Unmet Supportive Care Needs Among Women With Breast and Gynecological Cancer: Relevance of Attachment Anxiety and Psychological Distress

Abstract

Objective: Attachment anxiety and avoidance are known risk factors for the development of unmet needs and poor well-being among patients with chronic diseases. Few studies have addressed this in individuals with cancer. We aimed to explore the relationship between supportive care needs, attachment styles and distress in women with breast and gynecological cancer. Methods: Using a cross-sectional paper-pencil (n = 157) and online survey (n = 614), a total of 771 patients with breast or gynecological cancer completed a set of validated questionnaires. From September 2013 to January 2014, consecutive inpatients and outpatients of the university hospital Tuebingen were included in the study. Further, participants were recruited through social media, patient internet platforms, self-help group leaders and patient networks. We used the Supportive Care Needs Survey (SCNS-SF-34) with the need dimensions: health system, patient care, psychological, physical, and sexual needs, as well as the Experiences in Close Relationships-Revised Questionnaire, and the Distress Thermometer. A multiple linear regression model was used to analyze the influence of attachment styles (anxiety and avoidance) on the SCNS-SF-34 dimensions. A moderation analysis was used to explore the influence of the interaction between attachment anxiety and distress for all SCNS-SF-34 dimensions. Results: Attachment anxiety was a significant determinant and led to higher unmet supportive care needs in all dimensions, whereas attachment avoidance was not significant. Distress did moderate the relationship between attachment anxiety and

Associations Between Personality Functioning, Childhood Trauma and Non-adherence in Cardiovascular Disease: A Psychodynamically-Informed Cross-Sectional Study

“…Our findings suggest that people who suffered trauma in childhood also have more difficulty adhering to medical recommendations. Several studies have shown that people with childhood trauma are more likely to develop insecure attachment styles, which are associated with difficulties in seeking help and maintaining stable relationships ( Pearlman and Courtois, 2005 ; Clark et al, 2011 ; Millar et al, 2021 ) and other factors related to somatic medicine ( Graetz et al, 2013 ; Graf et al, 2020 ; Graetz et al, 2021 ). Therapeutic alliance, a marker of a stable relationship, indeed appears to play an important role in adherence ( Pringle and Fawcett, 2017 ).…”

The most unmet needs on Gynecological and Breast Cancer Survivors, A Systematic Review

“…La mayor parte de la investigación sobre artículos seleccionados de este estudio de revisión sistemática muestra que las necesidades insatisfechas más altas en sobrevivientes de cáncer ginecológico y de mama son las necesidades de información y las necesidades de apoyo psicológico (9,12,13,17,19,21,(23)(24)(25)(26)(27)(28) . Esta necesidad no solo se siente en las sobrevivientes de cáncer ginecológico y de mama en el período temprano del diagnóstico, sino que también se siente como una necesidad insatisfecha desde el inicio del diagnóstico cuando el período de tratamiento hasta las fases de rehabilitación, terminal y paliativa (9,17,26) .…”

“…Los efectos de las necesidades insatisfechas de información y apoyo psicológico son mayor angustia, tendencia a experimentar depresión y disminución de la calidad de vida (9,21,23,25) . Otros impactos incluyen una mayor morbilidad que sienten los sobrevivientes, caracterizada por un empeoramiento de los síntomas físicos y quejas de los efectos secundarios del tratamiento (21) .…”

Patients’ Desire for Psychological Support When Receiving a Cancer Diagnostic

“…Public health policies should take into account this situation and should plan interventions providing psychological support to patients in order to reduce emotional distress and, hence, years lived with a disability. This psychological support should be provided as soon as the disease has been diagnosed, since a cancer diagnosis produces emotional distress in patients and their families [ 1 , 2 , 3 , 4 , 5 ]. Depending on the study, the incidence of clinically significant distress could range between 24% [ 6 ], 52% [ 7 ] and 61% [ 8 ].…”