Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Locked Bag 2000 Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
Support Care Cancer. 2018 Mar;26(3):701-710. doi: 10.1007/s00520-017-3971-6. Epub 2017 Dec 4.
This review aimed to determine the prevalence of met and unmet needs, and the risk factors for unmet needs among people affected by gynaecological cancer.
The review was undertaken using the PRISMA guidelines. Eligible studies were identified though a range of electronic databases in October and November 2016. Study quality was independently appraised by two people.
Thirty-seven studies were included (1 review, 24 quantitative and 12 qualitative). The evidence was of mixed quality. The total burden of needs affecting women with gynaecological cancer and also their caregivers predominately related to comprehensive care and psychological concerns. The major moderate-to-high-level unmet needs of women with gynaecological cancer were for help explicitly with fear of recurrence, worries of caregivers and fatigue, and for women who developed lymphoedema were with pain and associated costs. Qualitative studies identified disease-specific needs related to sexuality issues (including fertility, sexual functioning, relationship concerns, managing vaginal changes, pregnancy care, premature menopause), genetic testing and disease-specific peer support. Women at risk of having unmet needs include those who are younger, with advanced disease, with lymphoedema or a high symptom burden, are unable to work, have mental health issues, have poor social support or live in rural or remote locations.
Understanding the needs of women with gynaecological cancer and their caregivers is essential to improving care and outcomes. Current data are limited thus there is a need for qualitative studies of patient-caregiver dyad and vulnerable subgroups and well-designed quantitative studies of women with each type of gynaecological and their caregivers.
本综述旨在确定妇科癌症患者的需求满足和未满足情况的发生率，以及未满足需求的危险因素。
本综述按照 PRISMA 指南进行。通过 2016 年 10 月和 11 月对多种电子数据库的检索，确定了符合条件的研究。由两人独立评估研究质量。
共纳入 37 项研究（1 项综述、24 项定量研究和 12 项定性研究）。证据质量参差不齐。影响妇科癌症患者及其护理人员的需求负担主要与综合护理和心理问题有关。妇科癌症患者的主要中高度未满足需求是明确帮助其应对复发恐惧、护理人员担忧和疲劳，以及对出现淋巴水肿的患者减轻疼痛和相关费用的需求。定性研究确定了与性行为问题（包括生育、性功能、关系问题、阴道变化管理、妊娠护理、早绝经）、基因检测和疾病特异性同伴支持相关的特定疾病需求。有未满足需求风险的妇女包括年龄较小、疾病晚期、患有淋巴水肿或症状负担较高、无法工作、有心理健康问题、社会支持较差或居住在农村或偏远地区的妇女。
了解妇科癌症患者及其护理人员的需求对于改善护理和结局至关重要。目前的数据有限，因此需要对患者-护理人员二人组和弱势群体进行定性研究，并对每一种妇科癌症患者及其护理人员进行精心设计的定量研究。
