title: Unmet needs of women with breast cancer during and after primary treatment: a prospective study in Denmark.
abstract: Integrated plans will be required to ensure care and rehabilitation for the growing number of cancer survivors. Information is lacking, however, about the extent to which patients' rehabilitation needs are being met, and characteristics of patients who experience unmet needs after their diagnosis and throughout the disease trajectory.
  
  
  METHODS
  Consecutive women with newly diagnosed breast cancer, undergoing surgery at the Breast Surgery Clinic, Rigshospitalet, Denmark, between 2008 and 2009 (N = 261), completed questionnaires on their unmet needs, anxiety, physical functioning, social support and demographic factors at the time of surgery and four and eight months after diagnosis. Associations between demographic and clinical factors at baseline and unmet needs four and eight months after diagnosis were examined in logistic regression models.
  
  
  RESULTS
  The percentage of women with unmet needs remained stable between four (42%) and eight months (40%). Unmet needs were reported for patient education, counselling and alternative treatment. The factors significantly associated with having unmet needs were younger age (OR 0.92; 95% CI 0.89-0.95), higher education (OR 2.49; 95% CI 1.14-5.44), not having a partner (OR 2.25; 95% CI 1.22-4.17) and anxiety (OR 1.13; 95% CI 1.05-1.20) at four months; and age (OR 0.91; 95% CI 0.87-0.94), not having a partner (OR 2.21; 95% CI 1.10-4.46) and having had one or more unmet needs at four months (OR 6.83, 95% CI 3.55-13.16) at eight months.
  
  
  CONCLUSIONS
  A total of 53% of women with breast cancer had unmet needs at some time between diagnosis and the end of primary treatment (eight months after diagnosis). A contextual understanding of unmet needs is necessary for planning cancer rehabilitation, as not only factors such as anxiety, physical functioning and previous unmet needs but also age, education and relationship status are associated with unmet needs.
authors: Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark. heymann@cancer.dk
authors: Annika B
authors: AB
authors: von Heymann-Horan
authors: Susanne O
authors: SO
authors: Dalton
authors: Angelika
authors: A
authors: Dziekanska
authors: Jane
authors: J
authors: Christensen
authors: Ingelise
authors: I
authors: Andersen
authors: Birgitte G
authors: BG
authors: Mertz
authors: Maja Halgren
authors: MH
authors: Olsen
authors: Christoffer
authors: C
authors: Johansen
authors: Pernille E
authors: PE
authors: Bidstrup
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006301:Health Services Needs and Demand / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D020360:Neoadjuvant Therapy / Q000706:statistics & numerical data; D011446:Prospective Studies; D011613:Psychotherapy / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology / Q000628:therapy