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Interpreting differences in patterns of supportive care needs between patients with breast cancer and patients with colorectal cancer

Wylie W Y Li, Wendy W T Lam, Angel H Y Au, Michelle Ye, Wai Lun Law, Jensen Poon, Ava Kwong, Dacita Suen, Janice Tsang, Afaf Girgis, Richard Fielding
Psycho-oncology 2013, 22 (4): 792-8
22419560

BACKGROUND: Understanding cancer patients' supportive care needs can help optimize health-care systems and inform services development. We therefore examined the prevalence of supportive care needs in Chinese breast (BC) and colorectal cancer (CRC) patients to identify prevalence and correlates of unmet needs.

METHODS: We assessed supportive care needs (Supportive Care Needs Survey-Short Form), psychological distress (the Hospital Anxiety and Depression Scale), symptom distress (The Memorial Symptom Assessment Scale-Short Form), and satisfaction with care (Patient Satisfaction Questionnaire) among 210 Chinese BC (97) or CRC (104) outpatient clinic attendees.

RESULTS: Breast cancer patients (89.7%) reported more unmet needs (χ(2)  = 4.409, p = 0.027), but both CRC and BC samples ranked unmet needs prevalence similarly, with health system and information needs reported as the most common. Younger patients reported higher health system and information and sexuality needs. After multivariate adjustment, the strength of unmet needs did not differ by cancer type. Unmet psychological, physical and daily living, and sexuality needs were positively associated with greater symptom distress. Greater health system information needs were associated with high global distress and low depression scores, whereas greater psychological needs were associated with higher anxiety scores.

CONCLUSIONS: Hong Kong Chinese BC and CRC patients strongly prioritized needs related to health systems and information provision. Symptoms and psychological distress were associated with unmet needs, reflecting a service shortfall in symptom management. Improving care provision by optimizing communication and clinic organization can better prepare cancer patients for their rehabilitation and improve symptom control.

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