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Lee and Kwon: Supportive Care Needs of Patients with Gynecologic Cancer
Original Article

Asian Oncol Nurs 2018;18(1):21-29.

Published online: 5 March 2018

DOI: https://doi.org/10.5388/aon.2018.18.1.21

Supportive Care Needs of Patients with Gynecologic Cancer

Hyun Jung Lee1, In Gak Kwon2

1Department of Nursing, Samsung Medical Center, Seoul, Korea

2Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Korea

∗ This article is based on a part of the first author's master's thesis from Sungkyunkwan University.

Address reprint requests to: Kwon, In Gak Graduate School of Clinical Nursing Science, Sungkyunkwan University, 81 Irwon-Ro Gangnam-gu, Seoul 06351, Korea Tel: +82-2-3410-2904 Fax: +82-2-3410-6616 E-mail: ingak.kwon@samsung.com

Received 17 Dec 20178 Feb 2018       Accepted 21 Mar 2018

Copyright © 2018 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose

The purpose of this study was to investigate the factors associated with the supportive care needs of gynecologic cancer patients, and to provide basic data for patient-centered care.

Methods

The data were collected from 153 patients with ovarian/cervix/ uterine cancer in 2016. For the data collection, the Korean version of the Supportive Care Needs Scale-gyne and electronic charts were used. T-test, one-way ANOVA, and logistic regression were used to analyze the data.

Results

The standardized scores for the supportive care needs of patients ranged from 19.45 to 35.66. The supportive care need in the psychological domain was the highest, followed by the emotional, physical, and information domains. The ten highest frequency items consisted of 5 items in information, 3 in psychological, 1 item each in the emotional and spiritual domain. Patients under 45 years old have more fear about treatment and disability, and uncertainty about their future. College graduates had higher needs for information about support groups and self-care. Patients with recurrence felt more bored and meaningless.

Conclusion

Patients with gynecologic cancer have various supportive care needs according to their characteristics. In order to fulfil their needs, a more intensive and patient-centered individualized approach based on the patient's characteristics should be introduced.

Keywords: Gynecologic Neoplasms, Needs Assessment, Quality of Life

REFERENCES

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Table 1.
Demographic and Medical Characteristics of Subjects (N =153)
Characteristics Categories n (%)
Age (year) ＜45 24 (15.7)
  45~65 115 (75.2)
  ＞65 14 (9.1)
Marital state Married 120 (78.4)
  Unmarried 9 (5.9)
  Divorced/widowed/ separated 24 (15.7)
Education level Elementary 12 (7.8)
  Middle school 15 (9.8)
  High school 72 (47.1)
  ≥ College 54 (35.3)
Religion Yes 111 (72.6)
  No 42 (27.4)
Monthly income ＜200 45 (29.4)
(10,000 won) 200~400 67 (43.8)
  ＞400 41 (26.8)
Family 0 13 (8.5)
  1~2 61 (39.9)
  ≥3 79 (51.6)
Main caregiver None 6 (3.9)
  Spouse 97 (63.4)
  Children 27 (17.7)
  Others 23 (15.0)
Length of time since ＜1 67 (43.8)
diagnosis (year) 1~＜3 36 (23.5)
  3~＜5 26 (17.0)
  ≥5 24 (15.7)
Cancer type Ovary 109 (71.3)
  Cervix 25 (16.3)
  Uterus 19 (12.4)
Stage I 25 (16.3)
  II 22 (14.4)
  III 73 (47.7)
  IV 33 (21.6)
Recurrence No 63 (41.2)
  Yes 90 (58.8)
Table 2.
Mean Standardized Scores of Supportive Care Need in Each Domain (N =153)
Domain Items M ± SD
Psychological 11 36.86 ± 10.00
Emotional 11 35.66 ± 9.58
Physical symptoms 14 34.86 ± 10.03
Informational 9 32.27 ± 7.39
Practical 8 23.20 ± 6.59
Spiritual 7 22.56 ± 7.31
Social 7 19.56 ± 6.42
Table 3.
Ten Highest Supportive Care Needs (N =153)
Rank Domain Item n* (%)
1 Informational To be informed about things you can do to help yourself get well 121 (79.0)
2 Emotional To have one member of clinic staff with whom you can talk to about all aspects of your condition, treatment, and follow-up 118 (77.1)
3 Informational To be informed about cancer that is under control or diminishing (that is, remission) 114 (74.5)
4 Informational To be informed about your test results as soon as possible 106 (69.2)
5 Informational To be adequately informed about the benefits and side effects of treatments before you choose to have them 105 (68.6)
6 Psychological Fears about the cancer returning 104 (67.9)
7 Psychological Fears about the cancer spreading 98 (64.0)
8 Spiritual Clinic staff to convey a sense of hope to you and your family 98 (64.0)
9 Informational To be given information (written, diagrams, drawings) about aspects of managing your illness and side effects at home 96 (62.7)
10 Psychological To be treated in a clinic that is pleasant as possible 95 (62.0)
*Sum of ‘Moderate’ and ‘High’
Table 4.
Comparison of Supportive Care Need for Each Domain according to Subjects’ Characteristics (N =153)
Domain Characteristic Categories n (%) Need M ± SD t or F p MC
Information Cancer type Ovary a 109 (71.3) 32.89 ± 6.50 4.48 .013 a,b＞ c
    Cervix b 25 (16.3) 33.08 ± 6.50      
    Uterus c 19 (12.4) 27.63 ± 9.46      
Physical Family 0 a 13 (8.5) 29.30 ± 6.19 3.51 .033 a,b＜ c
    1~2 b 61 (39.9) 33.88 ± 11.01      
    ≥3 c 79 (51.6) 36.54 ± 9.37      
Social Religion Yes 111 (72.6) 18.84 ± 6.24 -0.29 .023  
    No 42 (27.4) 21.47 ± 6.56      

MC= Multiple comparison.

Table 5.
Factors Affecting Moderate to High Need in Item of Each Domain
Domain Item Characteristic Categories OR (95% Cl) p
Emotional Anxiety about having any treatment Age (year) ＜45 1  
      45~65 0.55 (0.22~1.35) .195
      ＞65 0.24 (0.05~0.97) .046
  The opportunity to talk with someone Education Elementary 0.55 (0.13~2.23) .408
  who understands and has been   Middle school 3.33 (1.03~10.79) .045
  through similar experience   High school 1  
      College 2.08 (1.01~4.27) .045
  Feeling bored and/or useless Recurrence No 1  
      Yes 2.13 (1.04~4.36) .038
Information To be given information about sexual Age (year) ＜45 1  
  relationship   45~65 0.31 (0.12~0.80) .015
      ＞65 0.10 (0.01~0.96) .046
  To be given written information about Education Elementary 0.94 (0.27~3.21) .929
  important aspects of your care   Middle school 1.89 (0.58~6.08) .285
      High school 1  
      College 2.24 (1.06~4.73) .033
  To be informed about support groups Education Elementary 0.75 (0.18~3.07) .697
  in your area   Middle school 1.98 (0.64~6.16) .234
      High school 1  
      College 2.44 (1.17~5.09) .017
  To be informed about the things you Cancer type Ovary 1  
  can do to help yourself get well   Cervix 0.84 (0.28~2.53) .763
      Uterus 0.29 (0.10~0.81) .019
  To be informed about support groups Cancer type Ovary 1  
  in your area   Cervix 0.44 (0.17~1.44) .093
      Uterus 0.13 (0.02~0.60) .009
  To be given information about sexual Income ＜200 1  
  relationship (10,000 won) 200~400 1.41 (0.49~4.10) .519
      ＞400 3.37 (1.15~9.87) .027
  To be adequately informed about the Caregiver None 0.69 (0.12~4.02) .684
  benefits and side effects of treatment   Spouse 1  
      Children 0.83 (0.32~2.11) .689
      Others 0.27 (0.10~0.68) .006
Practical Concerns about getting to and from Religion Yes 1  
  the clinic   No 2.12 (1.00~4.46) .048
  More choice about which clinic you at- Education Elementary 1.16 (0.28~4.82) .832
  tend   Middle school 1.75 (0.52~5.86) .364
      High school 1  
      College 2.22 (1.02~4.85) .044
  Concerns about your Education Elementary 1.00 (0.24~4.10) 1.000
  financial situation   Middle school 2.62 (0.83~8.25) .099
      High school 1  
      College 0.30 (0.10~0.88) .029
  Concerns about paying for prescrip- Education Elementary 1.84 (0.43~7.92) .408
  tion medications   Middle school 3.69 (1.09~12.47) .035
      High school 1  
      College 0.32 (0.08~1.23) .099
  Concerns about your financial situation Income ＜200 1  
    (10,000 won) 200~400 0.47 (0.20~1.11) .080
      ＞400 0.14 (0.03~0.53) .004
  Concerns about paying for prescrip- Income ＜200 1  
  tion medications   200~400 0.37 (0.13~1.00) .051
      ＞400 0.21 (0.05~0.83) .026
  Concerns about getting to and from Length of time ＜1 1  
  the clinic since diagnosis 1≤~＜3 0.89 (0.38~2.10) .801
    (year) 3≤~＜5 0.79 (0.30~2.10) .646
      ≥5 0.25 (0.06~0.94) .041
Psychological Fears about physical disability or dete- Age ＜45 1.00  
  rioration   45~65 0.41 (0.15~1.13) .086
      65＞ 0.18 (0.04~0.77) .021
  More fully protected rights to privacy Recurrence No 1  
  when you are at the clinic   Yes 0.4 (0.18~0.85) .019
  Fears about pain Family 0 1  
      1~2 3.46 (0.96~12.53) .058
      ≥3 4.33 (1.22~15.37) .023
  To be treated in a clinic that is as Length of time ＜1 1  
  pleasant as possible since diagnosis (year) 1≤~＜33≤~＜5 1.52 (0.66~3.50)1.62 (0.63~4.16) .322.310
    (year) 3≤~＜5≥5 1.62 (0.63~4.16)3.27 (1.09~9.79) .310.034
      ≥5 3.27 (1.09~9.79) .034
  More fully protected rights to privacy Length of time ＜1 1  
  when you are at the clinic since diagnosis (year) 1≤~＜33≤~＜5 0.25 (0.08~0.81)0.61 (0.21~1.74) .021.360
    (year) 3≤~＜5 0.61 (0.21~1.74) .360
      ≥5 0.40 (0.12~1.34) .141
  More fully protected rights to privacy Marital states Married 1  
  when you are at the clinic   Unmarried 5.00 (1.24~20.05) .023
      Div/Wid/Sep 1.64 (0.61~4.42) .322
  Fears about pain Marital state Married 1  
      Unmarried 5.00 (1.24~20.05) .023
      Div/Wid/Sep 1.64 (0.61~4.42) .322
  To have access to professional coun- Cancer type Ovary 1  
  selling of you or your family need it   Cervix Uterus 1.11 (0.46~2.68)0.31 (0.10~0.93) .801.037
      Uterus 0.31 (0.10~0.93) .037
  More fully protected rights to privacy Cancer type Ovary 1  
  when you are at the clinic   Cervix 0.40 (0.16~0.97) .044
      Uterus 0.88 (0.32~2.42) .806
  Fears about pain Religion Yes 1  
      No 2.62 (1.17~5.95) .019
  Fears about pain Caregiver None Spouse 0.76 (0.29~1.99)1 .578
      Spouse Children 10.71 (0.29~1.72) .455
      Children Others 0.71 (0.29~1.72)0.37 (0.15~0.95) .455.040
      Others 0.37 (0.15~0.95) .040
Social Talking to other people about the cancer Income ＜200200~400 10.42 (0.19~0.97) .042
  cer   200~400400 0.42 (0.19~0.97)1.30 (0.55~3.05) .042.542
      ＞400 1.30 (0.55~3.05) .542
  Family and friends to be allowed with you in the clinic whenever you want Caregiver None Spouse 0.97 (0.16~5.57)1 .973
  you in the clinic whenever you want   Spouse Children 12.42 (1.01~5.77) .045
      Children Others 2.42 (1.01~5.77)1.77 (0.70~4.45) .045.220
      Others 1.77 (0.70~4.45) .220
  Concerns about fulfilling your role as a partner Recurrence No Yes 12.57 (1.11~5.94) .027
  partner   Yes 2.57 (1.11~5.94) .027
Spiritual Uncertainty about the future Age (year) ＜45 45~65 1.000.55 (0.21~1.44) .226
      45~65 65 0.55 (0.21~1.44)0.16 (0.03~0.70) .226.015
      65＞ 0.16 (0.03~0.70) .015
  Making the most of your time Recurrence No Yes 12.13 (1.04~4.36) .038
           
OR= Odds ratio; Div/Wid/Sep= Divorced/widowed/separated.
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