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Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer

Breast Cancer Research and Treatment volume 130, pages 531–541 (2011)Cite this article

Abstract

The comparison of psychosocial needs across different cultural settings can identify cultural and service impacts on psychosocial outcomes. We compare psychosocial needs in Hong Kong Chinese and German Caucasian women with breast cancer. Completed questionnaires were collected from 348 Chinese and 292 German women with breast cancer for assessing unmet psychosocial needs (Supportive Care Needs Survey Short Form), psychological distress (the Hospital Anxiety and Depression scale), and listed physical and psychological symptoms. Only 11% of the participants reported not needing help for any of the 34 items. More German (14%) than Chinese women (8%) reported no unmet needs (χ2 = 6.16, P = .013). With both samples combined, the Health System and Information domain unmet needs were the most prevalent, apart from one Psychological need domain item, “Fear about the cancer spreading.” Chinese and German samples differed significantly in prevalence and patterns of unmet psychosocial needs. Multivariate adjustment for demographic, clinical, and sample characteristics, psychological distress, and symptoms showed that significantly greater unmet Health system and Information, and Patient care and support domain needs, associated with the presence of symptoms (β = .232, P < .001), high HADS Anxiety (β = .187, P < .001), higher education attainment (β = .120, P = .002), and Chinese sample membership (β = .280, P < .001). Greater unmet Psychological, Physical and Daily Living, and Sexuality domain needs were associated with the presence of symptoms, psychological distress, and German group membership, among others. German women reported more anxiety (t = 10.45, P < .001) and depression (t = 3.71, P < .001). In post hoc analyses, German, but not Chinese women reporting greater anxiety and depression had greater unmet Psychological and Sexuality domain needs (P < .001). It can be concluded that culture-specific differences in supportive care needs exist. Hong Kong Chinese women prioritize needs for information about their disease and treatment, whereas German Caucasian women prioritize physical and psychological support. Planning for cancer supportive care services or interventions to reduce unmet needs must consider cultural and/or health service contexts.

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Acknowledgments

Hong Kong: This study was supported by a grant from the Germany/Hong Kong Joint Research Scheme sponsored by the Research Grants Council of Hong Kong and the Germany Academic Exchange Service of Germany (Reference no. G_HK027/09 and a grant from The Hong Kong Cancer Fund). The authors would like to thank Pheebie Kwok, Ella Ho, April Chiu, Teresa Wong, and Wylie Li for their valuable contributions to data collection and management, and the women who participated in the study. The authors would also like to thank Professor Afaf Girgis for providing us with the scoring instructions of the SCNS-SF-34. Finally, the authors thank the Culturally and Linguistically Diverse (CALD) study team, headed by Professor Phyllis Butow, for the use of the translated Chinese version of the SCNS-SF-34. Germany: This research has been supported by the grants from the Barbara and Michael Hell Stiftung Hamburg and the German Cancer Aid, Germany. The Psycho-Oncological and Palliative Care Research Group at the Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, is funded by grants from the Fritz und Hildegard Berg-Stiftung, and the Stiftung Wissenschaft Hamburg within the Donors’ Association for the Promotion of Sciences and Humanities in Germany.

Conflict of interest

The authors declare that they have no competing interests.

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Affiliations

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

    Wendy W. T. Lam, Angel H. Y. Au, Jennifer H. F. Wong & Richard Fielding

  2. Department of Medical Psychology, Centre of Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, University of Hamburg, Martinistrasse 52, 20246, Hamburg, Germany

    Claudia Lehmann, Uwe Koch & Anja Mehnert

Authors
  1. Wendy W. T. Lam
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  2. Angel H. Y. Au
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  5. Uwe Koch
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Correspondence to Wendy W. T. Lam.

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Lam, W.W.T., Au, A.H.Y., Wong, J.H.F. et al. Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat 130, 531–541 (2011). https://doi.org/10.1007/s10549-011-1592-1

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  • DOI: https://doi.org/10.1007/s10549-011-1592-1

Keywords

  • Supportive care needs
  • Psychological distress
  • Culture
  • Psychosocial support