title: A tailored, supportive care intervention using systematic assessment designed for people with inoperable lung cancer: a randomised controlled trial.
abstract: OBJECTIVE
  People with inoperable lung cancer experience higher levels of distress, more unmet needs and symptoms than other cancer patients. There is an urgent need to test innovative approaches to improve psychosocial and symptom outcomes in this group. This study tested the hypothesis that a tailored, multidisciplinary supportive care programme based on systematic needs assessment would reduce perceived unmet needs and distress and improve quality of life.
  
  
  METHODS
  A randomised controlled trial design was used. The tailored intervention comprised two sessions at treatment commencement and completion. Sessions included a self-completed needs assessment, active listening, self-care education and communication of unmet psychosocial and symptom needs to the multidisciplinary team for management and referral. Outcomes were assessed with the Needs Assessment for Advanced Lung Cancer Patients, Hospital Anxiety and Depression Scale, Distress Thermometer and European Organization of Research and Treatment of Cancer Quality of Life Q-C30 V2.0.
  
  
  RESULTS
  One hundred and eight patients with a diagnosis of inoperable lung or pleural cancer (including mesothelioma) were recruited from a specialist facility before the trial closed prematurely (original target 200). None of the primary contrasts of interest were significant (all p > 0.10), although change score analysis indicated a relative benefit from the intervention for unmet symptom needs at 8 and 12 weeks post-assessment (effect size = 0.55 and 0.40, respectively).
  
  
  CONCLUSIONS
  Although a novel approach, the hypothesis that the intervention would benefit perceived unmet needs, psychological morbidity, distress and health-related quality of life was not supported overall.
authors.affiliation: Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia; School of Behavioural Science, The University of Melbourne, Parkville, Australia; School of Nursing, The University of Melbourne, Parkville, Australia.
authors.forename: Penelope
authors.initials: P
authors.lastname: Schofield
authors.forename: Anna
authors.initials: A
authors.lastname: Ugalde
authors.forename: Karla
authors.initials: K
authors.lastname: Gough
authors.forename: John
authors.initials: J
authors.lastname: Reece
authors.forename: Meinir
authors.initials: M
authors.lastname: Krishnasamy
authors.forename: Mariko
authors.initials: M
authors.lastname: Carey
authors.forename: David
authors.initials: D
authors.lastname: Ball
authors.forename: Sanchia
authors.initials: S
authors.lastname: Aranda
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016014:Linear Models; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010043:Outcome and Process Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D063189:Symptom Assessment
keywords: cancer; intervention; lung cancer; oncology; quality of life; unmet needs