title: Unmet psychosocial needs of Pennsylvanians with cancer: 1986-2005.
abstract: BACKGROUND
  The purpose of the current study was to identify unmet psychosocial needs of cancer survivors, understand the distribution of needs across subgroups, and compare unmet needs in 2005 with those identified by Houts et al. in 1986.
  
  
  METHODS
  Using a sequential mixed methods design, qualitative interviews were conducted with 32 cancer survivors or family members to identify the psychosocial needs of people from the time of cancer diagnosis through survivorship. These data were used to modify a needs assessment that was mailed to a stratified random sample of survivors obtained from the Pennsylvania Cancer Registry.
  
  
  RESULTS
  A total of 614 survivors returned usable questionnaires. Nearly two-thirds of respondents reported experiencing at least 1 unmet psychosocial need, particularly emotional, physical, and treatment-related needs. It is likely that unmet needs in insurance, employment, information, and home care increased during the 20-year interval between surveys. Demographics associated with increased unmet need included later stage of disease at the time of diagnosis, younger age, more comorbidities, and lower income.
  
  
  CONCLUSIONS
  Unmet psychosocial need remains high despite 20 years of effort to address psychosocial issues. This may be due to a mismatch between needs and services. Unmet need may be related to access issues, a lack of awareness of resources, "new" needs that have arisen in a changing healthcare climate, and patient preferences for types of service. Cancer treatment staff should be especially alert for psychosocial problems in younger individuals with an additional illness burden.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA. bargf@uphs.upenn.edu
authors.forename: Frances K
authors.initials: FK
authors.lastname: Barg
authors.forename: Peter F
authors.initials: PF
authors.lastname: Cronholm
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Straton
authors.forename: Shimrit
authors.initials: S
authors.lastname: Keddem
authors.forename: Kathryn
authors.initials: K
authors.lastname: Knott
authors.forename: Joyce
authors.initials: J
authors.lastname: Grater
authors.forename: Peter
authors.initials: P
authors.lastname: Houts
authors.forename: Steven C
authors.initials: SC
authors.lastname: Palmer
mesh_terms: D000328:Adult; D005260:Female; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data* / Q000600:supply & distribution; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D010414:Pennsylvania / Q000453:epidemiology; D012944:Social Support; D017741:Survivors