Unmet supportive care needs of older adults with advanced cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10040-10040 ◽  
Author(s):  
Brandon Temel ◽  
Margaret Ruddy ◽  
Emily Olson ◽  
Samantha M.C. Moran ◽  
Charn-Xin Fuh ◽  
...  
Keyword(s):  
Older Adults ◽  
Linear Regression ◽  
Supportive Care ◽  
Advanced Cancer ◽  
Psychological Symptom ◽  
Symptom Burden ◽  
Physical Symptoms ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Gi Cancer

10040 Background: Cancer disproportionately affects older adults, yet research defining the supportive care needs of these patients is lacking. We sought to examine associations between geriatric impairments, quality of life (QOL), and physical and psychological symptom burden in older adults with newly diagnosed incurable gastrointestinal (GI) cancer. Methods: We prospectively enrolled patients age ≥70 within 8 weeks of diagnosis of incurable GI cancer at Massachusetts General Hospital from 10/2015-11/2016. We used surveys to assess geriatric impairments (Vulnerable Elders Survey-13 [range 0-10, scores ≥3 identify patients with impairments), QOL (EORTC QLQ-C30 [range 0-100, higher scores indicate better QOL]), physical symptoms (Edmonton Symptom Assessment System [range 0-10, higher scores indicate greater symptom burden]) and psychological symptoms (Geriatric Depression Scale, [range 0-15, higher scores indicate greater depression symptoms]). We used descriptive statistics to determine differences in patient characteristics by the presence or absence of geriatric impairments. We used linear regression adjusted for age, employment, cancer type, and comorbidity to examine associations between geriatric impairments, QOL, and physical and psychological symptom burden. Results: We enrolled 50 of 58 (86%) patients approached (mean age = 78.7; 52% with pancreatic cancer). Nearly half (46%) screened positive for geriatric impairments; these patients were older (81.7 vs 76.1, p < .01) and had more comorbid conditions (2.4 vs 1.2, p = .01). On linear regression, patients with geriatric impairments reported worse QOL across all domains (General QOL: B = -28.3, p < .01; Physical: B = -36.8, p < .01; Role: B = -36.8, p < .01; Emotional: B = -30.1, p < .01; Cognitive: B = -17.8, p = .03; Social: B = -39.7, p < .01), higher depression scores (B = 5.1, p < .01) and worse fatigue (B = 4.6, p < .01), drowsiness (B = 4.0, p < .01), appetite (B = 3.8, p < .01), and pain (B = 2.7, p = .02). Conclusions: Older adults with advanced cancer experience considerable unmet supportive care needs, particularly those with geriatric impairments. Future research is needed to assess older patients for geriatric impairments and address their unique palliative and supportive care needs.

scholarly journals Assessment of Needs of Hospitalized Cancer Patients with Advanced Cancer

2016 ◽  
Vol 9 (6) ◽  
pp. 184
Author(s):  
Theocharis I. Konstantinidis ◽  
George Samonis ◽  
Pavlos Sarafis ◽  
Anastas Philalithis
Keyword(s):  
Supportive Care ◽  
Psychometric Properties ◽  
Advanced Cancer ◽  
Unmet Needs ◽  
Supportive Care Needs ◽  
University Hospital ◽  
Validity And Reliability ◽  
Treatment Needs ◽  
Care Needs ◽  
Optimal Care

BACKGROUND: Needs assessment of patients with advanced cancer (ACPs) is essential for optimal care. This study evaluated the psychometric properties of the Needs Evaluation Questionnaire (NEQ) and assessed the supportive care needs of hospitalized ACPs with solid tumors.METHODS: The validated Greek version of the NEQ along with demographic and clinical data of 95 consecutive breast, colon and lung ACPs hospitalized in the University Hospital of Heraklion, Crete, Greece, were used to assess their supportive care needs. The NEQ score was subsequently rescaled to 0-100.RESULTS: NEQ displayed adequate psychometric properties in validity and reliability tests. The average number of needs reported was 8.4(4.1). Female and younger patients reported a higher score of unmet needs than their male (40.3 versus 30.0, p=0.005) and elder (40.1 versus 29.2, p=0.001) counterparts. Patients reported higher needs in receiving information about their future (73.7%), treatments (56.8%), examinations (51.6%) and for the need "to speak with people who had the same experience" (53.7%). In contrast, lower scores were observed in the assistance and treatments needs regarding intimacy (11.6%), "better attention from nurses" (15.8%), "more help with eating, dressing, and going to the bathroom" (18.9%). Lung ACPs reported more assistance and treatment needs than colon and breast ACPs (p<0.05).CONCLUSIONS: ACPs reported many unmet needs, mainly informational, that were related to gender, age, and type of cancer. NEQ is a useful tool in everyday clinical practice for obtaining information for supportive care needs. Health care personnel has to address these needs for implementing effective patient-centered care.

Patient-reported symptom burden and supportive care needs at cancer diagnosis: a retrospective cohort study

2020 ◽  
Vol 28 (12) ◽  
pp. 5889-5899 ◽  
Author(s):  
Colleen A. Cuthbert ◽  
Devon J. Boyne ◽  
Xu Yuan ◽  
Brenda R. Hemmelgarn ◽  
Winson Y. Cheung
Keyword(s):  
Cohort Study ◽  
Supportive Care ◽  
Cancer Diagnosis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Symptom Burden ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Patient Reported

Disparities in supportive care needs among minority and non-minority patients with advanced lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21690-e21690
Author(s):  
Danielle Seiden ◽  
Jose Morillo ◽  
Juan P. Wisnivesky ◽  
Cardinale B. Smith
Keyword(s):  
Lung Cancer ◽  
Supportive Care ◽  
Performance Status ◽  
Ethnic Disparities ◽  
Physical Symptoms ◽  
Social Needs ◽  
Supportive Care Needs ◽  
Advanced Lung Cancer ◽  
Care Needs ◽  
Medical Communication

e21690 Background: Significant racial and ethnic disparities exist in lung cancer care. Thus, minorities are diagnosed with late stage cancer and have inferior outcomes likely leading to increased suffering. Little is known, however, about disparities in supportive care needs among patients with advanced lung cancer. Methods: We performed a prospective cohort study of patients newly diagnosed with advanced lung cancer (stage III and IV). At baseline (within 3 months of diagnosis), patients completed a validated survey assessing needs among seven domains: medical communication and information, psychological and emotional support, daily living, financial concerns, physical symptoms, spiritual needs, and social needs. Univariate and multivariate regression analyses compared differences in supportive care needs among minority (Black and Hispanic) and non-minority patients with advanced lung cancer. Results: We have enrolled 95/160 patients (60%). To date, baseline surveys have been completed on 55 patients. Of those, 37 (67%) are minorities and 18 (33%) non-minorities. Minorities were less likely to be married (p = 0.01), had a lower annual income (p < 0.001), lower education attainment (p = .02) and more likely to have Medicaid (p < 0.001). There were no differences in gender (p = 0.35) or performance status (p = 0.13). Overall, 39% of minorities report having higher supportive care needs across all domains compared with 25% of non-minorities (p < 0.001). Similarly, minorities reported having significantly higher needs among each domain except medical communication and information (p = 0.06). Multivariate analysis, controlling for patient characteristics, found minorities had increased odds of overall supportive care needs (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 1.03-1.16). Conclusions: Minority patients with advanced lung cancer are more likely to have increased supportive care needs than non-minority patients. Ensuring minority patients have adequate supportive care evaluation and treatment is necessary to mitigating health disparities among patients with lung cancer. Future studies will be performed to evaluate how these needs change throughout the trajectory of lung cancer.

scholarly journals Perawatan Suportif Pada Penyintas Kanker Ginekologi: A Literature Review

2020 ◽  
Vol 11 (4) ◽  
pp. 338
Author(s):  
Meyke Rosdiana ◽  
Yati Afiyanti
Keyword(s):  
Literature Review ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Gynecological Cancer ◽  
Gynecologic Cancer ◽  
Physical Symptoms ◽  
Supportive Care Needs ◽  
Care Providers ◽  
Care Needs ◽  
Gynecological Cancer Survivors

Supportive care for gynecologic cancer survivors is part of the treatment process and affects their quality of life, so this literature review is intended to improve supportive care for gynecological cancer survivors. The database were used CINAHL Plus and Scopus in the last 10 years. 8 articles found which related to supportive care in five domain, specifically are psychological, system and health information, physical and daily activities, patient care and support, and sexuality. The result of the review indicated that the highest supportive care needs for gynecological cancer survivors were in the physical domain, such as complaints reduction of physical symptoms and psychological domains like fears of cancer recurrence. Based on the case, it will be important for health care providers to improve services in gynecology in terms of meeting the supportive care needs that affected their life. Keywords: supportive care; gynecologic cancer survivors ABSTRAK Perawatan suportif pada penyintas kanker ginekologi merupakan bagian dari proses perawatan dan memengaruhi kualitas hidup mereka, sehingga literature review ini bertujuan untuk mengidentifikasi perawatan suportif pada penyintas kanker ginekologi. Pencarian database yang digunakan yaitu CINAHL Plus dan Scopus pada 10 tahun terakhir. Sebanyak 8 artikel berkaitan dengan perawatan suportif pada lima domain yaitu psikologis, sistem dan informasi kesehatan, fisik dan aktivitas sehari-hari, perawatan dan dukungan pasien dan seksualitas. Hasil review menunjukkan bahwa kentuhan perawatan suportif tertinggi pada penyintas kanker ginekologi yaitu pada domain fisik seperti pengurangan keluhan gejala fisik dan domain psikologis seperti kekhawatiran kambuhnya kanker. Berdasarkan hal tersebut menjadi penting bagi tenaga kesehatan penyedia layanan kesehatan untuk meningkatkan pelayanan pada penyintas kanker ginekologi dalam hal pemenuhan kebutuhan perawatan suportif secara komprehensif yang akan memengaruhi kualitas hidup mereka. Kata kunci: perawatan suportif; penyintas kanker ginekologi

Differences among Asian/Asian American, and Caucasian breast and gynecologic cancer patient-reported survivorship needs, symptoms, and illness mindsets (N=220).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11620-11620
Author(s):  
Lidia Schapira ◽  
Elisa Hofmeister ◽  
Allison W. Kurian ◽  
Sean Zion ◽  
Hanyang Shen ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Asian American ◽  
Physical Symptoms ◽  
Supportive Care Needs ◽  
Depression Symptoms ◽  
Care Needs ◽  
Gynecologic Cancers ◽  
Patient Reported ◽  
Caucasian Patients

11620 Background: Cancer experiences are mediated by host and disease factors and affected by social and cultural determinants of health. We sought to characterize perceived supportive care needs and domains of psychosocial functioning among a diverse group of women attending routine appointments for treatment or follow-up of breast and gynecologic cancers. Methods: From July 2018 until January 2019, all patients seen at the Stanford Women’s Cancers Program (serving women treated for breast and gynecologic cancers) were approached to participate. 220 cancer patients (78% breast and 22% gynecologic), mean age 54 (SD = 12) completed an online survey on their supportive care needs assessment (The Short-form Supportive Care Needs Survey Questionnaire) which contains physical, social, information, sexual and psychological scales, anxiety and depression (Patient Health Questionnaire-4) and mindsets about illness and the body mindset (Brief Illness Mindset Inventory). Only 14% of patients refused to take part in the survey. Results: T-test showed that Asian/Asian-American cancer patients (n = 57, 26%) reported fewer needs related to coping with physical symptoms, side effects of treatment and performing usual tasks and activities compared to Caucasian patients (n = 137, 62%), p = .038. Moreover, Asian/Asian-American cancer patients reported fewer depression symptoms (p = .049). Chi-square analyses showed that Asian/Asian-American patients reported less use of psychotherapy over their lifetimes (24.6% vs. 54.0%, p < .001), but significantly higher utilization of Chinese Medicine for cancer symptom management (24.6% vs. 5.8%; p < . 001) compared to the Caucasian patients. T-tests showed that Asian/Asian American patients reported significantly greater agreement with the mindsets that ‘cancer is a catastrophe’ (p = .006) and that their ‘body is an adversary’ (p = .047). Conclusions: In this population of breast and gynecologic patients and survivors we found differences in cancer mindsets, coping and use of mental health and complementary therapies between Asian and Asian-American and Caucasian women. Further analysis to understand the cultural differences are ongoing.

Distress and Supportive Care Needs of Ethnically Diverse Older Adults With Advanced or Recurrent Cancer

2018 ◽  
Vol 45 (4) ◽  
pp. 496-507 ◽  
Author(s):  
Hilda Haynes-Lewis ◽  
Margaret Clayton ◽  
Shankar Viswanathan ◽  
Alyson Moadel-Robblee ◽  
Lauren Clark ◽  
...  
Keyword(s):  
Older Adults ◽  
Supportive Care ◽  
Ethnically Diverse ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Recurrent Cancer

Cancer Survivorship

2019 ◽  
pp. 530-538
Author(s):  
Anne Reb ◽  
Denice Economou
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Advanced Cancer ◽  
Cancer Survivorship ◽  
Symptom Management ◽  
Symptom Burden ◽  
Physical Symptoms ◽  
Fear Of Recurrence ◽  
Care Approach

Cancer survivors are living longer as a result of treatment advances, and, for those with advanced cancer, there is more uncertainty regarding prognosis and future needs. Survivors will need support to manage long-term side effects including physical and emotional concerns such as fear of recurrence and uncertainty. The palliative care approach to cancer survivors includes assessment of physical, psychological, social, family, and spiritual concerns. Psychosocial, emotional, and spiritual concerns may contribute to physical symptoms, a fact that supports the importance of a holistic and comprehensive approach to symptom management. Referrals to palliative or supportive care should be based on patient and caregiver needs rather than on prognosis. Survivors with advanced cancer or high symptom burden should be referred to interdisciplinary palliative care teams. Survivors in transition from active treatment and those in remission may benefit from early referrals to rehabilitation services to help improve function and manage common symptoms. A comprehensive geriatric assessment can help to identify health concerns and the need for supportive care interventions. This chapter will discuss considerations for incorporating palliative care during the cancer survivorship trajectory; common symptoms and assessment strategies; communication challenges; and a brief overview of nonpharmacologic approaches to symptom management.

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