al, 2009). However, several studies reported that unmet needs in survivors are associated with rural residency, having received chemotherapy, being single and younger age (Chahine et al, 2021;Von Heymann-Horan et al, 2013). In one study of low-income survivors, Yi et al (2011) reported the highest unmet needs were emotional (44%) and practical (36%).…”