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Changes and Predictors of Unmet Supportive Care Needs in Taiwanese Women With Newly Diagnosed Breast Cancer

Mei-Nan Liao
Shu-Ching Chen
Shin-Cheh Chen
Yung-Chang Lin
Ya-Hui Hsu
Hsueh-Chih Hung
Chao-Hui Wang
Miin-Fu Chen
Sui-Whi Jane
ONF 2012, 39(5), E380-E389 DOI: 10.1188/12.ONF.E380-E389

Purpose/Objectives: To investigate changes in unmet supportive care needs and factors affecting those needs in Taiwanese women with newly diagnosed breast cancer.

Design: Prospective longitudinal survey.

Setting: Two general surgery outpatient departments at a large medical center in northern Taiwan.

Sample: 124 women with newly diagnosed breast cancer.

Methods: Needs were assessed with the Supportive Care Needs Survey-Short Form at diagnosis (T1) and one month (T2), two months (T3), and three months (T4) after diagnosis.

Main Research Variables: Supportive care needs.

Findings: Women had moderate-to-high levels of unmet needs, with the highest being in the health system and information domain at each time point. Levels in the domains of psychological, health system and information, and sexuality needs were higher (p < 0.001) at T1 than at T2, T3, and T4. However, levels of unmet physical and daily living needs increased significantly over time (p < 0.001). Unmet supportive care needs were significantly predicted by younger age and higher levels of education, symptom distress, trait anxiety, state anxiety, and time since diagnosis.

Conclusions: Supportive care needs changed significantly over time and were predicted by personal characteristics, as well as physical and emotional factors.

Implications for Nursing: Oncology nurses should assess the needs of patients with breast cancer and provide them with individualized, culturally sensitive informational, social, and emotional support from breast cancer diagnosis through the first four months of treatment.


Alqaissi, N. M., & Dickerson, S. S. (2010). Exploring common meanings of social support as experienced by Jordanian women with breast cancer. <i>Cancer Nursing, 33</i>, 353-361. doi:10.1097/NCC.0b013e3181d55d33

Armes, J., Crowe, M., Colbourne, L., Morgan, H., Murrells, T., Oakley, C., … Richardson, A. (2009). Patients' supportive care needs beyond the end of cancer treatment: A prospective, longitudinal survey. <i>Journal of Clinical Oncology, 27</i>, 6172-6179. doi:10.1200/JCO.2009.22.5151

Ballinger, G. A. (2004). Using generalized estimating equations for longitudinal data analysis. <i>Organizational Research Methods, 7</i>, 127-150. doi:10.1177/1094428104263672

Beesley, V., Eakin, E., Steginga, S., Aitken, J., Dunn, J., & Battistutta, D. (2008). Unmet needs of gynaecological cancer survivors: Implications for developing community support services. <i>Psycho-Oncology, 17</i>, 392-400. doi:10.1002/pon.1249

Bonevski, B., Sanson-Fisher, R., Girgis, A., Burton, L., Cook, P., & Boyes, A. (2000). Evaluation of an instrument to assess the needs of patients with cancer. <i>Cancer, 88</i>, 217-225.

Boyes, A., Girgis, A., & Lecathelinais, C. (2009). Brief assessment of adult cancer patients' perceived needs: Development and validation of the 34-item Supportive Care Needs Survey (SCNS-SF34). <i>Journal of Evaluation in Clinical Practice, 15</i>, 602-606. doi:10.1111/j.1365-2753.2008.01057.x

Cherny, N. I., Catane, R., Kosmidis, P., & ESMO Taskforce on Supportive and Palliative Care. (2003). ESMO takes a stand on supportive and palliative care. <i>Annals of Oncology, 14</i>, 1335-1337.

Chung, S. K., & Long, C. F. (1984). A study of the revised State-Trait Anxiety Inventory. <i>Psychological Testing, 31</i>, 27-36.

Cohen, S., & Hoberman, H. (1983). Positive events and social supports as buffers of life change stress. <i>Journal of Applied Social Psychology, 13</i>, 99-125. doi:10.1111/j.1559-1816.1983.tb02325.x

Endacott, R. (1997). Clarifying the concept of need: A comparison of two approaches to concept analysis. <i>Journal of Advanced Nursing, 25</i>, 471-476.

Erci, B., & Karabulut, N. (2007). Appraising the self-assessed support needs of Turkish women with breast cancer. <i>European Journal of Cancer Care, 16</i>, 137-143. doi:10.1111/j.1365-2354.2006.00721.x

Fobair, P., Stewart, S. L., Chang, S., D'Onofrio, C., Banks, P. J., & Bloom, J. R. (2006). Body image and sexual problems in young women with breast cancer. <i>Psycho-Oncology, 15</i>, 579-594. doi:10.1002/pon.991

Ganz, P. A., Kwan, L., Stanton, A. L., Bower, J. E., & Belin, T. R. (2011). Physical and psychosocial recovery in the year after primary treatment of breast cancer. <i>Journal of Clinical Oncology, 29</i>, 1101-1109. doi:10.1200/JCO.2010.28.8043

Gärtner, R., Jensen, M. B., Nielsen, J., Ewertz, M., Kroman, N., & Kehlet, H. (2009). Prevalence of and factors associated with persistent pain following breast cancer surgery. <i>JAMA, 302</i>, 1985-1992. doi:10.1001/jama.2009.1568

Girgis, A., Breen, S., Stacey, F., & Lecathelinais, C. (2009). Impact of two supportive care interventions on anxiety, depression, quality of life, and unmet needs in patients with nonlocalized breast and colorectal cancers. <i>Journal of Clinical Oncology, 27</i>, 6180-6190. doi:10.1200/JCO.2009.22.8718

Hayes, S. C., Janda, M., Cornish, B., Battistutta, D., & Newman, B. (2008). Lymphedema after breast cancer: Incidence, risk factors, and effect on upper body function. <i>Journal of Clinical Oncology, 26</i>, 3536-3542. doi:10.1200/JCO.2007.14.4899

Hayes, S. C., Rye, S., Battistutta, D., & Newman, B. (2010). Prevalence of upper-body symptoms following breast cancer and its relationship with upper-body function and lymphedema. <i>Lymphology, 43</i>, 178-187.

Hwang, S. Y., & Park, B. W. (2006). The perceived care needs of breast cancer patients in Korea. <i>Yonsei Medical Journal, 47</i>, 524-533.

Kagawa-Singer, M., & Wellisch, D. K. (2003). Breast cancer patients' perceptions of their husbands' support in a cross-cultural context. <i>Psycho-Oncology, 12</i>, 24-37.

Leong, S. P., Shen, Z. Z., Liu, T. J., Agarwal, G., Tajima, T., Paik, N. S., … Foulkes, W. D. (2010). Is breast cancer the same disease in Asian and Western countries? <i>World Journal of Surgery, 34</i>, 2308-2324. doi:10.1007/s00268-010-0683-1

Lai, Y. H. (1998). Symptom distress and home care needs in patients receiving chemotherapy in an outpatient setting [In Chinese]. <i>Journal of Nursing Research, 6</i>, 274-283.

Liao, M. N., Chen, M. F., Chen, S. C., & Chen, P. L. (2007). Healthcare and support needs of women with suspected breast cancer. <i>Journal of Advanced Nursing, 60</i>, 289-298.

Liao, M. N., Chen, M. F., Chen, S. C., & Chen, P. L. (2008). Uncertainty and anxiety during the diagnostic period for women with suspected breast cancer. <i>Cancer Nursing, 31</i>, 274-283. doi:10.1097/01.NCC.0000305744.64452.fe

Liao, M. N., & Chen, P. L. (2006). Women's experience during the diagnostic periods of breast cancer [In Chinese]. <i>Journal of Oncology, 6</i>, 19-29.

Liao, M. N., Chen, P. L., Chen, M. F., & Chen, S. C. (2010). Effect of supportive care on the anxiety of women with suspected breast cancer. <i>Journal of Advanced Nursing, 66</i>, 49-59.

Liao, M. N., Chen, P. L., Chen, M. F., Chen, S. C., & Chen, Y. H. (2009). Supportive care for Taiwanese women with suspected breast cancer during the diagnostic period: Effect on healthcare and support needs. <i>Oncology Nursing Forum, 36</i>, 585-592. doi:10.1188/09.ONF.585-592

Lin, SY. (2002). <i>Perceived stress, coping behaviors and social support of caregivers of the ventilator dependents</i> (unpublished master's thesis). National Yang-Ming University, Taipei, Taiwan.

Marin, G., & Marin, B. V. (Eds.). (1991). <i>Research with Hispanic populations. Applied social research methods series</i> (vol. 23). Newbury Park, CA: Sage.

McCorkle, R., & Young, K. (1978). Development of symptom distress scale. <i>Cancer Nursing, 1</i>, 373-378.

McDowell, M. E., Occhipinti, S., Ferguson, M., Dunn, J., & Chambers, S. K. (2010). Predictors of change in unmet supportive care needs in cancer. <i>Psycho-Oncology, 19</i>, 508-516. doi:10.1002/pon.1604

McElduff, P., Boyes, A., Zucca, A., & Girgis, A. (2004). <i>The supportive care needs survey: A guide to administration, scoring and analysis.</i> Newcastle, Australia: Centre for Health Research and Psycho-Oncology.

Millar, K., Jelicic, M., Bonke, B., & Asbury, A. J. (1995). Assessment of preoperative anxiety: Comparison of measures in patients awaiting surgery for breast cancer. <i>British Journal of Anaesthesia, 74</i>, 180-183.

Minstrell, M., Winzenberg, T., Rankin, N., Hughes, C., & Walker, J. (2008). Supportive care of rural women with breast cancer in Tasmania, Australia: Changing needs over time. <i>Psycho-Oncology, 17</i>, 58-65. doi:10.1002/pon.1174

Ng, R., Verkooijen, H. M., Ooi, L. L., & Koh, W. P. (2011). Unmet psychosocial needs among cancer patients undergoing ambulatory care in Singapore. <i>Supportive Care in Cancer, 20</i>, 1049-1056.

Rosedale, M., & Fu, M. R. (2010). Confronting the unexpected: Temporal, situational, and attributive dimensions of distressing symptom experience for breast cancer survivors [Online exclusive]. <i>Oncology Nursing Forum, 37</i>, E28-E33. doi:10.1188/10.ONF.E28-E33

Smithies, M., Bettger-Hahn, M., Forchuk, C., & Brackstone, M. (2009). Telephone contact intervention in women undergoing treatment for breast cancer. <i>Canadian Oncology Nursing Journal, 19</i>, 122-128.

Spielberger, C. D., Gorssuch, R. L., Lushene, P. R., Vagg, P. R., & Jacobs, G. A. (1983). <i>Manual for the State-Trait Anxiety Inventory.</i> Palo Alto: CA: Consulting Psychologists Press.

Taiwan Cancer Registry. (2010). 2007 annual report [in Chinese]. Retrieved from <a target="_blank" href='http://crs.cph.ntu.edu.tw/main.php?page=A5#t01'>http://crs.cph.ntu.edu.t...

Tighe, M., Molassiotis, A., Morris, J., & Richardson, J. (2011). Coping, meaning and symptom experience: A narrative approach to the overwhelming impacts of breast cancer in the first year following diagnosis. <i>European Journal of Oncology Nursing, 15</i>, 226-232.

Yip, C. H. (2009). Breast cancer in Asia. <i>Methods in Molecular Biology, 471</i>, 51-64.

Zeger, S. L., & Liang, K. Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. <i>Biometrics, 42</i>, 121-130.