Skip to main content

Advertisement

Log in

What are the unmet supportive care needs of people with cancer? A systematic review

Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Goals of work

The identification and management of unmet supportive care needs is an essential component of health care for people with cancer. Information about the prevalence of unmet need can inform service planning/redesign.

Materials and methods

A systematic review of electronic databases was conducted to determine the prevalence of unmet supportive care needs at difference time points of the cancer experience.

Results

Of 94 articles or reports identified, 57 quantified the prevalence of unmet need. Prevalence of unmet need, their trends and predictors were highly variable in all domains at all time points. The most frequently reported unmet needs were those in the activities of daily living domain (1–73%), followed by psychological (12–85%), information (6–93%), psychosocial (1–89%) and physical (7–89%). Needs within the spiritual (14–51%), communication (2–57%) and sexuality (33–63%) domains were least frequently investigated. Unmet needs appear to be highest and most varied during treatment, however a greater number of individuals were likely to express unmet need post-treatment compared to any other time. Tumour-specific unmet needs were difficult to distinguish. Variations in the classification of unmet need, differences in reporting methods and the diverse samples from which patients were drawn inhibit comparisons of studies.

Conclusion

The diversity of methods used in studies hinders analysis of patterns and predictors of unmet need among people with cancer and precludes generalisation. Well-designed, context-specific, prospective studies, using validated instruments and standard methods of analysis and reporting, are needed to benefit future interventional research to identify how best to address the unmet supportive care needs of people with cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. American Cancer Society (1979) Report on the social economic and psychological needs of cancer patients in California. Greenleigh Associates, San Francisco, CA

    Google Scholar 

  2. Aranda S, Schofield P, Weih L, Yates P, Milne D, Faulkner R et al (2004) Mapping the quality of life and unmet needs of urban women with metastatic breast cancer. Eur J Cancer Care (Engl) 14:211–222

    Article  Google Scholar 

  3. Ashbury FD, Findlay H, Reynolds B, McKerracher K (1998) A Canadian survey of cancer patients’ experiences: Are their needs being met? J Pain Symptom Manage 16:298–306

    Article  PubMed  CAS  Google Scholar 

  4. Billet J, Crossing S (2003) A consumer-initiated survey of women’s experiences of breast cancer services in NSW. NSW Public Health Bull 14:117–119

    Article  Google Scholar 

  5. Borberg EW, Gustafson DH, Hawkins RP, Offord KP, Koch C, Wen K et al (2003) Assessing the unmet information, support and care delivery needs of men with prostate cancer. Patient Educ Couns 49:233–242

    Article  Google Scholar 

  6. Bonevski B, Sanson-Fisher RW, Girgis A, Burton L, Cook BA (2000) Evaluation of an instrument to assess the needs of patients with cancer. Cancer 88:217–225

    Article  PubMed  CAS  Google Scholar 

  7. Bonevski B, Sanson-Fisher RW, Hersey P, Paul C, Foot G (1999) Assessing the perceived needs of patients attending an outpatient melanoma clinic. J Psychosoc Oncol 17:101–118

    Article  Google Scholar 

  8. Bourgeois-Law G, Lotocki R (1999) Sexuality and gynaecological cancer: A needs assessment. Can J Hum Sex 8:231–240

    Google Scholar 

  9. Bullard DG, Causey GG, Newman AB, Orloff R, Schanche K, Wallace DH (1980) Sexual health care and cancer: a needs assessment. Front Radiat Ther Oncol 14:55–58

    Google Scholar 

  10. Campbell-Forsyth L (1990) Patients’ perceived knowledge and learning needs concerning radiation therapy. Cancer Nurs 13:81–89

    Article  PubMed  CAS  Google Scholar 

  11. Canadian Cancer Society (1992) Final report on the needs of people living with cancer across Canada. Canadian Cancer Society, Ontario

  12. Cawley M, Kostic J, Cappello C (1990) Informational and psychosocial needs of women choosing conservative surgery/primary radiation for early stage breast cancer. Cancer Nurs 13:90–94

    Article  PubMed  CAS  Google Scholar 

  13. Charles K, Sellick SM, Montesanto B, Mohide EA (1996) Priorities of cancer survivors regarding psychosocial needs. J Psychosoc Oncol 14:57–72

    Article  Google Scholar 

  14. Christ G, Siegel K (1990) Monitoring the quality of life needs of cancer patients. Cancer 65:760–765

    Article  PubMed  CAS  Google Scholar 

  15. Clavarino AM, Lowe JB, Carmony S, Balanda K (2002) The needs of cancer patients and their families from rural and remote areas of Queensland. Austr J Rural Health 10:188–195

    Article  Google Scholar 

  16. Dale J, Jatsch W, Hughes N, Pearce A, Meystre C (2004) Information needs and prostate cancer: the development of a systematic means of identification. BJU Int 94:63–69

    Article  PubMed  Google Scholar 

  17. Davis C, Girgis A, Williams P, Beeney L (1998) Needs assessment of rural and remote women travelling to the city for breast cancer treatment. Aust N Z J Public Health 22:525–527

    Article  PubMed  CAS  Google Scholar 

  18. Davis C, Willimans P, Parle M, Redman S, Turner J (2004) Assessing the support needs of women with early breast cancer in Australia. Cancer Nurs 27:169–174

    Article  PubMed  Google Scholar 

  19. Department of Health (2000) The NHS Cancer Plan. Department of Health, London

    Google Scholar 

  20. Duke J, Byles J, Treloar C (2001) The perceived needs of men diagnosed with prostate cancer. Australasian Epidemiologist 8:34–40

    Google Scholar 

  21. Epstein RM, Street RL Jr (2007) Patient-centred communication in cancer care: promoting healing and reducing suffering. National Cancer Institute, NIH Publication No. 07-6225, Bethesda, MD

  22. Foot G, Sanson-Fisher R (1995) Measuring the unmet needs of people living with cancer. Cancer Forum 19:131–135

    Google Scholar 

  23. Gates MF, Lackey NR, White MR (1995) Needs of hospice and clinic patients with cancer. Cancer Pract 3:226–232

    PubMed  CAS  Google Scholar 

  24. Girgis A, Boyes A, Sanson-Fisher RW, Burrows S (2000) Perceived needs of women diagnosed with breast cancer: rural versus urban location. Aust N Z J Public Health 24:166–173

    Article  PubMed  CAS  Google Scholar 

  25. Gozum S, Akcay D (2005) Response to the needs of Turkish chemotherapy patients and their families. Cancer Nurs 28:469–475

    Article  PubMed  Google Scholar 

  26. Grobe ME, Ahmann DL, Ilstrup DM (1982) Needs assessment for advanced cancer patients and their families. Oncol Nurs Forum 9:26–30

    PubMed  CAS  Google Scholar 

  27. Guadagnoli E, Mor V (1991) Daily living needs of cancer outpatients. J Community Health 16:37–47

    Article  PubMed  CAS  Google Scholar 

  28. Gustafson DH (2005) Needs assessment in cancer. In: Lipscomb J, Gotay CC, Snyder C (eds) Outcomes assessment in cancer: Measures methods and applications. Cambridge University Press, Cambridge, pp 305–328

    Google Scholar 

  29. 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, London

    Google Scholar 

  30. Hodgkinson K, Butow P, Fuchs A, Hunt GE, Stenlake A, Hobbs KM et al (2007) Long-term survival from gynecologic cancer: Psychosocial outcomes, supportive care needs and positive outcomes. Gynecol Oncol 104:381–389

    Article  PubMed  Google Scholar 

  31. Hodgkinson K, Butow P, Hunt GE, Pendlebury S, Hobbs KM, Wain G (2007) Breast cancer survivors’ supportive care 2–10 years after diagnosis. Support Care Cancer 15:515–523

    Article  PubMed  Google Scholar 

  32. Hodgkinson K, Butow P, Hunt GE, Pendlebury S, Hobbs KM, Wain G (2007) The development and evaluation of a measure to assess cancer survivors’ unmet supportive care needs: the CaSUN (Cancer Survivors Unmet Needs measure). Psychooncology 16:796–804

    Article  PubMed  CAS  Google Scholar 

  33. Houldin AD, Wasserbauer N (1996) Psychosocial needs of older cancer patients: A pilot study abstract. Medsurg Nurs 5:253–256

    PubMed  CAS  Google Scholar 

  34. Barg FK, Cronholm PF, Straton JB, Keddem S, Knott K, Grater J et al (2007) Unmet psychosocial needs of Pennsylvanians with cancer: 1986–2005. Cancer 110:631–639

    Article  PubMed  Google Scholar 

  35. Hwang AA, Chang VT, Cogswell J, Alejandro Y, Osenenko P, Morales E et al (2004) Study of unmet needs in symptomatic veterans with advanced cancer. J Pain Symptom Manage 28:421–432

    Article  PubMed  Google Scholar 

  36. Institute of Medicine (2008) Cancer care for the whole patient: meeting psychosocial concerns. The National Academic Press, Washington DC

    Google Scholar 

  37. Institute of Medicine (2001) Crossing the quality chasm: A new health system for the 21st century. National Academy Press, Washington DC

    Google Scholar 

  38. Jonker-Pool G, Hoekstra HJ, van Imhoff GW, Sonneveld DJA, DTh S, van Driel MF et al (2004) Male sexuality after cancer treatment - needs for information and support: testicular cancer compared to malignant lymphoma. Patient Educ Couns 52:143–150

    Article  PubMed  Google Scholar 

  39. Krishnasamy M, Wilkie E, Haviland J (2001) Lung cancer health care needs assessment: patients’ and informal carers’ responses to a national mail questionnaire survey. Palliat Med 15:213–227

    Article  PubMed  CAS  Google Scholar 

  40. Li J, Girgis A (2006) Supportive care needs: are patients with lung cancer a neglected population? Psychooncology 15:509–516

    Article  PubMed  Google Scholar 

  41. Lintz K, Moynihan C, Steginga A, Norman A, Eeles R, Huddart R et al (2003) Prostate cancer patients’ support and psychological care needs: Survey from a non-surgical oncology clinic. Psychooncology 12:769–783

    Article  PubMed  Google Scholar 

  42. Longman AJ, Atwood JR, Blank Sherman J, Benedict J, Shang T (1992) Care needs of home-based cancer patients and their caregivers. Cancer Nurs 15:182–190

    Article  PubMed  CAS  Google Scholar 

  43. McCaughan EM, Thompson KA (2000) Information needs of cancer patients receiving chemotherapy at a day unit in Northern Ireland. J Clin Nurs 9:851–858

    Article  Google Scholar 

  44. McElduff P, Boyes A, Zucca A, Girgis A (2004) The Supportive Care Needs Survey: a guide to administration scoring and analysis. Centre for Health Research & Psycho-oncology, Newcastle

    Google Scholar 

  45. Miller BE, Pittman B, Strong C (2003) Gynecologic cancer patients’ psychosocial needs and their views on the physician’s role in meeting those needs. Int J Gynecol Cancer 13:111–119

    Article  PubMed  CAS  Google Scholar 

  46. Moadel A, Morgan C, Fatone A, Greennan J, Carter J, Laruffa G et al (1999) Seeking meaning and hope: Self-reported spiritual and existential needs among an ethnically-diverse cancer patient population. Psychooncology 8:378–385

    Article  PubMed  CAS  Google Scholar 

  47. Mor V, Allen SM, Houts P, Siegel K (1992) The changing needs of patients with cancer at home. Cancer 69:829–838

    Article  PubMed  CAS  Google Scholar 

  48. Mor V, Allen SM, Siegel K, Houts P (1992) Determinants of needs and unmet need among cancer patients residing at home. Health Serv Res 27:337–360

    PubMed  CAS  Google Scholar 

  49. Mor V, Guadagnoli E, Wool M (1987) An examination of the concrete service needs of advanced cancer patients. J Psychosoc Oncol 5:1–17

    Article  Google Scholar 

  50. National Health Priority Action Council (NHPAC) (2006) National Service Improvement Framework for Cancer. Australian Government Department of Health and Ageing, Canberra

    Google Scholar 

  51. Newell S, Sanson-Fisher RW, Girgis A, Ackland S (1999) The physical and psychosocial experience of patients attending an outpatient medical oncology department: A cross sectional study. Eur J Cancer Care (Engl) 8:73–82

    Article  CAS  Google Scholar 

  52. O’Hare PA, Malone D, Lusk E, McCorkle R (1993) Unmet needs of black patients with cancer posthospitalization: A descriptive study. Oncol Nurs Forum 20:659–664

    PubMed  Google Scholar 

  53. Osse BHP, Vernooij-Dassen MJFJ, Schade E, Grol RPTM (2005) The problems experienced by patients with cancer and their needs for palliative care. Support Care Cancer 13:722–732

    Article  PubMed  Google Scholar 

  54. Osse BHP, Vernooij-Dassen MJFJ, Schade E, Grol RPTM (2004) Towards a new clinical tool for needs assessment in palliative care of cancer patients: The PNPC instrument. J Pain Symptom Manage 28:329–341

    Article  PubMed  Google Scholar 

  55. Richardson A, Medina J, Brown V, Sitzia J (2007) Patients’ needs assessment in cancer care: a review of assessment tools. Support Care Cancer 15:1125–1144

    Article  PubMed  Google Scholar 

  56. Sanson-Fisher R, Girgis A, Boyes A, Boneveski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Cancer 88:225–236

    Article  Google Scholar 

  57. Scahg CAC, Ganz PA, Heinrich RL (1991) CAncer Rehabilitation Evaluation System-Short Form (CARES-SF). Cancer 68:1406–1413

    Article  Google Scholar 

  58. Schag CAC, Heinrich RL (1990) Development of a comprehensive quality of life measurement tool: CARES. Oncology 4:135–138

    PubMed  CAS  Google Scholar 

  59. Siegel K, Palamara Mesagno F, Karus DG, Christ G (1992) Reducing the prevalence of unmet needs for concrete services of patients with cancer. Cancer 69:1873–1883

    Article  PubMed  CAS  Google Scholar 

  60. Siegel K, Raveis VH, Houts P, Mor V (1991) Caregiver burden and unmet patient needs. Cancer 68:1131–1140

    Article  PubMed  CAS  Google Scholar 

  61. Silveira JM, Winstead-Fry P (1997) The needs of patients with cancer and their caregivers in rural areas. Oncol Nurs Forum 24:71–76

    PubMed  CAS  Google Scholar 

  62. Soderback I, Pettersson I, von Essen L, Stein F (2000) Cancer patients’ and their physicians’ perceptions of the formers’ need for occupational therapy. Scand J Occup Ther 7:77–86

    Article  Google Scholar 

  63. Somjai A, Chaipoom A (2006) Psychosocial needs of women with cancer of the reproductive system: A comparison of Buddhist and Muslim patients in Thailand. Ment Health Relig Cult 9:379–388

    Article  Google Scholar 

  64. Soothill K, Morris SM, Harman J, Francis B, Thomas B, McIllmurray MB (2001) The significant unmet needs of cancer patients: probing psychosocial concerns. Support Care Cancer 9:597–605

    Article  PubMed  CAS  Google Scholar 

  65. Steginga SK, Occhipinti S, Dunn J, Gardiner RA, Heathcote P, Yaxley J (2001) The supportive care needs of men with prostate cancer. Psychoocology 10:66–75

    Article  CAS  Google Scholar 

  66. Sullivan T, Weinert C, Fulton RD (1993) Living with cancer: Self-identified needs of rural dwellers. Community Health 16:41–49

    Google Scholar 

  67. Sutherland G, Morland M, Hill D, Pruden M, McLachlan S (2004) The supportive care needs of newly diagnosed patients with cancer: A pilot study. The Cancer Council Victoria, Melbourne

    Google Scholar 

  68. Tamburini M, Gangeri L, Brunelli C, Beltrami E, Boeri P, Borreani C et al (2000) Assessment of hospitalised cancer patients’ needs by the Needs Evaluation Questionnaire. Ann Oncol 11:31–37

    Article  PubMed  CAS  Google Scholar 

  69. Tamburini M, Gangeri L, Brunelli C, Boeri P, Borreani C, Bosisio M et al (2003) Cancer patients’ needs during hospitalisation: a quantitative and qualitative study. BMC Cancer 3:12

    Article  PubMed  Google Scholar 

  70. Taylor K, Currow D (2003) A prospective study identified unmet activity of daily living needs among cancer patients at a comprehensive cancer care centre. Aust Occup Ther J 50:79–85

    Article  Google Scholar 

  71. Templeton H, Coates V (2003) Informational needs of men with prostate cancer on hormonal manipulation therapy. Patient Educ Couns 49:243–256

    Article  PubMed  Google Scholar 

  72. Thomas C, Morris SM, McMllmurray MB, Soothill K, Francis B, Harman JC (2001) The psychosocial needs of cancer patients and their main carers. Institute for Health Research, Lancaster University, Lancaster

    Google Scholar 

  73. Voogt E, van Leeuwen A, Visser A, van der Heide A, van der Maas P (2005) Information needs of patients with incurable cancer. Support Care Cancer 13:943–948

    Article  PubMed  Google Scholar 

  74. Wen K, Gustafason DH (2004) Needs assessments for cancer patients and their families. Health Qual Life Outcomes 2:11

    Article  PubMed  Google Scholar 

  75. Whelan TJ, Mohide EA, Willan AR, Arnold A, Tew M, Sellick S et al (1997) The supportive care needs of newly diagnosed cancer patients attending a regional cancer center. Cancer 80:1518–1524

    Article  PubMed  CAS  Google Scholar 

  76. Wool MS, Guadagnoli E, Thomas M, Mor V (1989) Negotiating concrete needs: short-term training for high-risk cancer patients. Health Soc Work 14:184–195

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James D. Harrison.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harrison, J.D., Young, J.M., Price, M.A. et al. What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17, 1117–1128 (2009). https://doi.org/10.1007/s00520-009-0615-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-009-0615-5

Keywords

Navigation