scholarly journals Dynamics of unmet need for social care in England

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 809-809
Author(s):  
Athina Vlachantoni ◽  
Maria Evandrou ◽  
Jane Falkingham ◽  
Min Qin
Keyword(s):  
Unmet Needs ◽  
Social Care ◽  
Significant Proportion ◽  
Unmet Need ◽  
Safety Net ◽  
Care Needs ◽  
Temporal Dimension ◽  
Core Element ◽  
Using Data ◽  
Over Time

Abstract Meeting individuals’ social care needs is a core element of UK social policy. However, the conceptualisation and operationalisation of ‘unmet need’ remain a challenge. This paper advances our understanding by incorporating a temporal dimension in the conceptual framework on unmet need to investigate the dynamics of met and unmet need for social care over time. Using data from Waves 6,7 and 8 of the English Longitudinal Study of Ageing, this paper examines five possible trajectories among individuals with a social care need at baseline: 1) no longer having such a need; 2) having continued needs met; 3) delayed needs met; 4) newly arisen unmet needs; and 5) persistent unmet needs. The results indicate that amongst those with need at baseline unmet need has decreased over time, indicating that some needs may be fulfilled with a delay. However, a significant proportion of older people experienced persistent unmet needs, particularly those who were younger, living alone, with educational qualifications, and with fewer difficulties with Activities of Daily Living at baseline. Understanding the dynamics of unmet need can support policymakers in ensuring that those facing an elevated risk of persistent unmet need over time do not fall through the social care safety net.

scholarly journals Supportive care needs of patients following treatment for colorectal cancer: risk factors for unmet needs and the association between unmet needs and health-related quality of life—results from the ColoREctal Wellbeing (CREW) study

2019 ◽  
Vol 13 (6) ◽  
pp. 899-909 ◽  
Author(s):  
S. C. Sodergren ◽  
◽  
S. J. Wheelwright ◽  
N. V. Permyakova ◽  
M. Patel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Unmet Needs ◽  
Unmet Need ◽  
Health Related Quality ◽  
Care Needs ◽  
End Of Treatment ◽  
Related Quality ◽  
Health Related ◽  
Over Time

Abstract Purpose To investigate unmet needs of patients with colorectal cancer (CRC) at the end of treatment and whether unmet needs improve over time. Identify predictors of need following treatment and whether unmet need is associated with worse health-related quality of life (HRQoL). Methods As part of the UK ColoREctal Wellbeing (CREW) cohort study, patients treated for CRC completed the Supportive Care Needs Survey Short Form-34 (SCNS SF-34) 15 and 24 months following surgery, along with questionnaires measuring HRQoL, wellbeing, life events, social support, and confidence to manage their cancer before surgery, 3, 9, 15, and 24 months post-surgery. Results The SCNS SF-34 was completed by 526 patients at 15 months and 510 patients at 24 months. About one-quarter of patients had at least one moderate or severe unmet need at both time points. Psychological and physical unmet needs were the most common and did not improve over time. Over 60% of patients who reported 5 or more moderate or severe unmet needs at 15 months experienced the same level of unmet need at 24 months. HRQoL at the beginning of treatment predicted unmet needs at the end of treatment. Unmet needs, specifically physical, psychological, and health system and information needs, were associated with poorer health and HRQoL at the end of treatment. Conclusions Unmet needs persist over time and are associated with HRQoL. Evaluation of HRQoL at the start of treatment would help inform the identification of vulnerable patients. Assessment and care planning in response to unmet needs should be integrated into person-centred care. Implications for Cancer Survivors Early identification of CRC patients at risk of unmet needs will help infrom personalised survivorship care plans. The implementation of personalised and tailored services are likely to confer HRQoL gains.

Patients' Supportive Care Needs Beyond the End of Cancer Treatment: A Prospective, Longitudinal Survey

2009 ◽  
Vol 27 (36) ◽  
pp. 6172-6179 ◽  
Author(s):  
Jo Armes ◽  
Maggie Crowe ◽  
Lynne Colbourne ◽  
Helen Morgan ◽  
Trevor Murrells ◽  
...  
Keyword(s):  
Negative Affect ◽  
Supportive Care ◽  
Unmet Needs ◽  
Unmet Need ◽  
Hormone Treatment ◽  
Longitudinal Survey ◽  
Supportive Care Needs ◽  
Fear Of Recurrence ◽  
Care Needs ◽  
Prospective Longitudinal

Purpose To estimate prevalence and severity of patients' self-perceived supportive care needs in the immediate post-treatment phase and identify predictors of unmet need. Patients and Methods A multicenter, prospective, longitudinal survey was conducted. Sixty-six centers recruited patients for 12 weeks. Patients receiving treatment for the following cancers were recruited: breast, prostate, colorectal, and gynecologic cancer and non-Hodgkin's lymphoma. Measures of supportive care needs, anxiety and depression, fear of recurrence, and positive and negative affect were completed at the end of treatment (T0) and 6 months later (T1). Results Of 1,850 patients given questionnaire packs, 1,425 (79%) returned questionnaires at T0, and 1,152 (62%) returned questionnaires at T1. Mean age was 61 years; and most respondents were female (69%) and had breast cancer (57%). Most patients had no or few moderate or severe unmet supportive care needs. However, 30% reported more than five unmet needs at baseline, and for 60% of these patients, the situation did not improve. At both assessments, the most frequently endorsed unmet needs were psychological needs and fear of recurrence. Logistic regression revealed several statistically significant predictors of unmet need, including receipt of hormone treatment, negative affect, and experiencing an unrelated significant event between assessments. Conclusion Most patients do not express unmet needs for supportive care after treatment. Thirty percent reported more than five moderate or severe unmet needs at both assessments. Unmet needs were predicted by hormone treatment, negative mood, and experiencing a significant event. Our results suggest that there is a proportion of survivors with unmet needs who might benefit from the targeted application of psychosocial resources.

scholarly journals Needs of patients with dementia and their caregivers in primary care: lessons learned from the Alzheimer plan of Quebec

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vladimir Khanassov ◽  
Laura Rojas-Rozo ◽  
Rosa Sourial ◽  
Xin Qiang Yang ◽  
Isabelle Vedel
Keyword(s):  
Primary Care ◽  
Unmet Needs ◽  
Social Care ◽  
Phase 1 ◽  
Lessons Learned ◽  
Community Dwelling ◽  
Care Plan ◽  
Phase 2 ◽  
Care Needs ◽  
Health And Social Care

Abstract Background Persons living with dementia have various health and social care needs and expectations, some which are not fully met by health providers, including primary care clinicians. The Quebec Alzheimer plan, implemented in 2014, aimed to cover these needs, but there is no research on the effect this plan had on the needs and expectations of persons living with dementia. The objective of this study is to identify persons living with dementia and caregivers’ met and unmet needs and to describe their experience. Methods This is a sequential mixed methods explanatory design: Phase 1: cross-sectional study to describe the met and unmet health and social care needs of community-dwelling persons living with dementia using Camberwell Assessment of Need of the Elderly and Carers’ Assessment for Dementia tools. Phase 2: qualitative descriptive study to explore and understand the experiences of persons living with dementia and caregivers with the use of social and healthcare services, using semi-structured interviews. Data from phase 1 was analyzed with descriptive statistics, and from phase 2, with inductive thematic analysis. Results from phases 1 and 2 were compared, contrasted and interpreted together. Results The mean total number of needs reported by the patients was 5.03 (4.48 and 0.55 met and unmet needs, respectively). Caregivers had 0.52 met needs (3.16 unmet needs). The main needs for both were memory, physical health, eyesight/hearing/communication, medication, looking after home, money/budgeting. Three categories were mentioned by the participants: Persons living with dementia and caregiver’s attitude towards memory decline, their perception of community health services and of the family medicine practice. Conclusions Our study confirms the findings of other studies on the most common unmet needs of the patients and caregivers that are met partially or not at all. In addition, the participants were satisfied with access to care, and medical services in primary practices, being confident in their family. Our results indicate persons living with dementia and their caregivers need a contact person, a clear explanation of their dementia diagnosis, a care plan, written information on available services, and support for the caregivers.

Colorectal cancer survivors’ quality of life: a qualitative study of unmet need

2020 ◽  
pp. bmjspcare-2020-002190
Author(s):  
Amanda Drury ◽  
Sheila Payne ◽  
Anne-Marie Brady
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Unmet Needs ◽  
Unmet Need ◽  
Safety Net ◽  
The Impact

ObjectiveCancer survivors’ perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors’ perceptions of how cancer-related healthcare affects their QoL.MethodsSemistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically.ResultsFive themes described the impact of healthcare experiences on CRC survivors’ QoL. While cancer survivors spoke positively of their relationships with healthcare professionals, many experienced a range of unmet information and supportive care needs. Participants described a range of positive and negative experiences, as power dynamics and navigation of healthcare systems had implications for their QoL. Where negative healthcare events aligned, survivors’ autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed a safety net(work) of supports to bridge the gap of unmet needs in healthcare with varying outcomes.ConclusionsCancer survivors’ experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors’ knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor’s unmet needs.

Supportive care needs among Mexican young women with breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21552-e21552
Author(s):  
C. Lizette Galvez ◽  
Cynthia Villarreal-Garza ◽  
Alejandro Mohar
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
Health Systems ◽  
Young Women ◽  
Active Treatment ◽  
Unmet Needs ◽  
Short Form ◽  
Unmet Need ◽  
Supportive Care Needs ◽  
Care Needs

e21552 Background: Despite high rates of breast cancer (BC) in young Mexican women, information about their particular needs and concerns is largely unknown. Understanding the patients individual needs in a population with unique socio-cultural features is essential to guide supportive care and improve their quality of life. We aim to describe the unmet needs of Mexican young women with breast cancer (YWBC). Methods: A cross-sectional study including women with stage I-III BC aged 40 years or younger at diagnosis was conducted at the National Cancer Institute in Mexico City. YWBC were invited to complete the Supportive Care Needs Survey, Short Form-34 (SCNS-SF34), a comprehensive tool that measures the perceived unmet needs of cancer patients. The survey was previously adapted and validated in our population for its use. Results: 81 consecutive patients with median age at diagnosis of 35.09 (SD 3.9) years were included. 45.7% were married and 29.2% completed secondary school. 92.6% had stage II-III BC. 70.4% were undergoing active treatment and 29.6% were either on hormonal therapy or surveillance. From a total standardized score of 100, the health systems and information domain had the highest mean score (39.3), followed by the psychological domain (36.3). The sexuality domain had the lowest mean score (27). The highest ranked items of unmet needs (by mean crude score) were: to be informed about cancer is under control or diminishing (2.9), to be informed about things you can do to help yourself get well (2.8), lack of energy and fatigue (2.7), and fear about the cancer spreading (2.7). Perceived needs among patients undergoing active treatment were greater compared to those in follow-up (z = -2.390 p = 0.017), predominantly in the sexuality domain (z = -2.084 p = 0.037). Conclusions: Mexican YWBC have specific needs that are currently not systematically addressed. The predominant unmet need regarding health systems and information should be a priority. Further research to understand the needs and concerns of this unique and understudied patient population will aid tailor clinical interventions and supportive care.

Age, Health, and Education Determine Supportive Care Needs of Men Younger Than 70 Years With Prostate Cancer

2007 ◽  
Vol 25 (18) ◽  
pp. 2560-2566 ◽  
Author(s):  
David P. Smith ◽  
Rajah Supramaniam ◽  
Madeleine T. King ◽  
Jeanette Ward ◽  
Martin Berry ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Supportive Care ◽  
Unmet Needs ◽  
Specific Antigen ◽  
Unmet Need ◽  
Psychological Needs ◽  
Supportive Care Needs ◽  
Newly Diagnosed ◽  
Treatment Needs ◽  
Care Needs

Purpose It is important to meet the supportive care needs of cancer patients to ensure their satisfaction with their care. A population-wide sample of men younger than 70 years and newly diagnosed with prostate cancer was surveyed to determine their unmet needs in five domains and the factors predicting them. Patients and Methods Eligible men were younger than 70 years and residents in New South Wales, Australia, with newly diagnosed histopathologically confirmed prostate cancer. Sixty-seven percent of eligible men diagnosed between October 2000 and October 2001 participated. Demographic, treatment, and self-reported health data were collected. Information on cancer stage, grade, and prostate-specific antigen was obtained from medical records. Logistic regression analyses determined patient and treatment variables that predicted higher unmet needs. Results More than half (54%) of men with prostate cancer expressed some level of unmet psychological need, and 47% expressed unmet sexuality needs. Nearly one fourth expressed a moderate or high level of unmet need with respect to changes in sexuality. Sexuality needs were independently predicted by being younger, having had a secondary school education only, having had surgery, and being married, living as married, or divorced. Uncertainty about the future was also an important area of unmet need. Conclusion Attention should be given to sexual and psychological needs in the early months after diagnosis or treatment of prostate cancer, particularly in younger men, those with less education, and those having surgery. Research into better ways of meeting these needs will enable us to meet them with as much rigor as we meet clinical treatment needs.

scholarly journals Unmet Supportive Care Needs of Survival Patients with Nasopharyngeal Carcinoma

2020 ◽  
Vol 17 (10) ◽  
pp. 3519
Author(s):  
Ya-Ling Lin ◽  
Chun-Yi Chuang ◽  
Vivian Chia-Rong Hsieh ◽  
Ming-Shou Tsai ◽  
Yen-Fang Liu ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Supportive Care ◽  
Patient Care ◽  
Unmet Needs ◽  
Unmet Need ◽  
Treatment Phase ◽  
Supportive Care Needs ◽  
Cancer Stage ◽  
Care Needs ◽  
Old Patients

This study examined unmet supportive care needs for nasopharyngeal carcinoma (NPC) patients by cancer stage and treatment phase, as well as the factors associated with these unmet needs. At a cancer center in central Taiwan, information on consultations and services patients received at the resource center was described in the service chart. We extracted data available for NPC patients to evaluate their unmet supportive care needs (health information, patient care, treatment, nutritional, psychosocial, and economic) and their association with sex, age, cancer stage, and treatment phase. The 145 NPC patients were 68.3% male, 60.0% less than 50 years old, and 83.5% diagnosed at stages III and IV. The most prevalent unmet need was nutritional (40.7%), followed by psychosocial and patient care, with economic unmet needs the least (4.8%). Women were more likely than men to have patient care unmet needs (32.6% vs. 15.2%). Nutritional unmet need was higher in older patients than in younger ones (83.3% vs. 35.6%), with an adjusted odds ratio (aOR) of 9.39 (95% confidence interval (CI) = 2.17–40.70). Psychosocial unmet needs were higher in younger patients than old patients (34.5% vs. 0%) and in patients interviewed during follow-up period than those at newly diagnosed (55.2% vs. 23.1%). In conclusion, the most commonly reported concern was nutritional unmet needs for NPC patients. Their unmet needs may vary by demographic and disease factors, including patient sex and age, cancer stage, and treatment phase.

scholarly journals Income-related inequalities in unmet dental care needs in Spain: traces left by the Great Recession

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Rosa M. Urbanos-Garrido
Keyword(s):  
Low Income ◽  
Dental Care ◽  
Great Recession ◽  
Unmet Need ◽  
Vulnerable Groups ◽  
Care Needs ◽  
Decomposition Approach ◽  
The Great Recession ◽  
Dental Care Needs ◽  
Over Time

Abstract Background Dental health is an important component of general health. Socioeconomic inequalities in unmet dental care needs have been identified in the literature, but some knowledge gaps persist. This paper tries to identify the determinants of income-related inequality in unmet need for dental care and the reasons for its recent evolution in Spain, and it inquires about the traces left by the Great Recession. Methods Data from the EU-SILC forming a decade (2007–2017) were used. Income-related inequalities for three years were measured by calculating corrected concentration indices (CCI), which were further decomposed in order to compute the contribution of different factors to inequality. An Oaxaca-type decomposition approach was also used to analyze the origin of changes over time. Men and women were analyzed separately. Results Pro-rich inequality in unmet dental care needs significantly increased over time (CCI 2007: − 0.0272 and − 0.0334 for males and females, respectively; CCI 2017: − 0.0704 and − 0.0776; p < 0.001). Inequality showed a clear “pro-cycle” pattern, growing during the Great Recession and starting to decrease just after the economic recovery began. Gender differences only were significant for 2009 (p = 0.004) and 2014 (p = 0.063). Income was the main determinant of inequality and of its variation along time -particularly for women-, followed by far by unemployment –particularly for men-; the contributions of both were mainly due to changes in elasticites. Conclusions The Great Recession left its trace in form of a higher inequality in the access to dental care. Also, unmet need for dental care, as well as its inequality, became more sensitive to the ability to pay and to unemployment along recent years. To broaden public coverage of dental care for vulnerable groups, such as low-income/unemployed people with high oral health needs, would help to prevent further growth of inequality.

Social determinants of sleep disturbance in safety-net primary care: unmet needs, classist discrimination, and anxiety

2019 ◽  
Vol 37 (2) ◽  
pp. 263-268
Author(s):  
Joseph S Tan ◽  
Annahir N Cariello ◽  
Mickeal Pugh ◽  
Richard S Henry ◽  
Paul B Perrin ◽  
...  
Keyword(s):  
Primary Care ◽  
Sleep Disturbance ◽  
Social Determinants ◽  
Unmet Needs ◽  
Unmet Need ◽  
Safety Net ◽  
Precipitating Factors ◽  
Convenience Sample ◽  
3P Model

Abstract Background The 3P model proposes that predisposing, precipitating, and perpetuating factors all play a role in sleep disturbance. Objective The purpose of the current study is to investigate social determinants of sleep disturbance by applying the 3P model to a safety-net primary care setting, specifically by evaluating the role of classism and unmet needs as precipitating factors for sleep disturbance, and anxiety as a perpetuating factor for sleep disturbance. Methods Participants (N = 210) were a convenience sample of racially/ethnically diverse adults over the age of 18 (age M = 44.7 years) recruited from a safety-net primary care clinic in an urban area. The study employed a cross-sectional design. Participants completed a survey assessing sleep disturbances, anxiety, unmet needs, classism, social support, and a researcher-generated demographic form. Results and Conclusions The unmet need for affordable long-term housing and greater experiences of classism were associated with more sleep disturbance, suggesting that both acted as precipitating factors. In a structural equation model with adequate fit indices, anxiety mediated the relationships with sleep disturbance for both the unmet need for affordable long-term housing and classism, suggesting that it serves as a perpetuating factor. Medical providers are recommended to explore these potential needs in safety-net primary care when patients present with sleep disturbance or anxiety. Assisting with connections to long-term housing and helping patients counteract and cope with classist discrimination may be effective in improving sleep in safety-net primary care.

Unmet supportive care needs and determinants among cancer patients treated at University of Gondar Specialized Hospital, Northwest Ethiopia: A prospective cross-sectional study

2020 ◽  
pp. 107815522097103
Author(s):  
Begashaw Melaku Gebresillassie ◽  
Asnakew Achaw Ayele ◽  
Tadesse Melaku Abegaz
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Unmet Needs ◽  
Unmet Need ◽  
Cross Sectional Study ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Cross Sectional ◽  
Predicting Factors ◽  
Specialized Hospital

Background Assessment of supportive care needs is an important requirement to plan supportive care intervention. This study aimed to assess the unmet supportive care needs of cancer patients treated at the University of Gondar Specialized Hospital, Ethiopia. Methods A prospective cross-sectional study was conducted from January 1, 2017 to August 30, 2017. Adult (18 years and greater) cancer patients and those who were receiving therapy were included. The 34-Item short-form Supportive Care Needs Survey(SCNS-SF34) tool was used to assess unmet needs. The data collected were analyzed using SPSS version-21. Results A total of 150 interview guides were included in the analysis (97.4% of response rate). In the majority of 65(43.3%) the participants, the disease was metastasized even though they have undergone surgery 78 (52%). The overall mean score level of unmet need for cancer care was 3.49. The highest unmet need mean score was reported from the health system and information need domain. A significant unmet need difference concerning different need domain was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors for unmet supportive care needs. Conclusion The overall level of unmet need was high. A significant unmet need difference was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors. Hence, professionals working in the oncology unit should be aware of unmet needs and expect changes over time. Certain programs and services to address the identified unmet needs should be urgently provided.

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