title: The relationship between unmet needs and distress amongst young people with cancer.
abstract: OBJECTIVE
  Most psychosocial research in cancer has been restricted to paediatric or older adult populations. This study aimed to explore psychological distress and unmet needs in adolescents and young adults (AYA) with cancer and identify predictors of distress among demographic and illness characteristics and supportive care needs.
  
  
  METHODS
  Fifty-three patients between 16 and 30 years completed a cross-sectional survey, administered shortly after presentation to an AYA oncology service and within 4 months of diagnosis. Measures included the Beck Depression Inventory-Fast Screen (BDI-FS), State-Trait Anxiety Inventory-State Form (STAI-S) and the Supportive Care Needs Survey. Level of distress-related sypmtomatology in this population was based on previous work, whereby a cut-off score of 4 or greater was used for the BDI-FS, and one standard deviation above the sample population mean was used for the STAI-S.
  
  
  RESULTS
  Prevalence of distress (25%) was lower than that found previously in AYA with cancer. Physical and daily living needs were the most frequently unmet needs overall, followed by psychological needs, health system and information needs and care and support needs. Lastly, being pre-treatment predicted increased depression and state anxiety, while having treatment post-surgery predicted reduced state anxiety. After controlling for treatment status, however, the main predictors of depression and state anxiety were physical and daily living needs and health system and information needs, respectively.
  
  
  CONCLUSIONS
  Lower levels of distress and unmet psychological needs were related to the few participants (17%) in this study who were pre-treatment, when distress was most likely. However, physical needs and information needs, which are almost inevitable throughout treatment and beyond, were more important predictors of distress. Further exploration must consider the psychosocial difficulties underlying this association and the needs of AYA at transitions between critical periods in their cancer journey (i.e., upon diagnosis, during treatment, etc.).
authors.affiliation: Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, 12 St. Andrews Place, East Melbourne, VIC 3002, Australia. gdyson@gra.net.au
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Dyson
authors.forename: Kate
authors.initials: K
authors.lastname: Thompson
authors.forename: Susan
authors.initials: S
authors.lastname: Palmer
authors.forename: David M
authors.initials: DM
authors.lastname: Thomas
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult