title: Comparison of problems and unmet needs of patients with advanced cancer in a European country and an Asian country.
abstract: BACKGROUND
  Patients with advanced cancer experience problems and unmet needs. However, we assume that patients with advanced cancer will have more problems and unmet needs in a country with a lower economic status than in an economically stronger country. We studied whether patients with advanced cancer in Indonesia have more problems and unmet needs than a similar group of patients in the Netherlands.
  
  
  METHODS
  We performed a cross-sectional survey. We compared the data for 180 Indonesian and 94 Dutch patients relating to 24 items of the Problems and Needs in Palliative Care-short version questionnaire. We performed descriptive and χ(2) analysis with Bonferroni correction.
  
  
  RESULTS
  The prevalence of most physical problems, including pain, was similar in the 2 groups. In Indonesia, financial problems were the most common: 70 to 80% vs. 30 to 42% in the Netherlands. In Indonesia, 25 to 50% of the patients reported psychological and autonomy problems versus 55 to 86% in the Netherlands. The Indonesian group had many more unmet needs for each problem (> 54%) than the Dutch group (< 35%).
  
  
  CONCLUSIONS
  Apparently, economic and cultural differences hardly influence physical problems. Nonetheless, fewer Indonesian patients reported psychological and autonomy problems than Dutch patients. This difference contradicts our hypothesis. However, we found more unmet needs for professional attention in Indonesia than in the Netherlands, which is compatible with our hypothesis. These simple comparative data provide interesting insights into problems and unmet needs and give rise to our new hypothesis about cultural influences. This hypothesis should be studied in more depth.
authors.affiliation: School of Nursing, Medical Faculty, Universitas Gadjah Mada, Yogyakarta, Indonesia.|Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Christantie
authors.initials: C
authors.lastname: Effendy
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Kris
authors.initials: K
authors.lastname: Vissers
authors.affiliation: Arentz en Osse Huisartsenpraktijk in Deventer, Deventer, the Netherlands.
authors.forename: Bart H P
authors.initials: BH
authors.lastname: Osse
authors.affiliation: Center of Development for Palliative and Pain Relief, Dr. Soetomo Hospital, Surabaya, Indonesia.
authors.forename: Sunaryadi
authors.initials: S
authors.lastname: Tejawinata
authors.affiliation: Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.|Department of Primary and Community Care, Radboud University Nijmegen Medical Centre and Kalorama Foundation, Beek-Ubbergen, the Netherlands.
authors.forename: Myrra
authors.initials: M
authors.lastname: Vernooij-Dassen
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Engels
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D010166:Palliative Care / Q000191:economics; D017060:Patient Satisfaction / Q000191:economics*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Indonesia; advanced cancer; cultural diversity; culture; economic; needs assessment; palliative; the Netherlands; unmet needs