Determining the Unmet Needs Among Breast Cancer Survivors: An Exploratory Sequential Mixed Methods Study
Determining the Unmet Needs Among Breast Cancer Survivors: An Exploratory Sequential Mixed Methods Study
This study was conducted to characterize the unmet supportive care and factors contributing to theneeds among breast cancer survivors in Kuching, Sarawak.METHODSIt was an exploratory sequential mixed methods study.RESULTSIn the qualitative exploration phase, nine respondents comprising survivors, healthcare providers, andinformal caregivers were interviewed. The need for an additional category of “practical, social, and spiritual support,” was indicated in the interviews, which was incorporated into the Short Form 34-itemSupportive Care Needs Survey (SCNS-SF34). In the quantitative phase, a total of 259 survivors participated. Regression analysis revealed that shorter duration of survival and younger age were significantfactors contributing to greater overall unmet needs. Other significant contributing factors were latestage (Stages III and IV) cancer, undergoing active treatment, being employed, Malays and Sarawakindigenous groups, high education level, and age at diagnosis of
___
- 1. Vachon ML. The meaning of illness to a long-term
survivor. Semin Oncol Nurs 2001;17(4):279–83.
- 2. Andrykowski MA, Lykins E, Floyd A. Psychological health in cancer survivors. Semin Oncol Nurs
2008;24(3):193-201.
- 3. Hewitt M, Greenfield S, Stovall E. From Cancer Patient
to Cancer Survivor: Lost in Transition. 1st ed. Washington D.C.: The National Academies Press; 2006.
- 4. Bonevski B, Sanson-Fisher R, Girgis A, Burton L,
Cook P, Boyes A. Evaluation of an instrument to assess
the needs of patients with cancer. Supportive Care Review Group. Cancer 2000;88(1):217-25.
- 5. Burg MA, Adorno G, Lopez ED, Loerzel V, Stein K,
Wallace C, Sharma DK. Current unmet needs of cancer survivors: analysis of open-ended responses to the
American Cancer Society Study of Cancer Survivors
II. Cancer 2015; 121(4): 623-30.
- 6. Adler NE, Page A, Institute of Medicine (U.S.). Committee on Psychosocial Services to Cancer Patients/
Families in a Community Setting. In: Cancer care for
the whole patient: meeting psychosocial health needs.
Washington DC: National Academies Press; 2008.
- 7. Fong EJ, Cheah WL. Unmet Supportive Care Needs
among Breast Cancer Survivors of Community-Based
Support Group in Kuching, Sarawak. Int J Breast
Cancer 2016;7297813.
- 8. Yip CH, Taib NA, Mohamed I. Epidemiology of
breast cancer in Malaysia. Asian Pac J Cancer Prev
2006;7(3):369-74.
- 9. Campbell JB. Breast cancer-race, ethnicity, and survival: a literature review. Breast Cancer Res Treat
2002;74(2):187-92
- 10. Huang R, Huang Y, Tao P, Li H, Wang Q, Li H, Li JY.
Evaluation of the quality of life in patients with breast
cancer at different TNM stages after standardized
treatment. [Article in Chinese]. Zhonghua Zhong Liu
Za Zhi 2013;35(1):71-7.
- 11.Ooi CH, Mastulu W. Epidemiology of Cancer in
Sarawak 2001-2005. Kuching: Sarawak Health Department; 2009.
- 12.Fitch MI. Supportive care framework. [Article in
English, French]. Can Oncol Nurs J 2008;18(1):6-24.
- 13.Daniel WW. Biostatistics: a foundation for analysis in
the health sciences. Hoboken, NJ: John Wiley & Sons;
2005.
- 14.Tejeda S, Darnell JS, Cho YI, Stolley MR, Markossian
TW, Calhoun EA. Patient barriers to follow-up care for
breast and cervical cancer abnormalities. J Womens
Health (Larchmt) 2013;22(6):507-17.
- 15.Peters K, Cotton A. Barriers to breast cancer screening
in Australia: experiences of women with physical disabilities. J Clin Nurs. 2015;24(3-4):563-72.
- 16. Freitas AG, Weller M. Patient delays and system delays in breast cancer treatment in developed and developing countries. Cien Saude Colet
2015;20(10):3177-89.
- 17.Boyes A, Girgis A, Lecathelinais C. Brief assessment
of adult cancer patients’ perceived needs: development
and validation of the 34-item Supportive Care Needs
Survey (SCNS-SF34). J Eval Clin Pract 2009;15(4):602-
6.
- 18.Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2):77-
101.
- 19.Pathy NB, Yip CH, Taib NA, Hartman M, Saxena N,
Iau P, et al; Singapore-Malaysia Breast Cancer Working
Group. Breast cancer in a multi-ethnic Asian setting:
results from the Singapore-Malaysia hospital-based
breast cancer registry. Breast 2011;20 Suppl 2:S75-80.
- 20.Edib Z, Kumarasamy V, Binti Abdullah N, Rizal AM,
Al-Dubai SA. Most prevalent unmet supportive care
needs and quality of life of breast cancer patients in
a tertiary hospital in Malaysia. Health Qual Life Outcomes 2016;14:26.
- 21.Ibrahim NI, Dahlui M, Aina EN, Al-Sadat N. Who are
the breast cancer survivors in Malaysia?Asian Pac J
Cancer Prev 2012;13(5):2213-8.
- 22.Al-Naggar RA, Isa ZM, Shah SA, Nor MI, Chen R,
Ismail F,et al. Eight year survival among breast cancer Malaysian women from University Kebangsaan
Malaysia Medical Centre. Asian Pac J Cancer Prev
2009;10(6):1075-8.
- 23.Fiszer C, Dolbeault S, Sultan S, Brédart A. Prevalence,
intensity, and predictors of the supportive care needs
of women diagnosed with breast cancer: a systematic
review. Psychooncology 2014;23(4):361-74
- 24.Mullan F. Seasons of survival: reflections of a physician
with cancer. N Engl J Med 1985;313(4):270-3.
- 25.Whelan TJ, Mohide EA, Willan AR, Arnold A, Tew
M, Sellick S, et al. The supportive care needs of newly
diagnosed cancer patients attending a regional cancer
center. Cancer 1997;80(8):1518-24.
- 26.Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P. The unmet supportive care needs of
patients with cancer. Supportive Care Review Group.
Cancer 2000;88(1):226-37.
- 27.Liao MN, Chen SC, Chen SC, Lin YC, Hsu YH, Hung
HC, Wang CH, Chen MF, Jane SW. Changes and predictors of unmet supportive care needs in Taiwanese
women with newly diagnosed breast cancer. Oncol
Nurs Forum 2012;39(5):E380-9.
- 28.Park JH, Chun M, Jung YS, Jung YM. Changes of Supportive Care Needs and Quality of Life in Patients with
Breast Cancer. Asian Oncol Nurs 2016;16(4): 217-25.
- 29.Ganz PA, Yip CH, Gralow JR, Distelhorst SR, Albain
KS, Andersen BL, et al. Supportive care after curative
treatment for breast cancer (survivorship care): resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus
statement. Breast 2013;22(5):606-15.
- 30. von Heymann-Horan AB, Dalton SO, Dziekanska A,
Christensen J, Andersen I, Mertz BG, et al. Unmet
needs of women with breast cancer during and after
primary treatment: a prospective study in Denmark.
Acta Oncol 2013;52(2):382-90.
- 31.Burman B, Margolin G. Analysis of the association
between marital relationships and health problems: an
interactional perspective. Psychol Bull 1992;112(1):39-
63.
- 32.Gourash N. Help-seeking: a review of the literature.
Am J Community Psychol 1978;6(5):413-23.
- 33.Harrison JD, Young JM, Price MA, Butow PN, Solomon
MJ. What are the unmet supportive care needs of people with cancer? A systematic review. 2009;17(8):1117-
28.
- 34.Akechi T, Okuyama T, Endo C, Sagawa R, Uchida M,
Nakaguchi T,et al. Patient’s perceived need and psychological distress and/or quality of life in ambulatory breast cancer patients in Japan. Psychooncology
2011;20(5):497-505.
- 35.Wei D, Liu XY, Chen YY, Zhou X, Hu HP. Effectiveness of Physical, Psychological, Social, and Spiritual
Intervention in Breast Cancer Survivors: An Integrative Review. Asia Pac J Oncol Nurs 2016;3(3):226-
32.
- 36.Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of
life, mood, symptoms of stress and levels of cortisol,
dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 2004;29(4):448-74.
- 37.Hwang SY, Park BW. The perceived care needs of breast
cancer patients in Korea. Yonsei Med J. 2006;47(4):524-
33.
- 38.Lam WW, Au AH, Wong JH, Lehmann C, Koch U,
Fielding R, et al. Unmet supportive care needs: a crosscultural comparison between Hong Kong Chinese and
German Caucasian women with breast cancer. Breast
Cancer Res Treat 2011;130(2):531-41
- 39.McLaughlin LA, Braun KL. Asian and Pacific Islander
cultural values: considerations for health care decision
making. Health Soc Work 1998;23(2):116-26.
- 40.Huang K. Chinese Americans. In: Mokuau N, editor.
Handbook of social services for Asians and Pacific Islanders. Westport CT: Greenwood Press; 1991. p. 79-
96.
- 41.Parsa P, Kandiah M, Abdul Rahman H, Zulkefli NM.
Barriers for breast cancer screening among Asian
women: a mini literature review. Asian Pac J Cancer
Prev 2006;7(4):509-14.