The evolution of supportive care needs trajectories in women with advanced breast cancer during the 12 months following diagnosis

• Published in: Supportive care in cancer 2014-03, Vol.22 (3), p.635-644
• Main Authors: Lam, Wendy W. T., Tsang, Janice, Yeo, Winnie, Suen, Joyce, Ho, Wing Ming, Yau, Tze Kok, Soong, Inda, Wong, Ka Yan, Kwong, Ava, Suen, Dacita, Sze, Wing Kin, Ng, Alice W. Y., Girgis, Afaf, Fielding, Richard
• Format: Article
• Language: English
• Subjects: Activities of Daily Living - psychology; Adult; Analysis; Asian people; Breast cancer; Breast Neoplasms - psychology; Breast Neoplasms - therapy; Cancer; Chemotherapy; China; Depression, Mental; Emotional disorders; Female; Health Services Needs and Demand; Humans; Logistic Models; Longitudinal Studies; Medicine; Medicine & Public Health; Middle Aged; Needs; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Patient Care Management; Patient satisfaction; Patient Satisfaction - statistics & numerical data; Psychiatric Status Rating Scales; Rehabilitation Medicine; Reproductive Health; Social support; Stress (Psychology); Surveys and Questionnaires; Women
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-013-2018-x

Purpose This longitudinal study examined if the evolution of supportive care needs differed over the first year following the diagnosis of advanced breast cancer and examined factors differentiating these trajectories. Methods Two hundred twenty-eight of 276 Chinese women with advanced breast cancer were assessed while they were awaiting or receiving initial chemotherapy, then again at 6 weeks, 3 months, 6 months, and 12 months post-baseline. Supportive care needs (SCNS-34-Ch), psychological distress (Hospital Anxiety and Depression scale), symptom distress (MSAS-Ch), and patient satisfaction (PSEQ-9) were assessed at baseline; supportive care needs were reassessed at each follow-up assessment. Latent growth mixture modeling explored if trajectories differed within each of four need domains: health system, information, and patient support (HSIPS); psychological; physical daily living (PDL); and sexuality needs. Logistic regression identified factors predicting trajectory patterns. Results Two distinct trajectories were identified for HSIPS and sexuality need domains and three distinct trajectories for psychological and physical daily living need domains. Most women showed stable low levels of HSIPS (78.9 %), psychological (82.4 %), PDL (83.7 %), and sexuality (97.4 %) supportive care needs. One in five and one in eight women showed high initial supportive care needs in HSIPS and psychological and PDL domains, respectively. With the exception of sexuality needs, trajectory patterns were predicted by physical symptom distress. Women in the high-decline group reported greater physical symptom distress. Conclusions Most Chinese women with advanced breast cancer showed low stable supportive care needs. Physical symptom distress predicted high supportive care needs. Interventions should focus on optimizing symptom assessment and management.