Immediate post-treatment supportive care needs of patients newly diagnosed with head and neck cancer
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ORIGINAL ARTICLE
Immediate post-treatment supportive care needs of patients newly diagnosed with head and neck cancer Melissa Henry 1,2,3,4,5 & Ali Alias 6 & Maria Cherba 5,7 & Claudia Woronko 5 & Zeev Rosberger 1,5,8 & Michael Hier 1,3,4 & Anthony Zeitouni 4,9 & Karen Kost 4,9 & Alex Mlynarek 3,4,9 & Keith Richardson 4,9 & Martin Black 3,4 & Christina MacDonald 3,10 & Gabrielle Chartier 3,10 & Saul Frenkiel 3,4,9 Received: 1 November 2019 / Accepted: 19 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective This study aimed at identifying supportive care needs of patients with head and neck cancer (HNC-P) immediately post-treatment, finding early predictors of unmet needs, and contrasting how immediate post-treatment needs differed from needs in longer-term survivorship. Methods Prospective longitudinal study of 223 consecutive adults (313 approached; 72% participation) newly diagnosed with a first occurrence of primary HNC. Patients completed the Supportive Care Needs Survey–Short Form (SCNS), the Structured Clinical Interview for DSM-IV, and other outcomes. Medical chart reviews were conducted. Results A total of 68% of patients (n = 145/223) completed the SCNS. The multiple linear regression indicated that when controlled for medical variables, patients presented higher levels of unmet needs when they presented with higher level of anxiety upon HNC diagnosis (p = 0.03), higher neuroticism (p = 0.03), and more stressful life events in the year pre-diagnosis (p = 0.01). Patients immediately post-treatment had a wider variety of unmet needs compared with those in extended survivorship, with psychological unmet needs most prevalent at both time points. Immediately post-treatment, patients needed more support regarding pain (p = 0.04) and worries about treatment results (p = 0.05), whereas patients in longer-term survivorship needed more support regarding anxiety (p = 0.02), changes in sexual relationships (p = 0.04), and fear of death and dying (p = 0.001). Conclusion This study identifies areas needing further development to improve quality of care for HNC-P in the immediate posttreatment period, as well as early determinants of unmet needs. HNC clinics may want to routinely screen for anxiety, neuroticism, and burden from other life events, to pro-actively address needs upon treatment completion and alleviate disease burden. Keywords Oncology . Head and neck cancer . Supportive care needs . Post-treatment . Survivorship
Background Unmet supportive care needs in oncology have generally been associated with lower quality of life (QoL) in patients and
higher levels of distress [1–3]. Unmet survivorship needs in oncology are common and identified in over 50% of patients [4]. A systematic review revealed that unmet needs of cancer patients varied in type and intensity according to cancer site,
* Melissa Henry [email protected]
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Lady-Davis Institute for Medical Research, Jewish General Hospital, 3755 Côte Ste. Catherine Road, Pavilion E room E-872, Montreal, Quebec H
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