P18 High satisfaction scores but high rates of unmet need- what is missing in breast cancer survivorship care?

Abstract

Background and purpose Breast cancer survivorship care will become increasingly important as advances in treatment continue to increase survival. This study was a benchmarking project for a large metropolitan breast cancer service. Methods Participants consisted of 130 women who were >1 year since diagnosis of breast cancer, attending any Breast Service outpatient clinic. They were assessed for demographic and clinical characteristics and completed a series of self-report questionnaires examining service satisfaction, clinical benchmarks, prevalence of survivorship issues, ongoing service utilisation, and incorporating the externally validated Cancer Survivorship Unmet Needs (CaSUN) questionnaire. The questionnaire concluded with a ‘blue sky’ qualitative question asking for suggestions for future service improvement. Results 91.3% of participants were satisfied or highly satisfied with their overall breast cancer care. However, 67% of participants reporting at least one unmet need, with an average of 4.9 unmet survivorship needs per participant. The most prevalent unmet needs were fear of cancer recurrence, difficulty coping with stress, coordination of medical care, hospital parking, and information provision. Despite this, utilisation of available services such as cancer psychology, social work, and cancer care coordinators was low. ‘Blue sky’ suggestions for improvement largely related to practical assistance such as free parking and reduced clinic wait times. Conclusions Despite high satisfaction ratings, ongoing unmet survivorship needs and issues were common in this patient group, and usage of relevant multidisciplinary care was low. Improvements in survivorship care must focus on deliberately eliciting patient survivorship needs and connecting them with available services.