A longitudinal study of supportive care needs among Chinese patients awaiting colorectal cancer surgery.

Abstract

Our aim is to determine supportive care needs trajectories over the first year following colorectal cancer (CRC) surgery and identify factors differentiating these trajectories in a sample of Hong Kong Chinese CRC patients. Overall, 247/274 Chinese patients diagnosed with CRC were recruited and assessed following admission for colorectal surgery, then at 1, 4, 8, and 12 months post-surgery. Supportive care needs were assessed at each assessment point. Latent growth mixture modeling identified trajectories within each of five assessed needs domains: health system and information (HSI), psychological (PSY), physical daily living (PDL), patient care and support (PCS), and sexuality (SEX) needs. Results indicated four needs trajectories each for HSI, PSY, and PDL domains, three for the PCS and two for the SEX domains. Most patients showed stable low levels of unmet PSY (86%), PDL (86%), PCS (81%), and SEX (98%) supportive care needs. One in seven patients showed persistent high, unmet HSI needs. The coexistence of two or more unmet need domains were found among patients in the high-decline needs group. HSI trajectories were predicted by education level and positive cancer-related rumination, PSY and PCS needs; PSY trajectories were predicted by stoma and HSI needs; PDL trajectories were predicted by physical symptom distress, stoma, PCS, and HSI needs; PCS trajectories were predicted by negative cancer-related rumination, depression, HSI, and PSY needs. These Chinese CRC patients showed generally low stable supportive care needs, but a minority demonstrated high persistent unmet needs. Supportive care services should target those at risk of prolonged high unmet needs.