Fiszer Chavie, Dolbeault Sylvie, Sultan Serge, Brédart Anne
Laboratoire de Psychopathologie et Processus de Santé (LPPS EA 4057), IUPDP, Université Paris Descartes, Boulogne-Billancourt, France; Psycho-Oncology Unit/Supportive Care Department, Curie Institute, Paris, France.
Psychooncology. 2014 Apr;23(4):361-74. doi: 10.1002/pon.3432. Epub 2013 Oct 28.
The assessment of supportive care needs is a crucial step in the development of appropriate interventions that may improve the quality of life of cancer patients. This review describes and analyzes the prevalence and predictors of the unmet supportive care needs of breast cancer (BC) patients and survivors and suggests paths for further research.
Multiple databases were searched, considering only quantitative studies using validated needs assessment instruments and focusing uniquely on women diagnosed with BC.
Out of 761 hits, 23 studies answered to all eligibility criteria. Nineteen were cross-sectional, and the remaining four were longitudinal. Most included patients at different moments along the BC trajectory, from diagnosis to decades into survivorship, with the major proportion of patients under treatment. Only five concentrated on the posttreatment phase into extended survivorship. The concerns of women diagnosed with BC clustered around psychological and information needs, with the top concern being 'fear of the cancer returning'. Predictors of higher levels of needs included advanced disease stage, greater symptom burden, shorter time since diagnosis, higher levels of distress, and younger age. Prevalence differed between cultures with Asian women reporting greater information needs and lower psychological needs compared with Western women.
Revealing which needs BC patients consider most urgent and the factors related to greater needs will permit the development of improved and targeted supportive care. Future research should comprise longitudinal designs concentrating on women at specific moments along the BC trajectory for a dynamic understanding of these needs.
评估支持性护理需求是制定可能改善癌症患者生活质量的适当干预措施的关键步骤。本综述描述并分析了乳腺癌（BC）患者及幸存者未满足的支持性护理需求的患病率及预测因素，并提出了进一步研究的方向。
检索了多个数据库，仅纳入使用经过验证的需求评估工具的定量研究，且仅关注被诊断为BC的女性。
在761条检索结果中，23项研究符合所有纳入标准。其中19项为横断面研究，其余4项为纵向研究。大多数研究纳入了BC病程不同阶段的患者，从诊断到存活数十年，其中大部分患者正在接受治疗。只有5项研究关注延长生存期的治疗后阶段。被诊断为BC的女性的担忧集中在心理和信息需求方面，最主要的担忧是“害怕癌症复发”。需求水平较高的预测因素包括疾病晚期、症状负担较重、诊断后时间较短、痛苦程度较高以及年龄较小。不同文化之间患病率存在差异，与西方女性相比，亚洲女性报告的信息需求更大，心理需求更低。
揭示BC患者认为最迫切的需求以及与更高需求相关的因素，将有助于开发改进的、有针对性的支持性护理。未来的研究应采用纵向设计，关注BC病程特定阶段的女性，以便动态了解这些需求。
