title: Variations in supportive care needs of patients after diagnosis of localised cutaneous melanoma: a 2-year follow-up study.
abstract: We aimed to describe variations in unmet supportive care needs of patients diagnosed with localised melanoma at high risk of recurrence and factors associated with initial and persisting moderate-to-high needs.
  
  
  
  We ascertained 386 patients diagnosed with clinical stage IB-II melanoma and administered surveys every 6 months for 2 years. The proportion experiencing at least one moderate-to-high need was assessed among salient subgroups: 306 patients with no previous melanoma and 80 with previous melanoma at enrolment, 30 who experienced disease recurrence during follow-up and 31 who developed another primary. Baseline factors associated with (a) needs at enrolment and (b) persistent needs over 2 years (or as long as disease-free) were identified by logistic regression analyses.
  
  
  
  The proportion of patients with needs substantially declined over the first 6 months (if no previous melanoma, from 48 to 22 %, p < 0.001; previous melanoma, 35 to 17 %, p = 0.007), and in those remaining disease-free, needs declined further by 24 months (to 14 and 6 % respectively). By contrast, 50 % of those experiencing recurrence, and 39 % of those who developed another primary, reported needs. Stressful life events and anxiety were associated with needs at enrolment. At least one need, mainly fear of recurrence, persisted in 22 % of disease-free participants. Persistent needs were predicted by age, depression, anxiety and other stressful life events.
  
  
  
  Melanoma patients' needs peak when first diagnosed and if disease recurs. Younger people or those experiencing additional stressful events, anxiety or depression are more likely to experience persistent needs and may benefit from tailored support.
authors: Population Health Department, QIMR Berghofer Medical Research Institute, Locked Bag 2000 Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia. Vanessa.Beesley@qimrberghofer.edu.au.
authors: Vanessa L
authors: VL
authors: Beesley
authors: Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia.
authors: B Mark
authors: BM
authors: Smithers
authors: Population Health Department, QIMR Berghofer Medical Research Institute, Locked Bag 2000 Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.
authors: Peter
authors: P
authors: O'Rourke
authors: Institute for Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
authors: Monika
authors: M
authors: Janda
authors: Experimental Dermatology Group, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.|The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.
authors: Kiarash
authors: K
authors: Khosrotehrani
authors: Population Health Department, QIMR Berghofer Medical Research Institute, Locked Bag 2000 Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia.|Cancer Research UK Manchester Institute, University of Manchester, Manchester, UK.
authors: Adèle C
authors: AC
authors: Green
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D020380:Needs Assessment; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D000096142:Cutaneous Malignant Melanoma
keywords: Anxiety; Depression; Localised melanoma; Longitudinal study; Supportive care needs