title: The problems experienced by patients with cancer and their needs for palliative care.
abstract: OBJECTIVE
  To investigate the problems that patients experience and their met- and unmet needs for professional help. This information is necessary to tailor palliative care to patient needs.
  
  
  METHODS
  Patients (n=94) with disseminated cancer completed a validated checklist with 90 potential problems and needs for palliative care (PNPC questionnaire).
  
  
  RESULTS
  On average, patients experienced 37 problems (range 0-68) and required more professional attention for eight problems (range 0-71). The five most prevalent problems were: fatigue, heavy housework, coping with the unpredictability of the future, fear of metastases, and frustrations because I can do less than before. The five issues most in need of extra attention were: informational needs, coping with the unpredictability of the future, fear of metastases, fear of physical suffering, and difficulties remembering what was told (during consultations). Younger patients experienced more social, psychological, and financial problems. Some 10% of patients expressed a multitude of problems and needs.
  
  
  CONCLUSIONS
  While patients with metastasized cancer experienced a wide variety of problems, they asked for more support for only a few specific problems. Evidently, "problems" are not synonymous with unmet needs. Therefore, not only problems but also needs for care should be assessed. A structural need for support to cope with fears of suffering and loss of autonomy was found. Ten percent of patients expressed a multitude of problems and needs and might benefit either from psychological counseling or better palliative care.
authors.affiliation: Center of Quality of Care Research (WOK), Radboud University, Nijmegen, The Netherlands. B.Osse@WOK.umcn.nl
authors.forename: Bart H P
authors.initials: BH
authors.lastname: Osse
authors.forename: Myrra J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
authors.forename: Egbert
authors.initials: E
authors.lastname: Schadé
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care; D017060:Patient Satisfaction; D026684:Personal Autonomy; D018794:Problem-Based Learning; D012944:Social Support; D013223:Statistics as Topic; D011795:Surveys and Questionnaires