title: Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia.
abstract: BACKGROUND
  Addressing breast cancer patients' unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients' characteristics, and their unmet supportive care needs.
  
  
  METHODS
  A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants' socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30).
  
  
  RESULTS
  The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL.
  
  
  CONCLUSIONS
  Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.
authors.affiliation: Department of Community Medicine, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia. dr.zobaidaedib@gmail.com.
authors.forename: Zobaida
authors.initials: Z
authors.lastname: Edib
authors.affiliation: Department of Community Medicine, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia. verasingam_kumarasamy@imu.edu.my.
authors.forename: Verasingam
authors.initials: V
authors.lastname: Kumarasamy
authors.affiliation: Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia. norlia@ppukm.ukm.edu.my.
authors.forename: Norlia
authors.initials: N
authors.lastname: Binti Abdullah
authors.affiliation: Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia. drmrizal@hotmail.com.
authors.forename: A M
authors.initials: AM
authors.lastname: Rizal
authors.affiliation: Faculty of Medicine, SEGi University, Kota Damansara, 47810, Petaling Jaya, Selangor, Malaysia. samidobaie@yahoo.com.
authors.forename: Sami Abdo Radman
authors.initials: SA
authors.lastname: Al-Dubai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008296:Malaysia; D008875:Middle Aged; D020380:Needs Assessment; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D062606:Tertiary Care Centers