Prioritizing care for women with breast cancer based on survival stage: A study examining the association between physical symptoms, psychological distress and unmet needs

Eur J Oncol Nurs. 2020 Oct:48:101816. doi: 10.1016/j.ejon.2020.101816. Epub 2020 Jul 25.

Abstract

Purpose: 1) To examine the differences in physical symptoms, psychological distress and unmet needs between short-term (2-5 years) and long-term (>5 years) breast cancer survivors (BCSs). 2) To explore how physical symptoms and psychological distress impact unmet needs among women in different survival stages.

Method: Three hundred forty-nine people with breast cancer completed questionnaires. Short-term (2-5 years) and long-term (>5 years) survival stages were examined. Physical symptoms (number of physical symptoms); psychological distress, including fear of recurrence (FOR) (FOR visual analogue scale (VAS)) and depressive symptoms (Center for Epidemiological Studies-Depression Scale); and unmet needs (Chinese Cancer Survivors' Unmet Needs scale) were measured. Structural equation modelling with multi-group analysis was used to assess differences between short- and long-term survivors in the magnitude of paths.

Results: In total, 157 women who had survived <5 years and 192 women who had survived >5 years were recruited. The path coefficients from physical and depressive symptoms to unmet needs were similar between short-term BCSs and long-term BCSs (p > .05). However, the path coefficient from FOR to unmet needs among women who had survived for >5 years was significantly greater than that among those who had survived <5 years (p < .001).

Conclusion: Based on these results, health care professionals should be aware of the FOR that women experience even 5 years after their initial diagnosis. Providing survivorship care plans with comprehensive side effect-related information soon after treatment is recommended.

Keywords: Breast cancer; Fear of recurrence; Survival stage; Survivor; Unmet needs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People / psychology*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / psychology*
  • Cancer Survivors / psychology*
  • Female
  • Health Services Needs and Demand
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / psychology*
  • Neoplasm Staging / psychology*
  • Psychological Distress*
  • Surveys and Questionnaires
  • Symptom Assessment / psychology*
  • Taiwan / epidemiology