Unmet supportive care needs and associated factors: Evidence from 4195 cancer survivors in Shanghai, China

Abstract

BackgroundCancer survivors at different stages of life often have different needs that make it challenging for services to provide satisfactory care. Few studies have considered whether services are truly meeting the needs of cancer patients by exploring and identifying their perspectives on unmet needs.ObjectiveThe aim of this study was to identify the unmet needs of cancer survivors and to further determine the potential impact of socio-demographic factors.MethodsA cross-sectional study that included 4195 cancer patients was conducted in Shanghai, China. Using Maslow’s hierarchy of needs theory as a conceptual framework, the questionnaire included five dimensions: information, life and finances, continuing care, emotions, and self-actualization. Correlation analysis and ordered logistic regression analysis was used to explore the relationship between demographic sociological factors and unmet needs for supportive care.ResultsThe most common unmet supportive care needs include information needs (2.91 ± 1.32), self-actualization needs (2.69 ± 1.32) and continuing care needs (2.59 ± 1.30). Unmet needs for life and finances were more pronounced among cancer participants in the 45-69 age group. After adjusting for confounders, we found that each 6-month increase in the time since diagnosis was associated with a 0.8% (OR: 0.992, 95% CI: 0.985-0.998) reduction in high need for continuing care and a 0.9% (OR:0.991, 95% CI: 0.983-0.999) reduction in high need for self-actualization, respectively.ConclusionsInformation needs are the most important concern among the diverse unmet needs of cancer survivors. Time since diagnosis is associated with unmet supportive care needs of cancer survivors. The findings highlight the large gap between actual health services and patients’ unmet need for supportive care, which will provide the basis for a patient-centered supportive care system for cancer survivors.

Mapping the Supportive Care Needs of Adult Survivors of Childhood Cancer at a Comprehensive Cancer Center in the Middle East

“…However, this effect diminishes upon adjusting for potential confounding variables using a multivariate regression model. This contradicts with previous empirical evidence suggesting a strong correlation between the time since diagnosis and greater supportive care needs [33,34]. Additionally, and in the context of our study's findings, it is noteworthy to discuss the significant independent association observed between singlehood and psychological need scores among childhood cancer survivors.…”

“…Previous reports suggested similar findings in adults and AYA groups [34][35][36][37]. This relationship, marginally significant on conventional levels, might be suggestive of a transition point where adult survivors of childhood cancer start to face increased difficulties navigating healthcare systems and require more information about their health and care.…”

Unmet supportive care needs of patients with breast cancer: A systematic review

“…Fear of cancer recurrence (FCR) could be a powerful determinant of physical symptoms [104], psychological distress [105] and quality of life [106]. Our study demonstrated that breast cancer patients not only faced the huge unmet need in FCR regarding "fears cancer spreading/recurrence", but also in "dealing with the impact that having a faulty gene has had on your family", which could be similarly re ected in high information need related to Information needs were proved to be the most important concern among the diverse unmet needs of cancer survivors [109]. Anxiety related to inadequate information support is common among breast cancer patient.…”

Unmet supportive care needs of breast cancer survivors: a systematic scoping review

“…There is a huge burden of supportive care needs among BCSs that are still under management, such as psychosocial issues [ 108 ], sexuality [ 109 ], information [ 110 ], and symptoms burden [ 111 ]. Most authors have investigated the USCNs among BCSs [ 112 , 113 ] through cross-sectional study or qualitative interview. However, to our knowledge, few researchers conducted evidence synthesis [ 23 , 114 ].…”

“…Information needs were proved to be the most important concern among the diverse USCNs of cancer survivors [ 113 ]. Among BCSs, anxiety related to inadequate information support is common.…”