title: Exploring patient support by breast care nurses and geographical residence as moderators of the unmet needs and self-efficacy of Australian women with breast cancer: Results from a cross-sectional, nationwide survey.
abstract: OBJECTIVE
  This study investigated whether use of services of a breast care nurse (BCN) at any time during treatment for breast cancer led to reduced unmet needs and increased self-efficacy among women with breast cancer. A secondary aim was to analyse comparisons between urban and rural and remote dwellers.
  
  
  METHODS
  Participants were Australian women who completed treatment for breast cancer at least 6 months before the survey date, recruited through two national databases of women diagnosed with breast cancer. The cross-sectional online survey consisted of two well validated measures, the SCNS-SF34 and the CASE-Cancer Scale. Statistical data were analysed using SPSS, with chi-square used to measure statistical significance.
  
  
  RESULTS
  A total of 902 participants responded to the survey. Unmet needs in the psychological domain were most prominent. Respondents who used the services of a BCN were significantly less likely to report unmet needs regarding tiredness, anxiety; future outlook; feelings about death and dying; patient care and support from medical staff; and provision of health systems and information. Scores of self-efficacy showed women using the services of a BCN had significantly higher self-efficacy when seeking and obtaining information (ρ ≤ 0.001) and understanding and participating in care (ρ = 0.032). Urban dwellers were more likely to have choice of health care service, but overall neither unmet needs nor perceived self-efficacy varied statistically significantly by remoteness.
  
  
  CONCLUSIONS
  Women with breast cancer experience a range of unmet needs; however those using BCN services demonstrated positive outcomes in terms of decreased unmet needs and increased self-efficacy.
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Australian Catholic University, PO Box 256, Dickson ACT 2602, Australia. Electronic address: traceyann.ahern@myacu.edu.au.
authors.forename: Tracey
authors.initials: T
authors.lastname: Ahern
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Australian Catholic University, PO Box 256, Dickson ACT 2602, Australia. Electronic address: anne.gardner@acu.edu.au.
authors.forename: Anne
authors.initials: A
authors.lastname: Gardner
authors.affiliation: Australian Catholic University, PO Box 456, Virginia QLD 4014, Australia. Electronic address: mary@roverville.com.au.
authors.forename: Mary
authors.initials: M
authors.lastname: Courtney
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001943:Breast Neoplasms / Q000451:nursing* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D012111:Residence Characteristics; D012424:Rural Population; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
keywords: Breast cancer; Breast care nurse; Geographical comparisons; Psychological domain; Self-efficacy; Survey; Unmet needs