title: The evolution of supportive care needs trajectories in women with advanced breast cancer during the 12 months following diagnosis.
abstract: OBJECTIVE
  This longitudinal study examined if the evolution of supportive care needs differed over the first year following the diagnosis of advanced breast cancer and examined factors differentiating these trajectories.
  
  
  METHODS
  Two hundred twenty-eight of 276 Chinese women with advanced breast cancer were assessed while they were awaiting or receiving initial chemotherapy, then again at 6 weeks, 3 months, 6 months, and 12 months post-baseline. Supportive care needs (SCNS-34-Ch), psychological distress (Hospital Anxiety and Depression scale), symptom distress (MSAS-Ch), and patient satisfaction (PSEQ-9) were assessed at baseline; supportive care needs were reassessed at each follow-up assessment. Latent growth mixture modeling explored if trajectories differed within each of four need domains: health system, information, and patient support (HSIPS); psychological; physical daily living (PDL); and sexuality needs. Logistic regression identified factors predicting trajectory patterns.
  
  
  RESULTS
  Two distinct trajectories were identified for HSIPS and sexuality need domains and three distinct trajectories for psychological and physical daily living need domains. Most women showed stable low levels of HSIPS (78.9 %), psychological (82.4 %), PDL (83.7 %), and sexuality (97.4 %) supportive care needs. One in five and one in eight women showed high initial supportive care needs in HSIPS and psychological and PDL domains, respectively. With the exception of sexuality needs, trajectory patterns were predicted by physical symptom distress. Women in the high-decline group reported greater physical symptom distress.
  
  
  CONCLUSIONS
  Most Chinese women with advanced breast cancer showed low stable supportive care needs. Physical symptom distress predicted high supportive care needs. Interventions should focus on optimizing symptom assessment and management.
authors.affiliation: Centre for Psycho-Oncology Research and Training, Division of Behavioural Health, School of Public Health, The University of Hong Kong, 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong, wwtlam@hku.hk.
authors.forename: Wendy W T
authors.initials: WW
authors.lastname: Lam
authors.forename: Janice
authors.initials: J
authors.lastname: Tsang
authors.forename: Winnie
authors.initials: W
authors.lastname: Yeo
authors.forename: Joyce
authors.initials: J
authors.lastname: Suen
authors.forename: Wing Ming
authors.initials: WM
authors.lastname: Ho
authors.forename: Tze Kok
authors.initials: TK
authors.lastname: Yau
authors.forename: Inda
authors.initials: I
authors.lastname: Soong
authors.forename: Ka Yan
authors.initials: KY
authors.lastname: Wong
authors.forename: Ava
authors.initials: A
authors.lastname: Kwong
authors.forename: Dacita
authors.initials: D
authors.lastname: Suen
authors.forename: Wing Kin
authors.initials: WK
authors.lastname: Sze
authors.forename: Alice W Y
authors.initials: AW
authors.lastname: Ng
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy*; D002681:China; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D010346:Patient Care Management; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D060728:Reproductive Health; D011795:Surveys and Questionnaires