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Ke Q, Timmins F, Furlong E, Stokes D. Unmet care needs of women who have undergone breast cancer surgery: A scoping review. J Adv Nurs 2024; 80:1732-1749. [PMID: 37950373 DOI: 10.1111/jan.15953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIM To summarize the evidence regarding the unmet care needs of women who have undergone breast cancer surgery and identify research gaps. DESIGN A scoping review. DATA SOURCES This review entailed a systematic search in EMBASE, Medline via PubMed, CINAHL Complete, APA PsycINFO, Cochrane Library, Web of Science and Scopus (up until 30 July 2023). REVIEW METHODS This review was guided by Arksey and O'Malley's Framework (2005) and the Preferred Reporting Items for Systematic Reviews and Meta-analysis-Scoping Review extension (PRISMA-ScR). RESULTS Twenty-five studies that included 4914 participants were retrieved. Fourteen studies employed quantitative designs, eight used qualitative methods, two were mixed-methods studies and one used a qualitative meta-synthesis. Women who have undergone breast cancer surgery experience a wide range of complex and multifaceted unmet care needs. The informational/educational and psychological/emotional domains were the most frequently reported among the identified domains. Meanwhile, the sexual and spiritual/religious beliefs domains remained relatively underexplored. Furthermore, none of the assessment tools used in these studies captured the entirety of the possible domains of unmet care needs. CONCLUSION Needs assessment should be integrated into the routine care of women who have undergone breast cancer surgery. Interventions should be developed to address the unmet informational/educational and psychological/emotional needs of women. Future studies should employ high-quality mixed-methods approaches to explore women's sexual and spiritual/religious concerns. IMPACT This review provides a comprehensive overview of the unmet care needs of women who have undergone the breast cancer surgery. These findings will contribute to the development of tailored interventions. This review also informs future studies to explore distinct domains of unmet care needs. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Qiaohong Ke
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Fiona Timmins
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Eileen Furlong
- School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Diarmuid Stokes
- College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
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Yu Y, Li Y, Zhao J, Yao J, Duan Y, Shao Y, Xie J, Zhu L. The longitudinal relationship between self-compassion and cancer patients' unmet supportive care needs. Psychooncology 2024; 33:e6319. [PMID: 38497821 DOI: 10.1002/pon.6319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/20/2023] [Accepted: 02/25/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES Unmet supportive care needs are associated with psychological symptoms such as depression and anxiety. However, so far, few studies have explored the protective psychological factors of unmet needs. Therefore, this study intends to explore the protective effect of self-compassion on unmet needs of Chinese cancer patients and to examine the predictive role of self-compassion on these needs during treatment. METHODS A longitudinal study was performed at Shaanxi Provincial Cancer Hospital in Xi'an, China. A total of 153 heterogeneous cancer patients were assessed after the first diagnosis (T1), at the beginning (T2) and end (T3) of medical treatment. Hierarchical linear regression analyses were used to examine the research questions. RESULTS Cross-sectional regression analyses showed that self-compassion at T1 was significantly related to psychological needs at T1. Negative self-compassion at T1 was significantly related to total unmet needs, psychological needs, health system, and information and sexual needs. Longitudinal regression analyses showed that self-compassion at T1 significantly predicted total unmet needs; health system and information (HSI) needs at T2, psychological needs at T3, and negative self-compassion at T1 significantly predicted total unmet needs, HSI needs, physical needs, and patient care needs at T2 when controlling for unmet needs at T1. Positive self-compassion was not a predictor of unmet needs. CONCLUSIONS Self-compassion can be a protective factor of unmet needs in cancer patients. Future intervention studies should focus on improving the overall level of self-compassion and reducing the level of negative self-compassion in cancer patients to reduce patients' unmet needs.
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Affiliation(s)
- Yunlei Yu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Yanze Li
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Jiang Zhao
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Juntao Yao
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Yaokun Duan
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Yufei Shao
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Juan Xie
- Shaanxi Provincial Cancer Hospital, Xi'an, China
| | - Lei Zhu
- School of Psychology, Shaanxi Normal University, Xi'an, China
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Masoudi A, Mahmoudian A, Jouybari L, Roshandel G, Behnampour N, Khandoozi R, Pourkhani R, Sanagoo A. Supportive Care Needs (SCN) of Cancer Patients Referred to the Medical Centers in Iran. Asian Pac J Cancer Prev 2023; 24:2983-2989. [PMID: 37774048 PMCID: PMC10762765 DOI: 10.31557/apjcp.2023.24.9.2983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/10/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the Supportive Care Needs s of cancer patients in Iran. METHODS This descriptive-analytical, cross-sectional study was conducted on cancer patients referred to public and private medical centers in Gorgan (Northern Iran) in 2020. Cancer patients refered to private medical ccentes were recruited into the study using the convenience sampling method. The reliable and valid "Supportive Care Needs Survey-Short Form" (SCNS-SF) with 34 items in five domains of need (physical and daily living, psychological, sexuality, patient care and support, health system, and information) was used to collect data. RESULTS Out of 247 patients, 54.7% were females with a mean age of 46.15± 9.36. The most common site of involvement was breast (25.1%), and the duration of involvement was 7.51±6.79 months. The total mean of SCNs was 68.80±18.5 so that the highest (73.68±15.03) and lowest (60.42±27.19) SCNs were related to physical and daily living as well as sexual domains, respectively. The highest frequency (62.3%) of SCNs was related to "fatigue/lack of energy". CONCLUSION This study showed that cancer patients experienced many unmet needs in various dimensions. Therefore, it is necessary to address these needs simultaneously treating the disease and developing and implementing a care plan based on patients' priorities.
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Affiliation(s)
| | | | | | - Gholeamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | | | | | | | - Akram Sanagoo
- Golestan University of Medical Sciences, Gorgan, Iran.
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Fan R, Wang L, Bu X, Wang W, Zhu J. Unmet supportive care needs of breast cancer survivors: a systematic scoping review. BMC Cancer 2023; 23:587. [PMID: 37365504 DOI: 10.1186/s12885-023-11087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women worldwide. Though improved treatments and prolonged overall survival, breast cancer survivors (BCSs) persistently suffer from various unmet supportive care needs (USCNs) throughout the disease. This scoping review aims to synthesize current literature regarding USCNs among BCSs. METHODS This study followed a scoping review framework. Articles were retrieved from Cochrane Library, PubMed, Embase, Web of Science, and Medline from inception through June 2023, as well as reference lists of relevant literature. Peer-reviewed journal articles were included if USCNs among BCSs were reported. Inclusion/exclusion criteria were adopted to screen articles' titles and abstracts as well as to entirely assess any potentially pertinent records by two independent researchers. Methodological quality was independently appraised following Joanna Briggs Institute (JBI) critical appraisal tools. Content analytic approach and meta-analysis were performed for qualitative and quantitative studies respectively. Results were reported according to the PRISMA extension for scoping reviews. RESULTS A total of 10,574 records were retrieved and 77 studies were included finally. The overall risk of bias was low to moderate. The self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). A total of 16 domains of USCNs were finally identified. Social support (74%), daily activity (54%), sexual/intimacy (52%), fear of cancer recurrence/ spreading (50%), and information support (45%) were the top unmet supportive care needs. Information needs and psychological/emotional needs appeared most frequently. The USCNs was found to be significantly associated with demographic factors, disease factors, and psychological factors. CONCLUSION BCSs are experiencing a large number of USCNs in fearing of cancer recurrence, daily activity, sexual/intimacy, psychology and information, with proportions ranging from 45% to 74%. Substantial heterogeneity in study populations and assessment tools was observed. There is a need for further research to identify a standard evaluation tool targeted to USCNs on BCSs. Effective interventions based on guidelines should be formulated and conducted to decrease USCNs among BCSs in the future.
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Affiliation(s)
- Rongrong Fan
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Lili Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Xiaofan Bu
- The School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Wenxiu Wang
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China
| | - Jing Zhu
- Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, No.37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, China.
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Consequences of Structural Urbanism: Urban-Rural Differences in Cancer Patients' Use and Perceived Importance of Supportive Care Services from a 2017-2018 Midwestern Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063405. [PMID: 35329094 DOI: 10.3390/ijerph19063405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Structural inequities, in part, undergird urban-rural differences in cancer care. The current study aims to understand the potential consequences of structural inequities on rural and urban cancer patients' access to and perceived importance of supportive cancer care resources. METHODS We used data collected from November 2017 to May 2018 from a larger cross-sectional needs assessment about patients' support needs, use of services, and perceptions at a Midwestern United States cancer center. Oncology patients received a study packet during their outpatient clinic visit, and interested patients consented and completed the questionnaires. RESULTS Among the sample of 326 patients, 27% of the sample was rural. In adjusted logistic regression models, rural patients were less likely to report using any secondary support services (15% vs. 27%; OR = 0.43, 95%CI [0.22, 0.85], p = 0.02) and less likely than urban counterparts to perceive secondary support services as very important (51% vs. 64%; OR = 0.57, 95%CI [0.33, 0.94], p = 0.03). CONCLUSION Structural inequities likely have implications on the reduced access to and importance of supportive care services observed for rural cancer patients. To eliminate persistent urban-rural disparities in cancer care, rural residents must have programs and policies that address cancer care and structural inequities.
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An J, Zhou K, Li M, Li X. Assessing the relationship between body image and quality of life among rural and urban breast cancer survivors in China. BMC Womens Health 2022; 22:61. [PMID: 35246115 PMCID: PMC8896367 DOI: 10.1186/s12905-022-01635-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/07/2022] [Indexed: 01/18/2023] Open
Abstract
Background Breast cancer survivors experience altered body image and quality of life (QoL) due to the disease and its treatment. The multidimensional nature of body image and QoL makes their relationships complex. This study aimed to examine the associations between the two concepts in Chinese breast cancer survivors and test whether these associations are moderated by rural–urban residence. Methods A cross-sectional design was adopted. Breast cancer survivors were recruited via a convenience sampling method. Two validated questionnaires (the Body Image Self-Rating Questionnaire for Breast Cancer and 36-item Short-Form Health Survey) and questions assessing demographic and clinical covariates were administered. Multiple linear regressions were used to assess the relationship between body image and QoL domains and to examine the moderating effect of rural–urban residence. Results In our sample of 354 breast cancer survivors, half (50.28%) lived in rural areas. After adjusting for demographic and clinical variables, better perception of body image-related sexual activity change, role change, and psychological change was significantly associated with better physical (β ranged from − 0.15 to − 0.11, p < 0.05) and mental (β ranged from − 0.46 to − 0.34, p < 0.001) well-being. Better perception of body image-related social and behavior change was significantly associated only with better mental well-being (β ranged from − 0.40 to − 0.33, p < 0.001). The association between body image and mental well-being was much stronger in urban subjects (b = − 0.38, p < 0.001) than in rural subjects (b = − 0.20, p < 0.001). Conclusions Our findings suggest that multidimensional body image is associated with physical and mental well-being in Chinese breast cancer survivors. Body image appears to play a larger role in urban breast cancer survivors’ mental well-being. Our results indicate that incorporating interventions that address body image issues would be advantageous for survivorship care to enhance QoL in breast cancer survivors. Furthermore, rural–urban differences should be considered in the strategic design of survivorship care programs in rural and urban settings.
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Affiliation(s)
- Jinghua An
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Kaina Zhou
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Minjie Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Central Ave, Shatin, Hong Kong, SAR
| | - Xiaomei Li
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China.
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Bu X, Jin C, Fan R, Cheng ASK, Ng PHF, Xia Y, Liu X. Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer 2022; 22:135. [PMID: 35109799 PMCID: PMC8811964 DOI: 10.1186/s12885-022-09224-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Breast cancer survivors (BCSs) often have potential unmet needs. Identification of the specific needs of BCSs is very significant for medical service provision. This study aimed to (1) investigate the unmet needs and quality of life (QoL) of BCSs in China, (2) explore the diverse factors associated with their unmet needs, and (3) assess the association between their unmet needs and QoL. Methods A multicentre, cross-sectional survey was administered to 1210 Chinese BCSs. The Cancer Survivor Profile-Breast Cancer and the Functional Assessment of Cancer Therapy-Breast scale were administered to survivors who gave informed consent to participate. Data were analysed using t-test, ANOVA, multiple regression analysis, and Pearson correlations. Results The 1192 participants completed questionnaires (response rate 98.51%). Our study reveals that the most prevalent unmet needs were in the ‘symptom burden domain’. The unmet needs of BCSs depend on eleven factors; age, time since diagnosis, education level, occupation, payment, family income status, stage of cancer, treatment, family history of cancer, pain, and physical activities. To ensure the provision of high-quality survivorship care and a high satisfaction level, more attention should be paid to actively identifying and addressing the unmet needs of BCSs. The problem areas identified in the Cancer Survivor Profile for breast cancer were negatively associated with all subscales of QoL except the health behaviour domain, with the correlation coefficient ranging from − 0.815 to − 0.011. Conclusion Chinese BCSs exhibit a high demand for unmet needs in this study, and the most prevalent unmet needs were in the ‘symptom burden domain’. There was a significant association between patients’ unmet needs (as defined in the Cancer Survivor Profile for breast cancer) and QoL. Future research should focus on enhancements to survivorship or follow-up care to address unmet needs and further improve QoL.
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Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Xiangya School of Nursing, Central South University, Changsha, China
| | - Cai Jin
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Department of Nursing, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Rongrong Fan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Peter H F Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yimin Xia
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
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Amane HY, Tessema AM, seid KA, Hassen AM, Assen HE, Asfaw ZA, endrie SM, Hussien FM. Factors associated with unmet supportive care needs of oncology patients at Dessie Referral Hospital, 2020. Ecancermedicalscience 2021; 15:1300. [PMID: 34824623 PMCID: PMC8580717 DOI: 10.3332/ecancer.2021.1300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Assessment of supportive care needs for cancer patients and identifying factors affecting these needs is important for the implementation of supportive care programmes, as the burden of cancer is increasing in Ethiopia. OBJECTIVE To determine the prevalence and associated factors of unmet supportive care needs of cancer patients at Dessie Referral Hospital, Dessie, South Wollo, North East Ethiopia, 2020. METHODS A cross-sectional study design was implemented among 405 cancer patients from February to 30 July 2020, at Dessie Referral Hospital. The data were collected using a validated supportive care needs survey questionnaire through face to face interview and data extraction tools. Both descriptive and inferential statistics were used and bi-variable and multivariable logistic regressions were used to describe the association between dependent and independent variables. Thus, a p-value of less than 0.05 was considered statistically significant. RESULT From the total 405 participants, 275 (67.5%) were females with a mean age of (mean ± standard deviation) 48.6 ± 15.4 years. Unmet supportive care needs were higher among psychological needs (81.0%, 95% (confidence interval) CI = 77.0-84.9) and physical needs (74.6%, 95% CI = 70.1-79.0). Old age was associated with unmet physical and psychological needs domain than young age (adjusted odds ratio (AOR) = 1.03; 95% CI: 1.01-1.06), (AOR = 1.06; 95% CI: 1.03-1.09), respectively. High household income was significantly associated with health information needs (AOR = 2.22; 95% CI: 1.33-13.93), remission status (AOR = 0.37; 95% CI: 0.22-0.62) was associated with patient/supportive care needs, late stage cancer was also significantly associated with physical, psychological and health information needs of patients (AOR = 2.19; 95% CI: 1.18-4.06), (AOR = 2.3; 95% CI: 1.18-4.57) and (AOR = 2:95%; CI: 1.03-3.86), respectively. Besides, source of information had a statistically significant association with psychological, health information and patient care needs domain (AOR = 2.61; 95% CI: 1.15-5.93), (AOR = 3.1; 95% CI: 1.65-5.82) and (AOR = 2.2; 95% CI: 1.25-3.87), respectively. CONCLUSION AND RECOMMENDATION This study shows that the prevalence of unmet supportive care needs in cancer patients is high in each domain. Age, income, cancer stage, cancer site, treatment option, time since diagnosis and sources of information were associated across one or more unmet supportive care needs domains. Therefore, the government and health professionals should work together to improve the unmet needs of cancer patients.
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Affiliation(s)
- Husniya Yasin Amane
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
| | - Asressie Molla Tessema
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
| | - Kemal Ahmed seid
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
| | - Anissa Mohammed Hassen
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
| | - Hussien Endris Assen
- Department of Anesthesia and Critical Care, College of Medicine and Health Science, University of Gondar, Gondar 196, Ethiopia
| | - Zinet Abegaz Asfaw
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
| | - Salih Mohamed endrie
- Department of Anesthesia, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
| | - Foziya Mohammed Hussien
- Department of Public Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie 1145, Ethiopia
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Cai YJ, Masaki H, Shi TY. Supportive Care Needs of Chinese Women With Newly Diagnosed Breast Cancer Prior to Adjuvant Chemotherapy. Oncol Nurs Forum 2021; 48:341-349. [PMID: 33855997 DOI: 10.1188/21.onf.341-349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the supportive care needs of Chinese women newly diagnosed with breast cancer prior to adjuvant chemotherapy. PARTICIPANTS & SETTING 13 women newly diagnosed with breast cancer were recruited from a public teaching hospital in northern China. METHODOLOGIC APPROACH Semistructured interviews were conducted, and data were analyzed following a qualitative descriptive approach and qualitative content analysis. FINDINGS The following five themes emerged. IMPLICATIONS FOR NURSING Nurses should focus on patients' prechemotherapy supportive care needs and comprehensively assess their specific needs and concerns related to post-surgery discomfort and chemotherapy, with considerations of the Chinese family concept, diet, and traditional culture. Targeted health information and psychological support are necessary to help patients transition to and adequately prepare for chemotherapy.
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Affiliation(s)
- Ying-Jie Cai
- First Affiliated Hospital of Dalian Medical University.,Chiba University
| | | | - Tie-Ying Shi
- First Affiliated Hospital of Dalian Medical University
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Husson O, Weidema M, Leonard H, Hartle DeYoung L, van der Graaf W, van de Poll-Franse L. Supportive care needs of patients living with an extremely rare and unpredictable cancer: The Epithelioid Haemangioendothelioma patient experience. Eur J Cancer Care (Engl) 2021; 30:e13461. [PMID: 33989441 DOI: 10.1111/ecc.13461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/10/2021] [Accepted: 04/27/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Epithelioid haemangioendothelioma (EHE) is an ultrarare vascular sarcoma with an incidence of <1/million/year and a large clinical heterogeneity. Data on supportive care needs of rare cancer patients are scarce. This study aimed to investigate the level of supportive care needs of EHE patients and its association with sociodemographic, clinical and symptom burden characteristics. METHODS We present secondary data of a cross-sectional questionnaire study involving EHE patients recruited from the international EHE Facebook group. Data were collected using the web-based PROFILES registry. Unmet needs were measured with Supportive Care Needs Survey Short Form (SCNS-SF34). RESULTS 115 EHE patients from 20 countries completed the online questionnaire. Mean level of supportive care needs was 68.4 (range 34-170), with the highest mean score on the psychological domain. Supportive care needs were associated with age, disease stage, years since diagnosis and number of tumour locations. Highly symptomatic patients (33%) reported more supportive care needs than patients with low or intermediate symptom burden. CONCLUSION Supportive care needs were found in all domains, highest in the psychological domain, and were associated with sociodemographic, clinical and symptom burden characteristics. Adequate and tailored supportive care should be offered especially to highly symptomatic EHE patients.
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Affiliation(s)
- Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Division of Clinical Studies, Institute of Cancer Research, London, UK
| | - Marije Weidema
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | | | - Winette van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lonneke van de Poll-Franse
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.,Department of Medical and Clinical Psychology, CoRPS - Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
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Krug K, Bossert J, Deis N, Krisam J, Villalobos M, Siegle A, Jung C, Hagelskamp L, Unsöld L, Jünger J, Thomas M, Wensing M. Effects of an Interprofessional Communication Approach on Support Needs, Quality of Life, and Mood of Patients with Advanced Lung Cancer: A Randomized Trial. Oncologist 2021; 26:e1445-e1459. [PMID: 33860592 PMCID: PMC8342586 DOI: 10.1002/onco.13790] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/02/2021] [Indexed: 12/16/2022] Open
Abstract
Background To address the support needs of newly diagnosed patients with lung cancer with limited prognosis, the Milestone Communication Approach (MCA) was developed and implemented. The main elements of the MCA are situation‐specific conversations along the disease trajectory conducted by an interprofessional tandem of physician and nurse. The aim of the study was to evaluate the effects of MCA on addressing support needs, quality of life, and mood as compared with standard oncological care. Patients and Methods A randomized trial was conducted with baseline assessment and follow‐up assessments at 3, 6, and 9 months in outpatients with newly diagnosed lung cancer stage IV at a German thoracic oncology hospital. The primary outcome was the Health System and Information Needs subscale of the Short Form Supportive Care Needs Survey (SCNS‐SF34‐G) at 3‐month follow‐up. Secondary outcomes included the other subscales of the SCNS‐SF34‐G, the Schedule for the Evaluation of Individual Quality of Life, the Functional Assessment of Cancer Therapy lung module, the Patient Health Questionnaire for Depression and Anxiety, and the Distress Thermometer. Results At baseline, 174 patients were randomized, of whom 102 patients (MCA: n = 52; standard care: n = 50) provided data at 3‐month follow‐up. Patients of the MCA group reported lower information needs at 3‐month follow‐up (mean ± SD, 33.4 ± 27.5; standard care, 43.1 ± 29.9; p = .033). No effects were found for secondary outcomes. Conclusion MCA lowered patient‐reported information needs but did not have other effects. MCA contributed to tailored communication because an adequate level of information and orientation set the basis for patient‐centered care. Implications for Practice By addressing relevant issues at predefined times, the Milestone Communication Approach provides individual patient‐centered care facilitating the timely integration of palliative care for patients with a limited prognosis. The needs of patients with lung cancer must be assessed and addressed throughout the disease trajectory. Although specific topics may be relevant for all patients, such as information about the disease and associated health care, situations of individual patients and their families must be considered. Additionally, using the short form of the Supportive Care Needs Survey in clinical practice to identify patients’ problems might support individually targeted communication and preference‐sensitive care. Addressing patient information needs in a timely fashion is of paramount importance for preference‐sensitive decisions and patient‐centered care. This article evaluates the Milestone Communication Approach to oncological care.
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Affiliation(s)
- Katja Krug
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Jasmin Bossert
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.,Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Nicole Deis
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Villalobos
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Anja Siegle
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Corinna Jung
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany.,Medical School Berlin, Berlin, Germany
| | - Laura Hagelskamp
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Laura Unsöld
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Jana Jünger
- German National Institute for State Examinations in Medicine, Pharmacy, and Psychotherapy, Mainz, Germany
| | - Michael Thomas
- Thoracic Clinic, Department of Thoracic Oncology, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), University Hospital Heidelberg, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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12
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Mohd Shariff N, Azman N, Hami R, Mohd Mujar NM, Leong Bin Abdullah MFI. Multicentre prospective cohort study of unmet supportive care needs among patients with breast cancer throughout their cancer treatment trajectory in Penang: a PenBCNeeds Study protocol. BMJ Open 2021; 11:e044746. [PMID: 33722872 PMCID: PMC7959240 DOI: 10.1136/bmjopen-2020-044746] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/14/2021] [Accepted: 02/23/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Proper assessment of unmet supportive care needs of patients with breast cancer and its influencing factors at different treatment intervals will improve the rehabilitation of patients with breast cancer. Therefore, this study aims to determine the prevalence of unmet supportive care needs, changes of needs over time and associated factors during the treatment period. METHODS AND ANALYSIS This multicentre, prospective cohort study will be conducted in three governmental hospitals and one tertiary cancer institute in Penang, Malaysia. Adult women diagnosed with primary or recurrent tumour, node, metastases stage I-IV breast cancer based on pathological biopsy will be eligible for this study. At least 281 samples are required for this study. Participants will undergo follow-up at three time intervals: T1 at breast cancer diagnosis; T2 at 3 months after diagnosis and T3 at 6 months after diagnosis. Patients will complete a set of questionnaires at each time. The primary outcome of this study includes the changes in supportive care needs over three time points, followed by the secondary outcome examining patients' characteristics, coping behaviours and positive psychological components as they affect changes in unmet supportive care needs over time. ETHICS AND DISSEMINATION The study has received ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-19-268-45809 IIR) and the Human Research Ethics Committee of Universiti Sains Malaysia (USM/JEPeM/17100443). The results of the prospective study will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Noorsuzana Mohd Shariff
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Nizuwan Azman
- Biostatistics and Bioinformatics Unit, Research and Networking Department, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Minden, Penang, Malaysia
| | - Rohayu Hami
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Noor Mastura Mohd Mujar
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
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13
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Self-management Needs of Breast Cancer Survivors After Treatment: Results From a Focus Group Interview. Cancer Nurs 2020; 43:78-85. [PMID: 30148729 DOI: 10.1097/ncc.0000000000000641] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Recognition of the importance of self-management (SM) for breast cancer survivors (BCSs) is increasing, but evidence from investigations of their needs focusing on SM is limited. OBJECTIVES The aim of this study was to explore the SM needs of BCSs who had completed treatment. METHODS Using a qualitative study design, we interviewed a focus group of 20 BCSs who underwent cancer therapy (mean time since diagnosis 3.4 years) at a university hospital in South Korea. Data were analyzed via conventional content analysis. RESULTS The focus group interviews revealed 10 subthemes that we organized into 5 themes about the posttreatment SM needs of BCSs: (1) symptom management needs, (2) emotional management needs, (3) information acquisition needs, (4) need for a relationship with healthcare providers, and (5) adaptation needs. Specifically, participants needed to acquire SM skills to relieve symptoms (eg, peripheral neuropathy, insomnia), deal with emotional problems (eg, fear of recurrence, anxiety, depression), and adapt to changes due to cancer treatment (eg, body image, lifestyle, and role changes). In particular, participants expressed a substantial need for a constructive relationship with healthcare providers who, by respecting and communicating with them, would help empower them. Participants placed a high value on building self-confidence for successful SM. CONCLUSIONS Our findings can contribute to the development of breast cancer survivorship care plans by emphasizing posttreatment SM. IMPLICATIONS FOR PRACTICE Future SM support intervention for BCSs after treatment should focus on training SM skills, enhancing the survivor-provider relationship, and building survivor self-confidence.
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14
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Suphanchaimat R, Sinam P, Phaiyarom M, Pudpong N, Julchoo S, Kunpeuk W, Thammawijaya P. A cross sectional study of unmet need for health services amongst urban refugees and asylum seekers in Thailand in comparison with Thai population, 2019. Int J Equity Health 2020; 19:205. [PMID: 33176812 PMCID: PMC7661252 DOI: 10.1186/s12939-020-01316-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the Thai government has introduced policies to promote the health of migrants, it is still the case that urban refugees and asylum seekers (URAS) seem to be neglected. This study aimed to explore the degree of healthcare access through the perspective of unmet need in URAS, relative to the Thai population. METHODS A cross-sectional survey, using a self-reporting questionnaire adapted from the Thai Health and Welfare Survey (HWS), was performed in late 2019, with 181 URAS completing the survey. The respondents were were randomly selected from the roster of the Bangkok Refugee Center. The data of the URAS survey were combined with data of the Thai population (n = 2941) from the HWS. Unmet need for health services was defined as the status of needing healthcare in the past 12 months but failing to receive it. Bivariate analysis was conducted to explore the demographic and unmet need difference between URAS and Thais. Multivariable logistic regression and mixed-effects (ME) model were performed to determine factors associated with unmet need. RESULTS Overall, URAS were young, less educated and living in more economically deprived households, compared with Thais. About 98% of URAS were uninsured by any of the existing health insurance schemes. The prevalence of unmet need among URAS was significantly higher than among Thais in both outpatient (OP) and inpatient (IP) services (54.1% versus 2.1 and 28.0% versus 2.1%, respectively). Being uninsured showed the strongest association with unmet need, especially for OP care. The association between insurance status and unmet need was more pronounced in the ME model, relative to multivariable logistic regression. URAS migrating from Arab nations suffered from unmet need to a greater extent, compared with those originating from non-Arab nations. CONCLUSION The prevalence of unmet need in URAS was drastically high, relative to the prevalence in Thais. Factors correlated with unmet need included advanced age, lower educational achievement, and, most evidently, being uninsured. Policy makers should consider a policy option to enrol URAS in the nationwide public insurance scheme to create health security for Thai society.
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Affiliation(s)
- Rapeepong Suphanchaimat
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. .,International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand.
| | - Pigunkaew Sinam
- International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand
| | - Mathudara Phaiyarom
- International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand
| | - Nareerut Pudpong
- International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand
| | - Sataporn Julchoo
- International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand
| | - Watinee Kunpeuk
- International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi, Thailand
| | - Panithee Thammawijaya
- Division of Innovation and Research, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
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15
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Groß SE, Weidner D, Cecon N, Pfaff H, Strauch C, Scholten N. Does basic information concerning nutrition improve the information needs of breast cancer patients? An evaluation. Support Care Cancer 2020; 28:5419-5427. [PMID: 32146546 PMCID: PMC7546988 DOI: 10.1007/s00520-020-05385-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/26/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE International and national studies have shown unmet information needs regarding nutrition in breast cancer patients. An intervention study has examined the question of the extent to which a fact sheet on the topic of nutrition is suitable to cover the need for information of breast cancer patients. METHOD The fact sheet with basic information on nutrition was distributed in 21 intervention breast care centres in 2017. The use of the fact sheets was evaluated in a quasi-experimental design as part of the annual breast cancer patients' survey of the University of Cologne. The breast cancer patients considered were being treated with primary breast carcinoma in a hospital in North Rhine-Westphalia. A multilevel analysis was carried out in order to quantify the effect of the intervention. RESULTS Unmet information needs are experienced more by younger and non-native German-speaking patients. With regard to education, patients without a graduation and a high grade of education express more unmet information needs. The multilevel analysis showed that patients who were treated at an intervention site and therefore possibly received the fact sheet have a significantly higher chance of their information needs being met (OR = 1.45; p ≤ 0.05). CONCLUSION The intervention study showed that a fact sheet with basic information on nutrition is a possible instrument to satisfy the information needs of breast cancer patients and therefore reduce unmet information needs regarding nutrition. This intervention study is a pragmatic example on how to reduce unmet information needs among breast cancer patients in Germany.
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Affiliation(s)
- Sophie E. Groß
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
- LVR-Institute of Health Care Research, LVR Clinic Cologne, Wilhelm-Griesinger Str. 23, 51109 Cologne, Germany
| | - Doreen Weidner
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Natalia Cecon
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
| | - Carmen Strauch
- Department of Integrated Oncology, Center of Integrated Oncology (CIO) Aachen, Bonn, Cologne, Düsseldorf (ABCD), University Hospital of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Nadine Scholten
- Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Straße 129, 50933 Cologne, Germany
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16
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Zhou K, Wang W, Li M, An J, Huo L, He X, Li J, Li X. Body image mediates the relationship between post-surgery needs and health-related quality of life among women with breast cancer: a cross-sectional study. Health Qual Life Outcomes 2020; 18:163. [PMID: 32487117 PMCID: PMC7268611 DOI: 10.1186/s12955-020-01400-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
Background Although body image (BI) disturbance is a common problem that often contributes to poor health-related quality of life (HRQoL) among women with breast cancer following surgery, the mediating role of BI (as a self-perceptive factor) in the relationship between needs and HRQoL after controlling for socio-demographic factors remains unclear. The purpose of this study was to identify the mediating role of BI between post-surgery needs and HRQoL after controlling for socio-demographic factors among women with breast cancer. Methods In this cross-sectional study, the primary outcome was HRQoL (as measured with the 36-item Short-Form Health Survey version 2 [SF-36v2] and Functional Assessment of Cancer Therapy-Breast version 4.0 [FACT-Bv4.0]). The secondary outcomes included needs (measured in terms of needs importance [NI] and needs satisfaction [NS]) and BI. Structural equation modeling was used to identify the mediating role of BI between needs and HRQoL while considering socio-demographics. Results The 406 eligible patients reported poor HRQoL, and approximately half reported important unmet needs and poor BI. NI, NS, and socio-demographics had differing direct effects on BI and HRQoL, and contrasting indirect effects on HRQoL via BI. NI, NS, surgery type, presence of chronic disease, and BI explained 4% of the variance in the SF-36v2 physical component summary score; NI, NS, surgery type, residence, and BI explained 20% of the variance in the mental component summary score; and NI, NS, marital status, employment status, radiotherapy, and BI explained 33% of the variance in the FACT-Bv4.0 total score. Conclusions After surgery, women with breast cancer have poor HRQoL and BI, and important unmet needs. BI mediates the relationship between needs and HRQoL after controlling for socio-demographics. The present findings provide information for developing comprehensive BI-based needs interventions and preparing targeted health-management programs for patients with breast cancer.
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Affiliation(s)
- Kaina Zhou
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Wen Wang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Minjie Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Jinghua An
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Lanting Huo
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Xiaole He
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Jin Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, No. 76 Yanta West Road, Xi'an, 710061, Shaanxi, China.
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