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The evolution of supportive care needs trajectories in women with advanced breast cancer during the 12 months following diagnosis

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Abstract

Purpose

This longitudinal study examined if the evolution of supportive care needs differed over the first year following the diagnosis of advanced breast cancer and examined factors differentiating these trajectories.

Methods

Two hundred twenty-eight of 276 Chinese women with advanced breast cancer were assessed while they were awaiting or receiving initial chemotherapy, then again at 6 weeks, 3 months, 6 months, and 12 months post-baseline. Supportive care needs (SCNS-34-Ch), psychological distress (Hospital Anxiety and Depression scale), symptom distress (MSAS-Ch), and patient satisfaction (PSEQ-9) were assessed at baseline; supportive care needs were reassessed at each follow-up assessment. Latent growth mixture modeling explored if trajectories differed within each of four need domains: health system, information, and patient support (HSIPS); psychological; physical daily living (PDL); and sexuality needs. Logistic regression identified factors predicting trajectory patterns.

Results

Two distinct trajectories were identified for HSIPS and sexuality need domains and three distinct trajectories for psychological and physical daily living need domains. Most women showed stable low levels of HSIPS (78.9 %), psychological (82.4 %), PDL (83.7 %), and sexuality (97.4 %) supportive care needs. One in five and one in eight women showed high initial supportive care needs in HSIPS and psychological and PDL domains, respectively. With the exception of sexuality needs, trajectory patterns were predicted by physical symptom distress. Women in the high-decline group reported greater physical symptom distress.

Conclusions

Most Chinese women with advanced breast cancer showed low stable supportive care needs. Physical symptom distress predicted high supportive care needs. Interventions should focus on optimizing symptom assessment and management.

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Acknowledgments

The authors would like to thank our research assistants for the contributions of the data collection and management, and to the women who participated in the study. This work was supported by a grant from the Hong Kong Cancer Fund and a grant from the Seed Funding Programme for Basic Research by The University of Hong Kong.

Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Centre for Psycho-Oncology Research and Training, Division of Behavioural Health, School of Public Health, The University of Hong Kong, 5/F, WMW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Pokulam, Hong Kong

    Wendy W. T. Lam & Richard Fielding

  2. Department of Clinical Oncology, The University of Hong Kong, Pokulam, Hong Kong

    Janice Tsang

  3. Department of Clinical Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong

    Winnie Yeo, Joyce Suen & Wing Ming Ho

  4. Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong

    Tze Kok Yau & Inda Soong

  5. Department of Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong

    Ka Yan Wong

  6. Department of Surgery, The University of Hong Kong, Pokulam, Hong Kong

    Ava Kwong & Dacita Suen

  7. Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong

    Wing Kin Sze & Alice W. Y. Ng

  8. Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, University of New South Wales, Kensington, Sydney, Australia

    Afaf Girgis

Authors
  1. Wendy W. T. Lam
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  2. Janice Tsang
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  8. Ka Yan Wong
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  11. Wing Kin Sze
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  12. Alice W. Y. Ng
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  13. Afaf Girgis
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  14. Richard Fielding
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Corresponding author

Correspondence to Wendy W. T. Lam.

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Lam, W.W.T., Tsang, J., Yeo, W. et al. The evolution of supportive care needs trajectories in women with advanced breast cancer during the 12 months following diagnosis. Support Care Cancer 22, 635–644 (2014). https://doi.org/10.1007/s00520-013-2018-x

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  • DOI: https://doi.org/10.1007/s00520-013-2018-x

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