Adjustment and perceived needs of cancer survivors: a qualitative exploratory study in a Portuguese island region

Abstract

Background: Cancer survivors from rural or isolated areas may experience psychosocial adjustment issues and needs following treatments. The adjustment and the perceived needs of cancer survivors in the Azores have not been investigated. Goals: To explore the adjustment to survivorship and perceived needs of cancer survivors from a Portuguese archipelago region.Methods: Cancer survivors from São Miguel Island (Azores archipelago) took part in this qualitative exploratory study. Three focus groups were carried out, which were transcribed, coded through thematic analysis, and analyzed using NVivo 12.Results: The sample comprised twenty-two cancer survivors. Five main themes emerged: 1) Current adjustment to diagnosis; 2) Barriers to current adjustment; 3) Promoters of current adjustment; 4) Post-diagnostic growth; and 5) Perceived needs and suggestions for improvement. The results revealed that the factors influencing cancer survivors´ adjustment and their perceived needs are similar to those of survivors from other rural or isolated regions. However, some differences were found, such as the perceived trauma related to the follow-up spaced-out period and the displacement to Portugal mainland to perform cancer therapy as a promoter of adjustment in survivorship. Beyond the financial and social concerns, the psychosocial support and continuity of care needs were also expressed by cancer survivors.Discussion: Assessing and monitoring survivors' needs during different stages of the disease could inform health and psychosocial care providers on how to better support cancer survivors from the Azores, preparing them for survivorship. A multidisciplinary approach which recognizes cancer survivors’ difficulties and unmet needs can promote optimal care delivery, improving their adjustment.