title: A systematic review of the supportive care needs of women living with and beyond cervical cancer.
abstract: BACKGROUND
  Women with cervical cancer constitute a patient population in need for ongoing, person-centred supportive care. Our aim was to synthesise current available evidence with regard to the supportive care needs of women living with and beyond cervical cancer.
  
  
  METHODS
  A systematic review was conducted according to the PRISMA Statement guidelines. Seven electronic databases (DARE, Cochrane, MEDLINE, CINAHL, BNI, PsychINFO and EMBASE) were searched to identify studies employing qualitative and/or quantitative methods. Pre-specified selection criteria were applied to all records published between 1990 and 2013. Methodological quality evaluation was conducted using the standardised QualSyst evaluation tool. Findings were integrated in a narrative synthesis.
  
  
  RESULTS
  Of 4936 references initially retrieved, 15 articles (13 unique studies) met eligibility criteria. One study fell below a pre-specified 55% threshold of methodological quality and was excluded. Individual needs were classified into ten domains of need. Interpersonal/intimacy (10; 83.3%), health system/information (8; 66.7%), psychological/emotional (7; 58.3%) and physical needs (6; 50%) were those most frequently explored. Spiritual/existential (1; 8.3%), family-related (2; 16.7%), practical (2; 16.7%), and daily living needs (2; 16.7%) were only rarely explored. Patient-clinician communication needs and social needs were addressed in 4 studies (33.3%). Dealing with fear of cancer recurrence, concerns about appearance/body image, lack of sexual desire, requiring more sexuality-related information, dealing with pain, and dealing with difficulties in relationship with partner were the most frequently cited individual needs (≥4 studies).
  
  
  CONCLUSIONS
  Despite a host of additional needs experienced by women with cervical cancer, a predominant focus on sexuality/intimacy and information seeking issues is noted. Study limitations preclude drawing conclusions as to how these needs evolve over time from diagnosis to treatment and subsequently to survivorship. Whether demographic or clinical variables such as age, race/ethnicity, disease stage or treatment modality play a moderating role, only remains to be answered in future studies.
authors.affiliation: School of Health Sciences, University of Surrey, Guildford, Surrey, UK. Electronic address: r.maguire@surrey.ac.uk.
authors.forename: Roma
authors.initials: R
authors.lastname: Maguire
authors.affiliation: School of Health Sciences, University of Surrey, Guildford, Surrey, UK.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Kotronoulas
authors.affiliation: NHS Lanarkshire, Lanarkshire, UK.
authors.forename: Mhairi
authors.initials: M
authors.lastname: Simpson
authors.affiliation: Ninewells Hospital, NHS Tayside, Dundee, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Paterson
mesh_terms: D022126:Access to Information; D005260:Female; D006801:Humans; D008603:Mental Health; D020380:Needs Assessment; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011788:Quality of Life; D012944:Social Support; D017741:Survivors / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000523:psychology* / Q000628:therapy; D016387:Women's Health
keywords: Cervical cancer; Patient-centred care; Supportive care needs; Systematic review; Unmet needs