Unmet supportive care needs in Hispanic/Latino cancer survivors: prevalence and associations with patient-provider communication, satisfaction with cancer care, and symptom burden
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The aim of this study was to elucidate the prevalence of unmet supportive care needs in Hispanic/Latino cancer survivors and examine the association between unmet needs and patient-provider communication, satisfaction with cancer care, and cancer-specific symptom burden.
Hispanics/Latinos diagnosed with breast, prostate, or colorectal cancer within 15 months of treatment completion (n = 288) completed questionnaires as part of an NCI-funded project.
Hispanic/Latino cancer survivors reported greater unmet needs compared to previously published norms in primarily non-Hispanic/Latino white samples. Across the three cancer types, the two most common unmet needs were in the psychological domain: fear of metastasis (32.6%) and concern for close others (31.3%). However, unmet needs varied by cancer type. Factors associated with greater unmet needs included more recent cancer diagnosis (OR .98 [.96–.99]), younger age (OR .96–.97 [.93–.99]), female gender (OR 2.53–3.75 [1.53–7.36]), and being single (OR 1.82 [1.11–2.97]). Breast cancer survivors reported greater unmet needs than both prostate and colorectal cancer survivors (OR 2.33–5.86 [1.27–14.01]). Adjusting for sociodemographic and medical covariates, unmet needs were associated with lower patient-provider communication self-efficacy (B = − .18–− .22, p’s < .01) and satisfaction with cancer care (B = − 3.57–− 3.81, p’s < .05), and greater breast (B = − 4.18–− 8.30, p’s < .01) and prostate (B = − 6.01–− 8.13, p’s < .01) cancer-specific symptom burden.
Findings document unmet supportive care needs in Hispanic/Latino cancer survivors and suggest that reducing unmet needs in Hispanic/Latino cancer survivors may improve not only satisfaction with care, but also health-related quality of life.
KeywordsHispanic Latino Survivorship Supportive care Unmet needs Patient-provider communication Satisfaction with care
Research supported by a National Cancer Institute grant (U54CA153511) awarded to Ramirez and Penedo and funding for the Robert H. Lurie Comprehensive Cancer Center at Northwestern University (P30CA060553) and the Mays Cancer Center at UT Health San Antonio (P30CA054174). Moreno and Fox were supported through a National Cancer Institute training grant (T32CA193193).
Compliance with ethical standards
All procedures performed were approved by the Institutional Review Board (IRB) of each institution and were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments.
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Bonevski B, Sanson-Fisher R, Girgis A, Burton L, Cook P, Boyes A, the Supportive Care Review Group (2000) Evaluation of an instrument to assess the needs of patients with cancer. Cancer 88:217–225. https://doi.org/10.1002/(SICI)1097-0142(20000101)88:1<217::AID-CNCR29>3.0.CO;2-Y CrossRefPubMedGoogle Scholar
- 7.McElduff P, Boyes A, Zucca A, Girgis A, et al (2004) Supportive Care Needs Survey: a guide to administration, scoring and analysis. Centre for Health Research & Psycho-oncology, NewcastleGoogle Scholar
- 9.Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, Palmer N, Ream E, Young A, Richardson A (2009) Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol 27:6172–6179. https://doi.org/10.1200/JCO.2009.22.5151 CrossRefPubMedGoogle Scholar
- 10.Brédart A, Kop J-L, Griesser A-C, Fiszer C, Zaman K, Panes-Ruedin B, Jeanneret W, Delaloye J-F, Zimmers S, Berthet V, Dolbeault S (2013) Assessment of needs, health-related quality of life, and satisfaction with care in breast cancer patients to better target supportive care. Ann Oncol 24:2151–2158. https://doi.org/10.1093/annonc/mdt128 CrossRefPubMedGoogle Scholar
- 12.Walling AM, Keating NL, Kahn KL, Mack JW, Malin J, Arora NK, Adams JL, Antonio ALM, Tisnado D (2016) Lower patient ratings of physician communication are associated with unmet need for symptom management in patients with lung and colorectal cancer. J Oncol Pract 12:564–e669. https://doi.org/10.1200/JOP.2015.005538 CrossRefGoogle Scholar
- 16.Moon Z, Moss-Morris R, Hunter MS, Carlisle S, Hughes LD (2017) Barriers and facilitators of adjuvant hormone therapy adherence and persistence in women with breast cancer: a systematic review. Patient Prefer Adherence 11:305–322. https://doi.org/10.2147/PPA.S126651 CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P, Supportive Care Review Group (2000) The unmet supportive care needs of patients with cancer. Cancer 88:226–237. https://doi.org/10.1002/(SICI)1097-0142(20000101)88:1<226::AID-CNCR30>3.0.CO;2-P CrossRefPubMedPubMedCentralGoogle Scholar
- 23.Pérez-Fortis A, Fleer J, Sánchez-Sosa JJ, Veloz-Martínez MG, Alanís-López P, Schroevers MJ, Ranchor AV (2017) Prevalence and factors associated with supportive care needs among newly diagnosed Mexican breast cancer patients. Support Care Cancer 25:3273–3280. https://doi.org/10.1007/s00520-017-3741-5 CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Tish Knobf M, Ferrucci LM, Cartmel B, Jones BA, Stevens D, Smith M, Salner A, Mowad L, Knobf MT, Ferrucci LM, Cartmel B, Jones BA, Stevens D, Smith M, Salner A, Mowad L (2012) Needs assessment of cancer survivors in Connecticut. J Cancer Surviv 6:1–10. https://doi.org/10.1007/s11764-011-0198-2 CrossRefPubMedGoogle Scholar
- 29.Ayanian JZ, Zaslavsky AM, Guadagnoli E, Fuchs CS, Yost KJ, Creech CM, Cress RD, O’Connor LC, West DW, Wright WE (2005) Patients’ perceptions of quality of care for colorectal cancer by race, ethnicity, and language. J Clin Oncol 23:6576–6586. https://doi.org/10.1200/JCO.2005.06.102 CrossRefPubMedGoogle Scholar
- 32.Luckett T, Goldstein D, Butow PN, Gebski V, Aldridge LJ, McGrane J, Ng W, King MT (2011) Psychological morbidity and quality of life of ethnic minority patients with cancer: a systematic review and meta-analysis. Lancet Oncol 12:1240–1248. https://doi.org/10.1016/S1470-2045(11)70212-1 CrossRefPubMedGoogle Scholar
- 33.American Cancer Society (2015) Cancer facts & figures for Hispanics/Latinos 2015–2017. American Cancer Society, AtlantaGoogle Scholar
- 35.Maly RC, Frank JC, Marshall GN, DiMatteo MR, Reuben DB (1998) Perceived Efficacy in Patient-Physician Interactions (PEPPI): validation of an instrument in older persons. J Am Geriatr Soc 46:889–894. https://doi.org/10.1111/j.1532-5415.1998.tb02725.x CrossRefPubMedGoogle Scholar
- 36.Jean-Pierre P, Fiscella K, Freund KM, Clark J, Darnell J, Holden A, Post D, Patierno SR, Winters PC, the Patient Navigation Research Program Group (2011) Structural and reliability analysis of a patient satisfaction with cancer-related care measure. Cancer 117:854–861. https://doi.org/10.1002/cncr.25501 CrossRefPubMedGoogle Scholar
- 41.Moreno PI, Ramirez AG, Miguel-Majors SLS, Fox RS, Castillo L, Gallion KJ, Munoz E, Estabrook R, Perez A, Lad T, Hollowell C, Penedo FJ Satisfaction with cancer care, self-efficacy, and health-related quality of life in Latino cancer survivors. Cancer 124:1770–1779. https://doi.org/10.1002/cncr.31263
- 42.Potosky AL, Reeve BB, Clegg LX, Hoffman RM, Stephenson RA, Albertsen PC, Gilliland FD, Stanford JL (2002) Quality of life following localized prostate cancer treated initially with androgen deprivation therapy or no therapy. J Natl Cancer Inst 94:430–437. https://doi.org/10.1093/jnci/94.6.430 CrossRefPubMedGoogle Scholar
- 43.Stanford JL, Feng Z, Hamilton AS, Gilliland FD, Stephenson RA, Eley JW, Albertsen PC, Harlan LC, Potosky AL (2000) Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the prostate cancer outcomes study. JAMA 283:354–360. https://doi.org/10.1001/jama.283.3.354 CrossRefPubMedGoogle Scholar
- 44.Litwin MS, Flanders SC, Pasta DJ, Stoddard ML, Lubeck DP, Henning JM (1999) Sexual function and bother after radical prostatectomy or radiation for prostate cancer: multivariate quality-of-life analysis from CaPSURE. Urology 54:503–508. https://doi.org/10.1016/S0090-4295(99)00172-7 CrossRefPubMedGoogle Scholar
- 45.Gonzalez V, Velez M, Pedro E, Cruz C, Cotto M, Colon M, Romaguera J, Chevere-Mourino C, Delgado- Mateu LA, Tirado-Gomez M (2009) Identification of supportive care needs in a sample of Puerto Rican cancer patients with the Supportive Care Needs Survey-34 (SCNS-34). J Clin Oncol 27:e20697–e20697. doi: https://doi.org/10.1200/jco.2009.27.15_suppl.e20697