Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.
Acta Oncol. 2013 Feb;52(2):382-90. doi: 10.3109/0284186X.2012.746468.
Integrated plans will be required to ensure care and rehabilitation for the growing number of cancer survivors. Information is lacking, however, about the extent to which patients' rehabilitation needs are being met, and characteristics of patients who experience unmet needs after their diagnosis and throughout the disease trajectory.
Consecutive women with newly diagnosed breast cancer, undergoing surgery at the Breast Surgery Clinic, Rigshospitalet, Denmark, between 2008 and 2009 (N = 261), completed questionnaires on their unmet needs, anxiety, physical functioning, social support and demographic factors at the time of surgery and four and eight months after diagnosis. Associations between demographic and clinical factors at baseline and unmet needs four and eight months after diagnosis were examined in logistic regression models.
The percentage of women with unmet needs remained stable between four (42%) and eight months (40%). Unmet needs were reported for patient education, counselling and alternative treatment. The factors significantly associated with having unmet needs were younger age (OR 0.92; 95% CI 0.89-0.95), higher education (OR 2.49; 95% CI 1.14-5.44), not having a partner (OR 2.25; 95% CI 1.22-4.17) and anxiety (OR 1.13; 95% CI 1.05-1.20) at four months; and age (OR 0.91; 95% CI 0.87-0.94), not having a partner (OR 2.21; 95% CI 1.10-4.46) and having had one or more unmet needs at four months (OR 6.83, 95% CI 3.55-13.16) at eight months.
A total of 53% of women with breast cancer had unmet needs at some time between diagnosis and the end of primary treatment (eight months after diagnosis). A contextual understanding of unmet needs is necessary for planning cancer rehabilitation, as not only factors such as anxiety, physical functioning and previous unmet needs but also age, education and relationship status are associated with unmet needs.
需要综合计划来确保不断增加的癌症幸存者的护理和康复。然而,缺乏信息表明患者的康复需求在何种程度上得到满足,以及在诊断后和疾病过程中经历未满足需求的患者的特征。
连续 261 名于 2008 年至 2009 年在丹麦里格医院乳腺外科诊所接受手术的新诊断乳腺癌女性在手术时以及诊断后 4 个月和 8 个月时完成了关于其未满足需求、焦虑、身体功能、社会支持和人口统计学因素的问卷。使用逻辑回归模型检查基线时的人口统计学和临床因素与诊断后 4 个月和 8 个月时未满足需求之间的关联。
4 个月(42%)和 8 个月(40%)之间,有未满足需求的女性百分比保持稳定。报告的未满足需求包括患者教育、咨询和替代治疗。与有未满足需求显著相关的因素是年龄较小(OR 0.92;95%CI 0.89-0.95)、较高的教育水平(OR 2.49;95%CI 1.14-5.44)、没有伴侣(OR 2.25;95%CI 1.22-4.17)和焦虑(OR 1.13;95%CI 1.05-1.20)在 4 个月时;年龄(OR 0.91;95%CI 0.87-0.94)、没有伴侣(OR 2.21;95%CI 1.10-4.46)和在 4 个月时有一个或多个未满足需求(OR 6.83,95%CI 3.55-13.16)在 8 个月时。
在诊断和主要治疗结束(诊断后 8 个月)之间的某个时间,总计 53%的乳腺癌女性有未满足的需求。对未满足需求的背景理解对于规划癌症康复是必要的,因为不仅焦虑、身体功能和以前的未满足需求等因素,而且年龄、教育和关系状况也与未满足需求相关。