Skip to main content

Advertisement

SpringerLink
Log in

Supportive care needs and associated factors among Chinese cancer survivors: a cross-sectional study

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

To investigate the unmet supportive care needs (SCNs) of Chinese cancer survivors and to identify factors associated with the unmet SCNs of cancer survivors.

Methods

A cross-sectional survey of Chinese cancer survivors was conducted using validated scales of the Cancer Survivors Unmet Needs scale (CaSUN), physical symptom concerns (Cancer Survivors Survey of Needs—CSSN subscale), and a single-item measure of global quality of life (QoL) perception.

Results

There were 330 participants, with a mean score of 7.1 (0–10) in overall QoL. The reported rate of the 19 symptom concerns ranged from 19.4 to 72.2%. The level of unmet SCNs (moderate and strong need) ranged from 12.1 to 59.1%. The top five unmet needs included concerns about the cancer re-occurring (59.1%), accessing the best medical care (52.7%), accessing complementary therapy services (51.5%), changes to beliefs (48.2%), and survivor expectations (47.6%). The strength of unmet SCNs was negatively correlated with participant age (P < 0.05), average time since diagnosis (P < 0.05), and overall QoL (P < 0.01) and positively correlated with all symptom concerns (all P < 0.001).

Conclusions

Study findings call attention to cancer survivors’ unmet SCNs and related factors. Underscored areas in developing survivorship care included paying special attention to existential survivorship, empowering survivor management of chronic symptoms, particularly for younger survivors, as well as for survivors with poor QoL, and those with a shorter time since diagnosis. This tailored survivorship care should be developed and delivered by a multidisciplinary team to support cancer services, with a greater capacity to deliver individualized, unmet SCN-driven care to survivors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. World Health Organisation (2018) Cancer fact sheet http://www.who.int/mediacentre/factsheets/fs297/en/. Accessed 20 Feb 2018

  2. Zhao P, Dai M, Chen W, Li N (2010) Cancer trends in China. Jpn J Clin Oncol 40(4):281–285

    Article  PubMed  Google Scholar 

  3. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66(2):115–132. https://doi.org/10.3322/caac.21338

    Article  Google Scholar 

  4. International Agency for Research on Cancer World Health Organization (2011) Cancer survival in Africa, Asia, the Caribbean and Central America. http://survcan.iarc.fr/survcan.pdf. Accessed 20 Feb 2018

  5. National Coalition for Cancer Survivorship (2014) Defining cancer survivorship. http://www.canceradvocacy.org/news/defining-cancer-survivorship/. Accessed 21 Feb 2018

  6. Hebdon M, Foli K, Mccomb S (2015) Survivor in the cancer context: a concept analysis. J Adv Nurs 71(8):1774–1786

    Article  PubMed  Google Scholar 

  7. Jarrett N, Scott I, Addingtonhall J, Amir Z, Brearley S, Hodges L, Richardson A, Sharpe M, Stamataki Z, Stark D (2013) Informing future research priorities into the psychological and social problems faced by cancer survivors: a rapid review and synthesis of the literature. Eur J Oncol Nurs 17(5):510–520

    Article  CAS  PubMed  Google Scholar 

  8. Stein KD, Syrjala KL, Andrykowski MA (2010) Physical and psychological long-term and late effects of cancer. Cancer 112(S11):2577–2592

    Article  Google Scholar 

  9. Loonen JJ, Blijlevens NM, Prins J, Dona DJ, Hartogh JD, Senden T, Broeder DD, Velden KVD, Hermens RP (2018) Cancer survivorship care: person centered care in a multidisciplinary shared care model. Int J Integr Care 18(1):1–7

    Article  Google Scholar 

  10. Hewitt ME, Ganz P, Council N (2006) From cancer patient to cancer survivor : lost in transition : an American Society of Clinical Oncology and Institute of Medicine Symposium. National Academies Press

  11. Tompkins C, Scanlon K, Scott E, Ream E, Harding S, Armes J (2016) Survivorship care and support following treatment for breast cancer: a multi-ethnic comparative qualitative study of women's experiences. BMC Health Serv Res 16(1):401. https://doi.org/10.1186/s12913-016-1625-x

    Article  PubMed  PubMed Central  Google Scholar 

  12. Jefford M, Karahalios E, Pollard A, Baravelli C, Carey M, Franklin J, Aranda S, Schofield P (2008) Survivorship issues following treatment completion—results from focus groups with Australian cancer survivors and health professionals. J Cancer Surviv 2(1):20–32

    Article  PubMed  Google Scholar 

  13. Sankaranarayanan R, Ramadas K, Qiao Y (2014) Managing the changing burden of cancer in Asia. BMC Med 12(1):3

    Article  PubMed  PubMed Central  Google Scholar 

  14. Hex N, Bartlett C (2013) Cost-effectiveness of follow-up services for childhood cancer survivors outside the cancer setting. Curr Opin Support Palliat Care 7(3):314–317

    PubMed  Google Scholar 

  15. Howell D, Harth T, Brown J (2017) Self-management education interventions for patients with cancer: a systematic review. Support Care Cancer 25(4):1323–1355

    Article  PubMed  Google Scholar 

  16. Schlairet M, Heddon MA, Griffis M (2010) Piloting a needs assessment to guide development of a survivorship program for a community cancer center. Oncol Nurs Forum 37(4):501–508

    Article  PubMed  Google Scholar 

  17. Fiszer C, Dolbeault S, Sultan S, Brédart A (2014) Prevalence, intensity, and predictors of the supportive care needs of women diagnosed with breast cancer: a systematic review. Psycho-Oncology 23(4):361–374

    Article  PubMed  Google Scholar 

  18. Okediji PT, Salako O, Fatiregun OO (2017) Pattern and predictors of unmet supportive care needs in cancer patients. Cureus 9(5):e1234. https://doi.org/10.7759/cureus.1234

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jansen F, van Uden-Kraan CF, van Zwieten V, Witte BI, Verdonck-de Leeuw IM (2015) Cancer survivors’ perceived need for supportive care and their attitude towards self-management and eHealth. Support Care Cancer 23(6):1679–1688. https://doi.org/10.1007/s00520-014-2514-7

    Article  PubMed  Google Scholar 

  20. Umezawa S, Fujisawa D, Fujimori M, Ogawa A, Matsushima E, Miyashita M (2015) Prevalence, associated factors and source of support concerning supportive care needs among Japanese cancer survivors. Psycho-Oncology 24(6):635–642

    Article  PubMed  Google Scholar 

  21. Mcdowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK (2010) Predictors of change in unmet supportive care needs in cancer. Psycho-Oncology 19(5):508–516

    Article  CAS  PubMed  Google Scholar 

  22. Drury A, Payne S, Brady AM (2017) Cancer survivorship: advancing the concept in the context of colorectal cancer. Eur J Oncol Nurs 29:135–147. https://doi.org/10.1016/j.ejon.2017.06.006

    Article  PubMed  Google Scholar 

  23. Giuliani ME, Milne RA, Puts M, Sampson LR, Kwan JY, Le LW, Alibhai SM, Howell D, Abdelmutti N, Liu G, Papadakos J, Catton P, Jones J (2016) The prevalence and nature of supportive care needs in lung cancer patients. Curr Oncol 23(4):258–265. https://doi.org/10.3747/co.23.3012

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Ellegaard MB, Grau C, Zachariae R, Bonde Jensen A (2017) Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study. Acta Oncol 56(2):314–320. https://doi.org/10.1080/0284186x.2016.1268714

    Article  PubMed  Google Scholar 

  25. So WK, Chow KM, Chan HY, Choi KC, Wan RW, Mak SS, Chair SY, Chan CW (2014) Quality of life and most prevalent unmet needs of Chinese breast cancer survivors at one year after cancer treatment. Eur J Oncol Nurs 18(3):323–328

    Article  PubMed  Google Scholar 

  26. Lam WW, Tsang J, Yeo W, Suen J, Ho WM, Yau TK, Soong I, Wong KY, Kwong A, Suen D (2014) The evolution of supportive care needs trajectories in women with advanced breast cancer during the 12 months following diagnosis. Support Care Cancer 22(3):635–644

    Article  PubMed  Google Scholar 

  27. Beesley VL, Alemayehu C, Webb PM (2018) A systematic literature review of the prevalence of and risk factors for supportive care needs among women with gynaecological cancer and their caregivers. Support Care Cancer 26(3):701–710. https://doi.org/10.1007/s00520-017-3971-6

    Article  PubMed  Google Scholar 

  28. Boyes AW, Clinton-Mcharg T, Waller AE, Steele A, D'Este CA, Sanson-Fisher RW (2015) Prevalence and correlates of the unmet supportive care needs of individuals diagnosed with a haematological malignancy. Acta Oncol 54(4):507–514

    Article  PubMed  Google Scholar 

  29. Chen SC, Chiou SC, Yu CJ, Lee YH, Liao WY, Hsieh PY, Jhang SY, Lai YH (2016) The unmet supportive care needs—what advanced lung cancer patients’ caregivers need and related factors. Support Care Cancer 24(7):2999–3009

    PubMed  Google Scholar 

  30. Molassiotis A, Yates P, Li Q, So WKW, Pongthavornkamol K, Pittayapan P, Komatsu H, Thandar M, Li MS, Titus Chacko S, Lopez V, Butcon J, Wyld D, Chan RJ (2017) Mapping unmet supportive care needs, quality-of-life perceptions and current symptoms in cancer survivors across the Asia-Pacific region: results from the international STEP study. Ann Oncology 28(10):2552–2558. https://doi.org/10.1093/annonc/mdx350

    Article  CAS  Google Scholar 

  31. Wu ML (2010) Statistical analysis of questionnaires: SPSS operation and application. Chongqing University Press, Chongqing

    Google Scholar 

  32. Hodgkinson K, Butow P, Hunt GE, Pendlebury S, Hobbs KM, Lo SK, Wain G (2007) The development and evaluation of a measure to assess cancer survivors’ unmet supportive care needs: the CaSUN (cancer survivors’ unmet needs measure). Psycho-Oncology 16(9):796–804

    Article  CAS  PubMed  Google Scholar 

  33. World Health Organisation (2014) Process of translation and adaptation of instruments. http://www.who.int/substance_abuse/research_tools/translation/en/. Accessed 22 Feb 2018

  34. Filsinger S, Burkhalter R, Campbell H (2011) Survivor unmet needs survey: user guide: codebook, analysis, Etc. PROPEL Centre for Population Health Impact and. University of Waterloo, Waterloo

    Google Scholar 

  35. Molassiotis A, Brunton L, Hodgetts J, Green AC, Beesley VL, Mulatero C, Newton-Bishop JA, Lorigan P (2014) Prevalence and correlates of unmet supportive care needs in patients with resected invasive cutaneous melanoma. Ann Oncol 25(10):2052–2058

    Article  CAS  PubMed  Google Scholar 

  36. Harrison SE, Watson EK, Ward AM, Khan NF, Turner D, Adams E, Forman D, Roche MF, Rose PW (2011) Primary health and supportive care needs of long-term cancer survivors: a questionnaire survey. J Clin Oncol 29(15):2091–2098

    Article  PubMed  Google Scholar 

  37. Beesley VL, Price MA, Webb PM, O'Rourke P, Marquart L, Butow PN (2013) Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs. Psycho-Oncology 22(7):1565–1571

    Article  PubMed  Google Scholar 

  38. Cockle-Hearne J, Charnay-Sonnek F, Denis L, Fairbanks HE, Kelly D, Kav S, Leonard K, van Muilekom E, Fernandez-Ortega P, Jensen BT, Faithfull S (2013) The impact of supportive nursing care on the needs of men with prostate cancer: a study across seven European countries. Br J Cancer 109(8):2121–2130

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Li Q, Lin Y, Chen Y, Loke AY (2017) Mutual support and challenges among Chinese couples living with colorectal cancer: a qualitative study. Cancer Nurs:1. https://doi.org/10.1097/ncc.0000000000000553

Download references

Acknowledgments

The first author (Qiuping LI) is especially grateful to Professor Alex Molasiotis (School of Nursing, Hong Kong Polytechnic University, Hong Kong) for his kind invitation to participate a collaborative research (The STEP Study). The authors gratefully acknowledge the support from the related hospitals and all the participants for their sharing of their experience in this study. The authors are also grateful to the reviewer for his/her very helpful comments on a previous version of this manuscript.

Funding

Financial support of this study was provided by the National Natural Science Foundation of China (No. 81773297, 81573250). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

We (the authors) have full control of all primary data and agree to allow the journal to review the data if requested.

Author information

Authors and Affiliations

  1. Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China

    Qiuping Li & Yi Lin

  2. Wuxi People’s Hospital, Wuxi, Jiangsu Province, China

    Huiya Zhou & Yinghua Xu

  3. Department of Health Statistics, Fourth Military Medical University, Xi’an, Shaanxi Province, China

    Yongyong Xu

Authors
  1. Qiuping Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yi Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Huiya Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yinghua Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yongyong Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Qiuping Li: study conception/design; data collection/analysis; drafting of manuscript.

Yi LIN, and Huiya ZHOU: data collection/analysis; drafting of manuscript.

Yinghua XU: data collection/analysis; drafting of manuscript; critical revisions of the manuscript.

Yongyong XU: supervision and critical revisions for important intellectual content.

Corresponding authors

Correspondence to Yinghua Xu or Yongyong Xu.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

We affirm that the content of our paper has not been published elsewhere and it does not overlap or duplicate any of our published work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, Q., Lin, Y., Zhou, H. et al. Supportive care needs and associated factors among Chinese cancer survivors: a cross-sectional study. Support Care Cancer 27, 287–295 (2019). https://doi.org/10.1007/s00520-018-4315-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4315-x

Keywords

Search

Navigation