Supportive care needs in Hong Kong Chinese women confronting advanced breast cancer.
BACKGROUND
Women with advanced breast cancer (ABC) are living longer, so understanding their needs becomes important. This cross-sectional study investigated the type and extent of unmet supportive care needs in Hong Kong Chinese women with advanced breast cancer.


METHODS
Face-to-face interviews were conducted among women with stage III or stage IV disease mostly awaiting chemotherapy (76%) to identify unmet needs using the Supportive Care Needs Survey Short Form, psychological morbidity using the Hospital Anxiety and Depression Scale, symptom distress using the Memorial Symptom Assessment Scale, and satisfaction with care using the Patient satisfaction questionnaire (PSQ-9).


RESULTS
About 27-72% of 198/220 (90%) women (mean age = 53.4 ± 9.74 (standard deviation) years) identified needs from the health system, information, and patient support (HSIPS) domain as the top 15 most prevalent unmet needs. 'having one member of hospital staff with whom you can talk to about all aspect of your condition, treatment, and follow-up' was most cited by 72% of the patients, with remaining unmet needs addressing mostly desire for information. Unmet need strength did not differ between women with stage III and stage IV disease, whereas women with first time diagnosis reported greater health system and information unmet needs compared with women with recurrent disease. Stepwise multiple regression analyses revealed that symptom distress was consistently positively associated with all but sexuality need domains, whereas low satisfaction with care was associated with HSIPS (β = 3.270, p < 0.001) and physical and daily living (β = 2.810, p < 0.01) domains.


CONCLUSIONS
Chinese women with ABC expressed need for continuity of care and improved information provision. High symptom distress was associated with lower levels of satisfaction with care. These unmet needs appear to reflect current care services shortcomings.
Centre for Psycho-Oncology Research & Training, Department of Community Medicine & Unit for Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong.
Angel
A
Au
Wendy
W
Lam
Janice
J
Tsang
Tsz-kok
TK
Yau
Inda
I
Soong
Winnie
W
Yeo
Joyce
J
Suen
Wing M
WM
Ho
Ka-yan
KY
Wong
Ava
A
Kwong
Dacita
D
Suen
Wing-Kin
WK
Sze
Alice
A
Ng
Afaf
A
Girgis
Richard
R
Fielding
D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D001943:Breast Neoplasms / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006301:Health Services Needs and Demand; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D020380:Needs Assessment; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires