Assessing unmet needs in patients with cancer: An investigation of differential item functioning of the Needs Evaluation Questionnaire across gender, age and phase of the disease

The psychosocial needs of head and neck cancer patients: a multicenter study

INTRODUCTION

Cancer is among the most frequent pathologies and a major cause of death and disability. Scientific research and surgeons focus mainly on aspects relating to etiopathogenesis, diagnosis, and treatment, but often neglect the psychological needs of patients and related social factors. The aim of this study is to investigate the psychological and social needs of patients affected by head and neck cancer to improve patient management and achieve more empathetic care.

MATERIALS AND METHODS

The Need Evaluation Questionnaire (NEQ) was administered to adult patients who had to undergo surgery in 4 Italian tertiary head and neck cancer centers the day before the operation.

RESULTS

188 patients affected by stage I-IV head and neck tumors were enrolled. The main needs expressed by patients fall under the categories of either "information and dialogue", (64.3% more information about future conditions, 50% more information about treatments, 45% more information about the diagnosis, 44% more reassurance) or "spiritual support" (50% need to talk to someone who had the same experience as them).

CONCLUSIONS

Common methods of explaining diagnosis, treatment, and prognosis have proven unsatisfactory to patients and most also require more psychosocial support. This highlights the need to implement interventions and activities that are increasingly geared toward supporting the psychological and relational aspects of the care journey.

Validation of the Standardized Needs Evaluation Questionnaire in Polish Cancer Patients

BACKGROUND

Cancer influences various aspects of patients' functioning. Cancer patients face not only medical problems but also organizational, socio-psychological, and spiritual problems. Their needs often seem to be unrecognized because patients do not express their concerns and clinicians do not ask appropriate questions. Unmet needs impact patients' quality of life. The aim of this study was to select, adapt, validate, and introduce a simple instrument for estimating cancer patients' unmet needs in Poland.

METHODS

The Needs Evaluation Questionnaire (NEQ) was chosen for validation in a Polish population. The Polish version of the NEQ was developed with a back-translation procedure, as approved by a psycho-oncologist and a public health specialist. The psychometric properties of the NEQ (content analysis, reliability, construct validity, comprehensibility, and acceptability) were measured.

RESULTS

This study was performed on a group of 121 cancer patients. The median time of completion for the NEQ was 10 min. The form, length, and font size of the NEQ were accepted by the respondents. Overall, the meaning of the questions was well understood, with only a few cases of discreetly heterogeneous interpretation of the content. The questionnaire showed good reliability and internal factor structure validity.

CONCLUSION

The NEQ is a simple, easy-to-administer instrument with good psychometric properties and seems to be useful in assessing the unexpressed needs of cancer patients.

Unmet non-medical needs of cancer patients in Poland: a quantitative and qualitative study

PURPOSE

Cancer itself and its treatment have a multifaceted impact on patients' daily lives. The aim of the study was to determine unmet non-medical needs among Polish cancer patients.

METHODS

Survey research using a 23-item Needs Evaluation Questionnaire (NEQ) was carried out among 1062 cancer patients from different regions of Poland. Quantitative and qualitative analyses were performed.

RESULTS

The quantitative analysis showed that 48% of the NEQ items (11/23) were expressed as unmet needs by at least half of patients. Unmet information needs were indicated by patients most often: information about their diagnosis, exams, treatment, future condition, funding and economic support. Cancer patients would like to get more attention from medical staff. Unmet needs were most frequently expressed by respondents who were men, with a lower level of education, living in village, pensioners. Qualitative analysis showed that each need may be understood in a variety of different ways across the cohort. Some patients added comments that the completing NEQ helped them to notice their non-medical needs.

CONCLUSION

Polish cancer patients have some unmet non-medical needs, especially informative needs.

The Perspective of Cancer Patients in Palliative Care on Unmet Needs: A Qualitative Synthesis Using Meta-Ethnography

BACKGROUND

As cancer patients approach the end of life, their needs become more complex, increasing the demand for palliative care. Advanced-stage cancer patients encounter increasing unmet psychological, physical, autonomy, and communication needs, reflecting the difference between patients' perceived requirements and the support from health care professionals. The objective of this study was to synthesize qualitative evidence on unmet needs in palliative cancer care among inpatient and outpatient adults.

METHODS

We conducted a meta-ethnographic review according to Noblit and Hare's framework and the operationalized guidelines developed by Sattar. The eMERGe Reporting Guidance was followed. A literature search was conducted in Cinahl, Embase, Medline, Scopus, Web of Science, PsycINFO and Google Scholar for gray literature. For all the studies, direct quotes from the participants and authors' results were identified, coded and analyzed in NVivo 1.7.1 and extracted as I and II order constructs from which higher third-order themes originated.

RESULTS

Eight studies were included. Four new themes emerged, representing areas where palliative cancer care patients expressed a need for help: the need for comprehensive, patient-centered care, the need for maintaining a sense of autonomy and dignity, the need for attentive support to patients' soul and the need for accessible and timely care.

CONCLUSIONS

Palliative care patients require a secure, suffering-free end-of-life journey with informed decision-making and team support. Ensuring continuity of care, validating their suffering, and allocating sufficient time are crucial aspects of care. This involves maintaining a consistent care plan, respecting patients' emotions and experiences, and providing services tailored to individual needs.

Supportive Care Needs (SCN) of Cancer Patients Referred to the Medical Centers in Iran

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.

The need of patients living with cancer for palliative care

BACKGROUND

A comprehensive assessment of patients' problems and needs is essential for all patients with chronic diseases, including cancer.

AIM

This study assesses the problems, unmet needs and requirement for palliative care (PC) among patients with cancer.

METHOD

A descriptive cross-sectional design was employed using a valid self-reported questionnaire.

RESULTS

On average, 62% of patients had problems that were unresolved. The need for patients to have more information about their health was identified (75.1%), followed by financial problems because of the illness and ability to afford healthcare (72.9%), and psychological issues, such as depression, anxiety and stress (67.1%). Patients stated that their spiritual needs were not being met (78.8%), and that they were experiencing psychological distress and problems with daily living that needed to be addressed through PC (78%, 75.1%, respectively). A chi-square test revealed that all problems are significantly associated with the need for PC (P<.001).

CONCLUSION

Patients needed more assistance in psychological, spiritual, financial and physical domains, and this can be provided by palliative care. Palliative care in low-income countries is a human right for patients with cancer.

Needs evaluation questionnaire for liver disease: a novel assessment of unmet needs in patients with chronic liver disease

Patients with chronic liver disease face debilitating complications in their daily living and constantly report several types of unmet needs, but there is a paucity of validated questionnaires to assess these needs. In this study, we present the development of the Needs Evaluation Questionnaire for Liver Diseases (NEQ-LD) for the assessment of unmet needs in patients with chronic liver disease. Two hundred eighty-six outpatients with chronic liver diseases from a single tertiary referral center completed the NEQ-LD and related validity measures. Item response theory analyses were performed and demonstrated the strong psychometric properties of the questionnaire. Differential item functioning analyses showed that the scale functions equally across groups differing for age, sex, and presence of cirrhosis, suggesting the large applicability of the NEQ-LD for the assessment of unmet needs and between-group comparisons. Criterion validity measures provided evidence that unmet needs were positively associated with measures of depression and anxiety and negatively associated with measures of subjective well-being and physical and mental health. Unmet needs were expressed by a high percentage of patients, especially in the areas of information and dialogue with clinicians. One third of the sample reported material needs. Most of the items describing unmet needs were reported more frequently by patients with cirrhosis. Conclusion: We developed a reliable, valid, and largely employable instrument that can promote patient-centered care and facilitate support services in Hepatology.

Harmful Interference of Detoxifying Diets and Nutraceuticals with Adherence to Abemaciclib in Advanced Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor-2-Negative Breast Cancer: A Case Report

Many cancer patients use integrative therapies with a combination of natural products and diets. In the Western world, integrative medicine is often not shared with oncologists even during antineoplastic treatments. This behavior stems from the unmet needs of cancer patients who may feel oncologists' underestimation of their symptoms and spiritual aspects. This case report demonstrates the potential harm of inadequate diet and nutraceutical intake in a 68-year-old woman with metastatic estrogen receptor-positive, human epidermal growth factor receptor-2-negative breast cancer. Her care team recommended hormone therapy with abemaciclib plus fulvestrant. Her diarrhea started after 10 days of therapy and did not disappear, despite the use of loperamide, causing a significant reduction in adherence and dose intensity of abemaciclib. The patient finally disclosed to her oncologist she was following a detoxifying diet and taking several nutraceuticals. Her diarrhea was correlated with abemaciclib but most probably exacerbated and prolonged by the diet. Evaluation of disease after 3 months showed progressive disease. Integrative medicine should be in the multidisciplinary management of cancer patients to avoid potentially harmful events and ameliorate patients' quality of life in a holistic approach.

Italian version of the Edmonton Symptom Assessment System (ESAS)-Total Care (TC): development and psychometric validation in patients undergoing cancer treatment or follow-up

INTRODUCTION

The routine use of patient-reported outcomes (PROs) in clinical practice improves quality of care, it helps in reducing the access to emergency services and unscheduled visits, and it can improve cancer patients' time survival. The Edmonton Symptom Assessment System (ESAS) is a PRO largely used in different care settings to monitor physical and psychological symptoms. Nonetheless, along with these symptoms, literature also highlighted the presence and effect of spiritual pain, financial distress, and social isolation on quality of care, treatment effectiveness, and survival.

AIM

The aims of the current study were (a) to complete the Italian version of the ESAS validation process by adding the missing symptom "insomnia" and (b) to develop and validate the ESAS-Total Care (ESAS-TC) that is intended to evaluate and screen not only physical and psychological symptoms but also spiritual pain, discomfort deriving from financial problems associated with illness, and suffering related to social isolation.

METHODS

A sample of Italian native outpatients, who referred to the dedicated Supportive Care Unit of the Fondazione IRCCS, Istituto Nazionale deiTumori (INT), Milano, were asked to fill the ESAS-TC to assess item properties, factorial structure, internal consistency, test-retest reliability (patients were asked to retake the scale after 2-6 weeks), and external validity. Concerning the latter, other self-administered scales were employed to assess perceived stress (Perceived Stress Scale), unmet needs (using theNeed Evaluation Questionnaire that describes informative, assistance/care, relational, needs for psycho-emotional support, material needs), and perceived social support (administering the Multidimensional Scale of Perceived Social Support that evaluates perceived support of family, friends, and significant others in the wider social field).

RESULTS

The scales were administered to 243 patients with solid (90%) and hematologic (10%) cancers, mean age 62.6, female 76.5%. Analysis suggested that a single factor better represents the structure of the ESAS scales, their internal consistency and test-retest reliability were good, and evidence of construct and criterion validity were provided. Additionally, incremental validity of the ESAS-TC was proved showing that the added items offer a unique contribution in predicting the patient's stress. Finally, known groups validity was confirmed testing the differences in the ESAS scores due to the Karnofsky Performance Status.

CONCLUSIONS

The current study allowed to complete the validation of the Italian version of the ESAS and to develop a psychometrically sound scale, the ESAS-Total Care, that potentially helps in moving cancer research toward personalized total cancer care.

Effectiveness of a Psychosocial Care Quality Improvement Strategy to Address Quality of Life in Patients With Cancer: The HuCare2 Stepped-Wedge Cluster Randomized Trial

IMPORTANCE

Many patients with cancer who would benefit from psychosocial care do not receive it. Implementation strategies may favor the integration of psychosocial care into practice and improve patient outcomes.

OBJECTIVE

To evaluate the effectiveness of the Humanization in Cancer Care (HuCare) Quality Improvement Strategy vs standard care as improvement of at least 1 of 2 domains (emotional or social function) of patient health-related quality of life at baseline and 3 months. A key secondary aim included investigation of the long-term effect.

DESIGN, SETTING, AND PARTICIPANTS

HuCare2 was a multicenter, incomplete, stepped-wedge cluster randomized clinical trial, conducted from May 30, 2016, to August 28, 2019, in three 5-center clusters of cancer centers representative of hospital size and geographic location in Italy. The study was divided into 5 equally spaced epochs. Implementation sequence was defined by a blinded statistician; the nature of the intervention precluded blinding for clinical staff. Participants included consecutive adult outpatients with newly diagnosed cancer of any type and stage starting medical cancer treatment.

INTERVENTIONS

The HuCare Quality Improvement Strategy comprised (1) clinician communication training, (2) on-site visits for context analysis and problem-solving, and (3) implementation of 6 evidence-based recommendations.

MAIN OUTCOMES AND MEASURES

The primary outcome was the difference between the means of changes of individual scores in emotional or social functions of health-related quality of life detected at baseline and 3-month follow-up (within each group) and during the postintervention epoch compared with control periods (between groups). Long-term effect of the intervention (at 12 months) was assessed as a secondary outcome. Intention-to-treat analysis was used.

RESULTS

A total of 762 patients (475 [62.3%] women) were enrolled (400 HuCare Quality Improvement Strategy and 362 usual care); mean (SD) age was 61.4 (13.1) years. The HuCare Quality Improvement Strategy significantly improved emotional function during treatment (odds ratio [OR], 1.13; 95% CI, 1.04-1.22; P = .008) but not social function (OR, 0.99; 95% CI, 0.89-1.09; P = .80). Effect on emotional function persisted at 12 months (OR, 1.05; 95% CI, 1.00-1.10; P = .04).

CONCLUSIONS AND RELEVANCE

In this trial, the HuCare Quality Improvement Strategy significantly improved the emotional function aspect of health-related quality of life during cancer treatment and at 12 months, indicating a change in clinician behavior and in ward organization. These findings support the need for strategies to introduce psychosocial care; however, more research is needed on factors that may maximize the effects.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03008993.

Psychometric evaluation of patient assessment of chronic illness care among Korean cancer survivors

Background

The Patient Assessment of Chronic Illness Care (PACIC) was developed in the United States to assess the implementation of the Chronic Care Model (CCM)-based intervention from the patient’s perspective. Although the psychometric properties of the PACIC have been reported in other chronically ill patients, it has not been reported in cancer survivors. Our aim was to evaluate the acceptability, validity, and reliability of a Korean version of the PACIC among cancer survivors (K-PACIC-CS).

Methods

Among 204 cancer survivors at a university-based hospital in South Korea, we performed psychometric evaluation of the K-PACIC-CS according to acceptability (descriptive statistics, missing values, and floor and ceiling effects), validity (confirmative factor analysis [CFA] and convergent validity), and reliability (internal consistency, i.e., Cronbach’s alpha).

Results

The item response was high (missing rate = 0.5%). The floor effect was 3.9%– 43.6% and the ceiling effect was 6.9%– 41.2%. The CFA revealed good indices of fit and confirmed the five structures predetermined in the original version of PACIC. The K-PACIC-CS scores had significant positive relationships with cancer survivors’ self-efficacy and health-related quality of life. The total K-PACIC-CS showed excellent internal consistency (Cronbach’s alpha = .94) and those of the subscales were acceptable (Cronbach’s alpha = .76 -.86).

Conclusions

This study suggests that the K-PACIC-CS is a valid and reliable instrument for measuring implementation of CCM-based chronic care from the survivor’s perspective.

Validity and reliability of the Amharic version of supportive care needs survey - short form 34 among cancer patients in Ethiopia

OBJECTIVES

Supportive care needs survey short form has a total of 34 items that have 5 domains that measure the unmet needs of cancer patients. It is important to validate this tool since there are differences in culture, geographic areas, and clinical care service which influence patients' needs. Therefore, this study aimed to assess the construct validity and reliability of the tool.

METHODS

The study was conducted among 170 cancer patients from April 1st to 30th 2019 in Hawassa hospital, South Ethiopia. Confirmatory factor analysis was done using fit indices. Convergent and discriminant validity was evaluated using average variance extracted and maximum shared variance respectively. Known group validity was checked using the Mann-Whitney U test. The reliability of the instrument was examined using Cronbach's alpha.

RESULTS

Domains except for health system and information, and patient care and support maintained convergent and divergent validity. The remaining validity was maintained after removing items that were redundant and double loading. The average variance extracted of domains varied from 0.52-0.81. The Square of correlation between constructs was lower than the average variance extracted for the constructs. The tool had reliability r = 0.932. The root mean square error of approximation was 0.057, comparative fit index 0.954, and the other fit indices were also indicating a good fit. Known groups difference was seen by age and type of treatment taken across the different domains.

CONCLUSION

After the health system and information, and patient care, and support domain validity issues were corrected by removing 8 items, the reduced tool was found to be a valid and reliable tool. The validated tool will be valuable if included in routine cancer care in our clinical settings.

Quality of life and associated factors among adults living with cancer and their family caregivers

This study examined the association of needs, health literacy, and quality of life among adult Nigerians with cancer and family caregivers. A descriptive study was conducted involving 240 adults with cancer and family caregivers attending a tertiary hospital. More than two-thirds of participants reported moderate or high needs. Information (90.8%) and spiritual support (85%) were the domains of highest need among adults with cancer. Family/social support (85%) and spiritual support (81.7%) ranked the highest among family caregivers. A negative correlation was found between needs and quality of life. Stepwise regression analysis showed that needs and literacy explained 36% of the variance in adults with cancer's quality of life and 28% of the variance in family caregivers' quality of life. Spiritual need accounted l for 9.5% and 9.1% of variation for adults with cancer and family caregivers, respectively. Findings suggest that interventions with a focus on social/family and spiritual needs may improve wellbeing of adults with cancer and caregivers in Nigeria. This research are generalizable to other low-income countries where family values and spirituality are often a strong feature of daily life.

The unmet needs of patients with sarcoma

OBJECTIVE

Sarcoma is a rare cancer that imposes a significant burden on the lives of patients. Many survivors have long-term disability as a result of treatment and the disease. Patients often experience functional issues, poorer mental health, reduced quality of life, and interpersonal issues. There is a need to explore the unmet needs of sarcoma patients as it is unclear how these issues are being addressed. The aim of this study was to explore the unmet needs of patients who have been diagnosed with sarcoma.

METHODS

The participants were individuals previously diagnosed with a sarcoma (n = 22). Participants completed a semi-structured interview about their unmet needs relating to sarcoma. The transcripts were analyzed using thematic analysis.

RESULTS

Five overarching themes were identified: daily living, financial needs, lack of information, need for a community, and navigating the healthcare system. Participants reported a range of practical needs, including transport, limited understanding of their treatments, and financial issues. Participants also described a need to connect with people who had gone through similar experiences.

CONCLUSIONS

Sarcoma patients have fundamental needs that affect their capacity to live their life in the best possible way. Health services need to better facilitate sarcoma patients at each stage of their experience by providing individualized referrals, support, and coordination. Support interventions are needed to help patients adjust to sarcoma and to improve their quality of life as an outpatient. Connecting patients with sarcoma support groups may provide them with more relevant and intimate support.

Existence of late-effects instruments for cancer survivors: A systematic review

Introduction

The number of cancer survivors is projected to increase to 22.1 million by 2030. Late effects incorporate the full domains of cancer survivorship (e.g., physiologic, psychosocial, economic). They are numerous, complex, and potentially alter the life trajectories of cancer survivors. Currently, research is missing on the impact of late effects (e.g., cardiomyopathy, fertility, lymphedema, anxiety) on cancer survivors.

Objective

The goal of this study is to present a systematic review of existing instruments for identifying, diagnosing, and managing late effects within cancer survivors.

Methods

Using PRISMA guidelines, a systematic search was conducted using the electronic databases of PubMed and Web of Science to identify relevant papers. Articles considered eligible for this review met the following criteria: 1) written in English, 2) published until September 30, 2019, and 3) containing instruments with questions on late effects. Hypothesis, study design, study sample, questionnaire domains, details of late effects, results, conclusions, and advantages/disadvantages of each article were assessed using a modified version of the NHLBI quality assessment tool.

Results

An exhaustive literature review revealed 576 publications in PubMed, 628 in Web of Science, and 260 from additional sources. After removing duplicates, articles without late-effects questionnaires, and publications using identical questionnaires, 11 studies fulfilled the eligibility criteria. Study quality assessment was measured on a scale of 0–6 (0 = poor quality; 6 = highest quality). Only one study was rated with a score of 5 (Rocque).

Conclusions

Taken in totality, none of the studies adequately addressed the prevalence, etiology, characteristics, management, and prevention of late effects. There is currently no comprehensive questionnaire that captures all of the relevant details of late effects across the cancer survivorship continuum nor that tracks the interrelatedness of multiple late effects. Hence, it is difficult to identify, diagnose, manage, and ultimately prevent late effects.

Prevalence and risk factors associated with the comprehensive needs of cancer patients in China

Background

The incidence and mortality rates of cancer have been increasing in developing countries, particularly in Asia. Therefore to provide optimal comprehensive care to the cancer patients, the care plan must focus on the comprehensive needs of cancer patients. The purpose of this study was to investigate the comprehensive needs of cancer patients, and explore the associated factors.

Methods

In a cross-sectional questionnaire study, a total of 200 cancer patient-caregiver dyads were selected and interviewed in Mainland China by convenient sampling method. Patients’ comprehensive needs were assessed with Comprehensive Needs Assessment Tool in cancer for Patients (CNAT), including seven domains (Information, Psychological Problems, Health Care Staffs, Physical Symptoms, Hospital Facilities and Services, Social/Religious/Spiritual Support and Practical Support). Both cancer patients and caregivers completed the sociodemographic survey. The mean differences in domain scores for different characteristics groups were compared by one-way ANOVA or non-parametric analyses, and influencing factors defined with multivariate regression analysis.

Results

The cancer patients’ need for Health Care Staffs (78.35 ± 13.08) was the highest among the seven domains, followed by the need for Information (71.18 ± 17.39) and the need for Hospital Facilities and Services (52.65 ± 13.35). The lowest score was the need for Physical Symptoms (35.12 ± 16.68). Patients who were female, with low family monthly income, at their own expense, and with highly educated caregivers had higher score of CNAT. Also sociodemographic characteristics were associated with each domain need of cancer patients.

Conclusion

This study shows that cancer patients experience high levels of needs for health-care staff and information, and the different needs are closely related to their sociological characteristics. The provision of health care can be adapted to meet the different needs of cancer patients of different epidemiological characteristics at different times during the course of treatment.

Prevalence and factors associated with unmet needs in post-treatment cancer survivors: A systematic review

Cancer survivors may experience unmet needs beyond the end of their treatment. This paper aimed to explore the prevalence and most frequently found unmet needs and to identify factors associated with higher levels of total unmet needs and with each domain separately. Five databases were searched using the keywords neoplasms, survivors, needs assessment, health services' needs and demands. The results were presented based on the strength of the evidence (strong, moderate and weak association) and the categorisation of the pooled prevalence of at least one unmet need (high, moderate, low). Twenty-six studies were included in the review. A higher prevalence of at least one reported unmet need was observed in survivors with less time since treatment and in women with breast cancer. The most frequently reported unmet needs were fear of cancer recurrence and requesting up to date information. Strong evidence was found for an association between a higher number of unmet needs and younger age, higher anxiety and poorer quality of life. Future studies on unmet needs should report how unmet needs are associated with each domain separately. This might solve the inconclusive evidence found for the stage of the disease at diagnosis and depression.

Sociodemographic, clinical, and psychological characteristics identify groups of Italian cancer patients with high rates of unmet needs

PURPOSE

Although an optimal goal remains the routine assessment of unmet needs of all patients with cancer, particular attention should be paid to those groups of patients with characteristics known to be more frequently associated with unmet needs in general or with specific areas of need. This report aims to describe the sociodemographic, clinical, and psychological characteristics associated with higher unmet needs in Italian cancer patients.

METHODS

A total of 835 cancer patients from different care settings (ward, day hospital, follow-up ambulatory, rehabilitation unit, and palliative care) filled out the Needs Evaluation Questionnaire (NEQ), the Psychological Distress Inventory, and the Sense of Coherence Scale. Association of NEQ scores with the clinical and demographic variables were tested using analysis of variance.

RESULTS

Higher NEQ total score was associated with lower educational level, inpatient care setting, radiotherapy treatment, psychological distress, and lower resilience trait sense of coherence. Different predictors were identified for different areas of unmet needs. Care setting, psychological distress, and resilience trait were the strongest indicators of unmet needs in every area: information/communication, assistance/care, material needs, relational needs, and psychoemotional support.

CONCLUSIONS

Clinicians should consider that inpatients with a high distress and a low resilience trait sense of coherence represent a group of cancer patients to be investigated with particular attention regarding unmet needs.

Unmet needs and quality of life in multiple myeloma patients

This cross-sectional study analysed the contributors and moderators of quality of life. The sample comprised 124 Portuguese multiple myeloma patients assessed on social support, spirituality, unmet needs, psychological morbidity and quality-of-life measures. Results showed that being older and a woman, as well as psychological morbidity and unmet emotional needs were significant predictors of worse quality of life as measured by the QLQ-C30. Unmet financial needs moderated the relationship between psychological morbidity and quality of life. Results emphasize the importance of intervening in patients’ unmet emotional needs and psychological morbidity in order to promote quality of life, in this population.