title: Unmet needs in cancer rehabilitation during the early cancer trajectory--a nationwide patient survey.
abstract: BACKGROUND
  A cancer diagnosis may lead to psychosocial problems and physical symptoms that can be relieved during rehabilitation. The aim of this study was to analyse patient-perceived unmet needs of rehabilitation close to time of diagnosis, i.e. frequencies of unmet needs and the association with sociodemographic characteristics, cancer type and treatment.
  
  
  METHODS
  All adult residents of Denmark diagnosed with cancer for the first time from 1 May to 31 August 2010 were mailed a patient questionnaire two to five months following diagnosis. The study population was identified by use of national administrative registers. Data on rehabilitation, family situation, education, and cancer treatment were obtained from the questionnaire, while sex, birth year and cancer type were obtained from the Danish National Patient Registry. The association between each type of unmet needs and the variables sex, age, cancer diagnosis, treatment, education, cohabitation status, and children (living at home and away from home) was analysed using multiple logistic regression.
  
  
  RESULTS
  Among the 4346 participants (64.7%) unmet needs were reported with regard to talking to patients in the same situation (24.1%), counselling with a psychologist (21.4%), physical rehabilitation (18.8%), practical help (17.3%), and counselling related to work or education (14.8%). Differences were observed with regard to type of unmet needs, sociodemographic and clinical characteristics, but generally, young age, male sex, low educational level and living alone increased the adjusted odds ratios of unmet needs. Breast cancer and to some extent melanoma cancer decreased the odds.
  
  
  CONCLUSIONS
  Unmet needs of rehabilitation are frequent during the early cancer trajectory and sociodemographic and clinical inequalities exist. The results support guideline recommendations of integration of cancer rehabilitation from the beginning of the cancer trajectory. Early interventions tailored to men, patients with low educational level, living alone, or treated with chemotherapy may help counterbalancing social and clinical inequalities in the long run.
authors: National Research Center for Cancer Rehabilitation, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Astrid Gisèle
authors: AG
authors: Veloso
authors: Cecilie
authors: C
authors: Sperling
authors: Lise Vilstrup
authors: LV
authors: Holm
authors: Anne
authors: A
authors: Nicolaisen
authors: Nina
authors: N
authors: Rottmann
authors: Susanne
authors: S
authors: Thayssen
authors: René Depont
authors: RD
authors: Christensen
authors: Janne
authors: J
authors: Lehmann Knudsen
authors: Dorte Gilså
authors: DG
authors: Hansen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways / Q000458:organization & administration / Q000592:standards*; D003625:Data Collection; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult