College of Medicine and Yonsei Cancer Center, Yonsei University, Seoul, South Korea.
College of Medicine, Chungnam National University, Daejeon, South Korea.
Support Care Cancer. 2020 Mar;28(3):1419-1431. doi: 10.1007/s00520-019-04954-3. Epub 2019 Jul 2.
Gastric cancer patients are expected to have considerable supportive care needs; however, few studies have been conducted. This study aimed to understand the unmet needs of gastric cancer patients at different phases of the cancer journey, identify factors contributing to their unmet needs and quality of life (QOL) and explore the relationships among unmet needs, symptom experience, anxiety, depression, and QOL.
A correlational study was conducted using data from 223 gastric cancer patients. The instruments include the SCNS-SF 34, HADS, MDASI, and EORTC QLQ-C 30 (Korean version). Descriptive statistics, t test/ANOVA, Pearson's correlation, multiple regression, and path analyses were used to analyze the data.
Unmet needs in the health system and information domain were the highest. The phase of the cancer journey had a significant association only with physical and daily living unmet needs (p = 0.027). Physical and daily living unmet needs, symptom severity, symptom interference, and depression demonstrated direct effects on QOL. The physical and daily living unmet needs mediated the association between symptom experience (symptom severity and interference with daily living caused by symptoms) and QOL. The overall paths explained 51.6% of the variance in the QOL of gastric cancer patients (p < 0.001).
The health system and information unmet needs of gastric cancer patients should be fulfilled by reinforcing the continuity of care, professional counseling, and self-care education. Unmet needs in the physical and daily living domain have to be appraised to facilitate improved symptom management to minimize the negative influence on QOL. Factors contributing to the unmet needs and QOL of gastric cancer patients need to be reflected in supportive care planning.
胃癌患者预计有相当多的支持性护理需求,但相关研究较少。本研究旨在了解胃癌患者在癌症病程不同阶段的未满足需求,确定导致其未满足需求和生活质量(QOL)的因素,并探讨未满足需求、症状体验、焦虑、抑郁和 QOL 之间的关系。
使用来自 223 名胃癌患者的数据进行相关性研究。采用的工具包括 SCNS-SF 34、HADS、MDASI 和 EORTC QLQ-C 30(韩语版)。采用描述性统计、t 检验/方差分析、皮尔逊相关、多元回归和路径分析来分析数据。
健康系统和信息领域的未满足需求最高。癌症病程阶段仅与身体和日常生活未满足需求显著相关(p=0.027)。身体和日常生活未满足需求、症状严重程度、症状干扰和抑郁对 QOL 有直接影响。身体和日常生活未满足需求中介了症状体验(症状严重程度和症状对日常生活的干扰)与 QOL 之间的关系。总路径解释了胃癌患者 QOL 的 51.6%的变异(p<0.001)。
应通过加强连续性护理、专业咨询和自我护理教育来满足胃癌患者在健康系统和信息方面的未满足需求。必须评估身体和日常生活领域的未满足需求,以促进改善症状管理,最大限度地减少对 QOL 的负面影响。应在支持性护理计划中反映导致胃癌患者未满足需求和 QOL 的因素。