title: Concerns across the survivorship trajectory: results from a survey of cancer survivors.
abstract: OBJECTIVE
  To evaluate the most prevalent physical, social, emotional, and spiritual concerns of cancer survivors.
  
  
  METHODS
  Descriptive, cross-sectional study.
  
  
  METHODS
  A matrix (multisite) cancer center in three urban centers in the United States.
  
  
  METHODS
  337 cancer survivors representing nine diagnostic groups in a broad spectrum of time since diagnosis.
  
  
  METHODS
  Participants completed a survey designed to evaluate the self-reported concerns of cancer survivors. Demographic information and questions using Likert scales were used to measure concerns and quality of life. Descriptive statistics and regression analyses were used to evaluate data.
  
  
  METHODS
  Cancer diagnosis; time since diagnosis; and physical, social, emotional, and spiritual concerns.
  
  
  RESULTS
  Overall, quality of life was reported as a mean of 8.44 on a scale of 0-10. The top five concerns identified were fear of recurrence, fatigue, living with uncertainty, managing stress, and sleep disturbance. Prevalence and severity of concerns differed by cancer diagnosis and time since diagnosis. Patients reporting extreme concerns related to fatigue were associated with lower quality-of-life scores.
  
  
  CONCLUSIONS
  The research indicated that fatigue and fear of recurrence are lasting concerns across the survivorship trajectory and that age, cancer diagnosis, and time since diagnosis will have an effect on the survivor's experience.
  
  
  CONCLUSIONS
  Nurses should take a proactive role in assessing the physical, social, emotional, and spiritual needs of all cancer survivors, regardless of cancer type and time since diagnosis. Future research and support programs for cancer survivors should focus on the major concerns of fatigue and fear of recurrence.
  
  
  CONCLUSIONS
  The results of this research confirmed the importance of designing programs to support cancer survivors in an integrative manner from initial diagnosis into the period of long-term survivorship. Specific attention should be placed on the concerns related to fear of recurrence, fatigue, financial burden, and the long-term effects of cancer treatment.
authors.affiliation: Mayo Clinic College of Medicine, Rochester, MN, USA. ness.sheryl@mayo.edu
authors.forename: Sheryl
authors.initials: S
authors.lastname: Ness
authors.forename: Janine
authors.initials: J
authors.lastname: Kokal
authors.forename: Kelliann
authors.initials: K
authors.lastname: Fee-Schroeder
authors.forename: Paul
authors.initials: P
authors.lastname: Novotny
authors.forename: Daniel
authors.initials: D
authors.lastname: Satele
authors.forename: Debra
authors.initials: D
authors.lastname: Barton
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000451:nursing* / Q000523:psychology*; D009859:Oncology Nursing; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012919:Social Behavior; D029181:Spirituality; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology