Barg Frances K, Cronholm Peter F, Straton Joseph B, Keddem Shimrit, Knott Kathryn, Grater Joyce, Houts Peter, Palmer Steven C
Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Cancer. 2007 Aug 1;110(3):631-9. doi: 10.1002/cncr.22820.
The purpose of the current study was to identify unmet psychosocial needs of cancer survivors, understand the distribution of needs across subgroups, and compare unmet needs in 2005 with those identified by Houts et al. in 1986.
Using a sequential mixed methods design, qualitative interviews were conducted with 32 cancer survivors or family members to identify the psychosocial needs of people from the time of cancer diagnosis through survivorship. These data were used to modify a needs assessment that was mailed to a stratified random sample of survivors obtained from the Pennsylvania Cancer Registry.
A total of 614 survivors returned usable questionnaires. Nearly two-thirds of respondents reported experiencing at least 1 unmet psychosocial need, particularly emotional, physical, and treatment-related needs. It is likely that unmet needs in insurance, employment, information, and home care increased during the 20-year interval between surveys. Demographics associated with increased unmet need included later stage of disease at the time of diagnosis, younger age, more comorbidities, and lower income.
Unmet psychosocial need remains high despite 20 years of effort to address psychosocial issues. This may be due to a mismatch between needs and services. Unmet need may be related to access issues, a lack of awareness of resources, "new" needs that have arisen in a changing healthcare climate, and patient preferences for types of service. Cancer treatment staff should be especially alert for psychosocial problems in younger individuals with an additional illness burden.
本研究的目的是确定癌症幸存者未满足的心理社会需求，了解各亚组需求的分布情况，并将2005年未满足的需求与霍茨等人1986年确定的需求进行比较。
采用序贯混合方法设计，对32名癌症幸存者或其家庭成员进行了定性访谈，以确定从癌症诊断到康复阶段人们的心理社会需求。这些数据被用于修改一份需求评估问卷，该问卷被邮寄给从宾夕法尼亚癌症登记处获得的分层随机抽样的幸存者。
共有614名幸存者返回了可用问卷。近三分之二的受访者表示至少有一项心理社会需求未得到满足，尤其是情感、身体和与治疗相关的需求。在两次调查的20年间隔期间，保险、就业、信息和家庭护理方面未满足的需求可能有所增加。与未满足需求增加相关的人口统计学特征包括诊断时疾病处于晚期、年龄较小、合并症较多以及收入较低。
尽管在解决心理社会问题方面付出了20年的努力，但未满足的心理社会需求仍然很高。这可能是由于需求与服务之间不匹配。未满足的需求可能与获取问题、对资源缺乏认识、不断变化的医疗环境中出现的“新”需求以及患者对服务类型的偏好有关。癌症治疗人员应特别警惕有额外疾病负担的年轻个体的心理社会问题。
