Identifying trajectory clusters in breast cancer survivors’ supportive care needs, psychosocial difficulties, and resources from the completion of primary treatment to 8 months later
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This study aimed to chart patterns of simultaneous trajectories over 8 months in breast cancer survivors’ (BCS) supportive care needs, psychological distress, social support, and posttraumatic growth. Clusters of BCS among these trajectories were identified and characterized.
Of 426 BCS study participants, 277 (65 %) provided full assessments in the last week of primary cancer treatment and 4 and 8 months later. Latent trajectories were obtained using growth mixture modeling for patients who responded to all scores for at least one time point (n = 348). Then, classification of BCS was performed by hierarchical agglomerative clustering on axes derived from a multiple factor analysis of trajectory assignments. Self-esteem, attachment security, and satisfaction with care were assessed at baseline.
Four trajectory clusters were identified, including two BCS subgroups (63 %) with low needs and low psychological distress. Two others (37 %) exhibited high or increasing needs and concerning levels of psychological distress. These latter clusters were characterized by higher insecure attachment, lower satisfaction with care, and either lower education or younger age, and having undergone chemotherapy.
More than a third of BCS present unfavorable patterns in supportive care needs over 8 months after primary cancer treatment. Identified psychosocial and cancer care characteristics point to targets for enhanced BCS supportive care.
KeywordsBreast neoplasms Patient care management Longitudinal studies Trajectory Cluster analysis Supportive care needs
This study is granted by the French National Cancer League and the French Ile-de-France region Cancerpole. The authors wish to acknowledge the assistance of Gariné Catanasian, Catherine Gravigny, Marie Jézéquel, and Sophie Simandoux for their assistance in recruiting patients. We thank Leslie Elliott for her linguistic revision of the manuscript.
Conflict of interest
The authors have declared no conflict of interest.
- 1.Gysels M, Higginson IJ, Rajasekaran M, Davies E, Harding R (2004) Improving supportive and palliative care for adults with cancer: research evidence. National Institute of Clinical Excellence & Kings College London, LondonGoogle Scholar
- 2.Burris JL, Armeson K, Sterba KR (2014) A closer look at unmet needs at the end of primary treatment for breast cancer: a longitudinal pilot study. Behav Med: 1-8Google Scholar
- 6.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: prevalence and predictors of supportive care needs in breast cancer. Psychooncology 23(4):361–374CrossRefPubMedGoogle Scholar
- 14.Howlader N, Noone A, Krapcho M, et al.: SEER Cancer Statistics Review, 1975-2011 [Internet]. Bethesda, MD: National Cancer Institute; April 2014. http://seer.cancer.gov/csr/1975_2011/
- 32.Rosenberg M (1965) Society and adolescent child. Princeton University Press, PrincetonGoogle Scholar
- 38.Tofighi D, Enders CK (2008) Identifying the correct number of classes in growth mixture models. advances in latent variable mixture models. Information Age Pub, CharlotteGoogle Scholar