Domains Of Need Research Articles

A scoping review of decision-making tools to support substitute decision-makers for adults with impaired capacity.

Substitute decision-makers (SDMs) make decisions that honor medical, personal, and end-of-life wishes for older adults who have lost capacity, including those with dementia. However, SDMs often lack support, information, and problem-solving tools required to make decisions and can suffer with negative emotional, relationship, and financial impacts. The need for adaptable supports has been identified in prior meta-analyses. This scoping review identifies evidence-based decision-making resources/tools for SDMs, outlines domains of support, and determines resource/tool effectiveness and/or efficacy. The scoping review used the search strategy: Population-SDMs for older adults who have lost decision-making capacity; Concept-supports, resources, tools, and interventions; Context-any context where a decision is made on behalf of an adult (>25 years). Databases included MEDLINE, Embase, CINAHL, PsycINFO, and Abstracts in Social Gerontology and SocIndex. Tools were scored by members on the research team, including patient partners, based on domains of need previously identified in prior meta-analyses. Two reviewers independently screened 5279 citations. Articles included studies that evaluated a resource/tool that helped a family/friend/caregiver SDMs outside of an ICU setting. 828 articles proceeded onto full-text screening, and 25 articles were included for data extraction. The seventeen tools identified focused on different time points/decisions in the dementia trajectory, and no single tool encompassed all the domains of caregiver decision-making needs. Existing tools may not comprehensively support caregiver needs. However, combining tools into a toolkit and considering their application relevant to the caregiver's journey may start to address the gap in current supports.

Content comparison of unmet needs self-report measures for lymphoma cancer survivors: A systematic review

Purpose The increasing recognition of the complex impacts of a cancer diagnosis and its treatment has led to efforts to develop instruments to reflect survivors’ needs accurately. However, evidence regarding the content and quality of instruments used to evaluate the unmet needs of lymphoma survivors is lacking. This review aimed to evaluate the psychometric properties and comprehensiveness of available self-report instruments to assess unmet needs and quality of life with adult lymphoma survivors. Methods A systematic search of five databases (CINAHL, EMBASE, Medline, PsycInfo and Scopus) was conducted to identify instruments measuring unmet needs or quality of life outcomes. Original articles reporting the instrument’s validation or development via citation screening were retrieved and screened against eligibility criteria. An appraisal of the instrument’s measurement properties was conducted, guided by the COSMIN methodology and reported in accordance with PRISMA guidelines. A content comparison using the Supportive Care in Cancer Framework was performed. Results Twelve instruments met the inclusion criteria; only one was explicitly developed for lymphoma (Functional Assessment of Cancer Therapy–Lymphoma). Four instruments focused on the construct of need, and eight focused on quality of life. The psychometric data in the published literature is not comprehensive; there is heterogeneity in their development, content and quality. No included instrument was examined for all COSMIN measurement properties, and methodological quality was variable; all instruments measured at least four domains of need. The emotional domain was reviewed by all instruments (n = 12), and the spiritual and informational domains received the least focus (n = 4 each). Conclusion This review provides a platform for instrument comparison, with suggestions for important factors to consider in systematically selecting unmet needs and quality of life self-report measures for adult lymphoma survivors. Considering the various discrepancies and limitations of the available instruments, using more than one instrument is recommended. In selecting measurement instruments, researchers should consider research objectives, study design, psychometric properties and the pros and cons of using more than one measure. Evaluating the participant burden and feasibility of completing the selected instrument is important for lymphoma survivors, a group burdened by cancer-related fatigue and cognitive impairment.

Supportive Care Needs (SCN) of Cancer Patients Referred to the Medical Centers in Iran.

The aim of this study was to evaluate the Supportive Care Needs s of cancer patients in Iran. This descriptive-analytical, cross-sectional study was conducted on cancer patients referred to public and private medical centers in Gorgan (Northern Iran) in 2020. Cancer patients refered to private medical ccentes were recruited into the study using the convenience sampling method. The reliable and valid "Supportive Care Needs Survey-Short Form" (SCNS-SF) with 34 items in five domains of need (physical and daily living, psychological, sexuality, patient care and support, health system, and information) was used to collect data. Out of 247 patients, 54.7% were females with a mean age of 46.15± 9.36. The most common site of involvement was breast (25.1%), and the duration of involvement was 7.51±6.79 months. The total mean of SCNs was 68.80±18.5 so that the highest (73.68±15.03) and lowest (60.42±27.19) SCNs were related to physical and daily living as well as sexual domains, respectively. The highest frequency (62.3%) of SCNs was related to "fatigue/lack of energy". This study showed that cancer patients experienced many unmet needs in various dimensions. Therefore, it is necessary to address these needs simultaneously treating the disease and developing and implementing a care plan based on patients' priorities.

Disparities in the Distribution of Social Programs for Expectant and Parenting Teens (EPTS) in Washington DC - A Review

Background: Although the teen birth rate declined to a low record in 2017 of 18.8 births per 1000 females ages 15-19, compared to other developed countries, it is still high [3,4]. Teen pregnancy can cause emotional, psychological and educational challenges, as well as affect the life and opportunities of young mothers and their children. Access to quality social services, plays an important role in supporting the health and well-being of adolescents and promoting health equity. Some teens face barriers in accessing these services. Geographically, Washington DC has eight wards, with significant disparities in socioeconomic conditions and population health. Aim: The objective of this study is to explore the distribution of community programs for Expectant and Parenting Teens in Washington DC by wards. Materials and Methods: We conducted computerized searches of PubMed, PsycINFO, Sociological Abstracts, CINAHL, and Cochrane Reviews to identify programs in Washington DC that provide services to adolescent parents, published in English from 1990 to December 2022. Search terms include: Washington DC, Ward, Teen parents, Social services, Community program. We identified and compiled locations of social service providers by wards across Washington DC, using findhelp directory (findhelp.org). Results: We identified 34 programs located in the different wards in Washington, District of Columbia. We identified 10 major interventions. These can be categorized into 10 domains of need involving (a) pregnancy and parenting support and services, (b) adoption resources, (c) housing resources for teen parents in foster care, (d) housing resources for teen parents not in foster care, (e) health care resources for young families, (f) education resources, (g) public benefits, (h) childcare resources, (i) early learning resources and (j) resources for fathers. There is a disparity in Program providers and interventions/services by wards in Washington DC.

GP assessment of unmet need in a complex multimorbid population using a data-driven and clinical triage system: a prospective cohort study.

Patients with unmet healthcare needs are more likely to access unscheduled care. Identifying these patients through data-driven and clinical risk stratification for active case management in primary care can help address patient need and reduce demand on acute services. To determine how a proactive digital healthcare system can be used to undertake comprehensive needs analysis of patients at risk of unplanned admission and mortality. Prospective cohort study of six general practices in a deprived UK city. To identify those with unmet needs, the study's population underwent digitally-driven risk stratification into Escalated and Non-escalated groups using seven risk factors. The Escalated group underwent further stratification using GP clinical assessment into Concern and No concern groups. The Concern group underwent Unmet Needs Analysis (UNA). From 24 746 patients, 516 (2.1%) were triaged into the Concern group and 164 (0.7%) underwent UNA. These patients were more likely to be older (t = 4.69, P<0.001), female (X2 = 4.46, P<0.05), have a Patients At Risk of Re-hospitalisation (PARR) score ≥80 (X2 = 4.31, P<0.05), be a nursing home resident (X2 = 6.75, P<0.01), or on an end-of-life (EOL) register (X2 = 14.55, P<0.001). Following UNA, 143 (87.2%) patients had further review planned or were referred for further input. The majority of patients had four domains of need. In those who GPs would not be surprised if they died within the next few months, n = 69 (42.1%) were not on an EOL register. This study showed how an integrated, patient-centred, digital care system working with GPs can highlight and implement resources to address the escalating care needs of complex individuals.

Gaps in Practice Management Skills After Training: A Qualitative Needs Assessment of Early Career Surgeons

Shifts in American healthcare delivery mechanisms pose significant hurdles to new physicians. Surgeons are particularly susceptible to these changes, but surgical residency educational efforts primarily focus on technical and clinical training to the exclusion of business and management practices. This study conducted a needs assessment of perceived gaps in practice management skills among early career surgeons to guide future training curricula. This study was an exploratory qualitative study following the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to identify early career (<5 years following fellowship completion) surgeons across the United States. A semi-structured interview guide was created from interviews with surgical administrators and physician administrative curricula. Transcripts were de-identified and analyzed using a constructivist grounded theory approach. Ten surgeons from 6 specialties and 6 institutions were interviewed along with 3 surgeon administrators. Three major domains of need were identified: (1) fundamentals of procedural coding, clinical billing, & compliance, (2) finding/building a practice, and (3) navigating organizational challenges. First, surgeons thought trainees would benefit from a better understanding of reimbursement schema and the basics of health policy. They also thought that more exposure to malpractice litigation, especially for handling case review or expert witness requests, would be helpful for discerning how to handle such issues early in their career. In addition, early career surgeons expressed a desire to have dedicated mentorship time, a primer on evaluating job offers with simulated contract negotiation, and guidance regarding administrative roles. Finally, surgeons requested training in change management techniques, care pathway construction, and the basics of staffing decisions. There are significant practice management gaps in surgical training which may be amenable to targeted educational efforts during a residency or fellowship program. Future research will test the generalizability of these findings as well as build curricula that adequately meet these needs.

A comparison of experiences of care and expressed emotion among caregivers of young people with first-episode psychosis or borderline personality disorder features.

Caregivers of individuals with severe mental illness often experience significant negative experiences of care, which can be associated with higher levels of expressed emotion. Expressed emotion is potentially a modifiable target early in the course of illness, which might improve outcomes for caregivers and patients. However, expressed emotion and caregiver experiences in the early stages of disorders might be moderated by the type of severe mental illness. The aim was to determine whether experiences of the caregiver role and expressed emotion differ in caregivers of young people with first-episode psychosis versus young people with 'first-presentation' borderline personality disorder features. Secondary analysis of baseline (pre-treatment) data from three clinical trials focused on improving caregiver outcomes for young people with first-episode psychosis and young people with borderline personality disorder features was conducted (ACTRN12616000968471, ACTRN12616000304437, ACTRN12618000616279). Caregivers completed self-report measures of experiences of the caregiver role and expressed emotion. Multivariate generalised linear models and moderation analyses were used to determine group differences. Data were available for 265 caregivers. Higher levels of negative experiences and expressed emotion, and stronger correlations between negative experiences and expressed emotion domains, were found in caregivers of young people with borderline personality disorder than first-episode psychosis. Caregiver group (borderline personality disorder, first-episode psychosis) moderated the relationship between expressed emotion and caregiver experiences in the domains of need to provide backup and positive personal experiences. Caregivers of young people with borderline personality disorder experience higher levels of negative experiences related to their role and expressed emotion compared with caregivers of young people with first-episode psychosis. The mechanisms underpinning associations between caregiver experiences and expressed emotion differ between these two caregiver groups, indicating that different supports are needed. For borderline personality disorder caregivers, emotional over-involvement is associated with both negative and positive experiences, so a more detailed understanding of the nature of emotional over-involvement for each relationship is required to guide action.

Young Stroke Survivors' Preferred Methods of Meeting Their Unique Needs: Shaping Better Care.

To determine how young stroke survivors want their unmet needs to be addressed, we undertook an international online survey of people living with stroke. Participants self-selected to complete an online survey that included a questionnaire on demographics and stroke-related characteristics, the Young Stroke Needs Screening Tool, and a questionnaire on how they wanted their needs to be met. One hundred seventy-one responses were received (68% female respondents, mean age 45 years, interquartile range 36-51 years). Preferences for methods of meeting needs varied depending on the domain of need and participants' demographic and stroke-related characteristics. Face-to-face contact with a health care professional was a popular means of meeting needs, but methods outside of a traditional health care setting such as a succinct list of tips or peer support were widely acceptable and sometimes preferred. This work provides the impetus for developing alternative methods of meeting young stroke survivors' needs, many of which are not resource intensive or do not require an appointment with a health care professional.

Social work involvement in the COVID-19 response in China: Interdisciplinary remote networking

Summary Social workers in China have been involved significantly in the response to the COVID-19 pandemic. This article introduces the innovative interdisciplinary remote networking framework which both provides a guide for medical and community social workers’ involvement during the COVID-19 outbreaks, and also to support interdisciplinary collaboration with the aim of helping individuals and families in need during the pandemic. Findings The implementation of interdisciplinary remote networking, developed by Chinese social workers, has effectively addressed the different domains of need experienced by the affected population and has established a new approach for social work in the field of health. The framework also provides an effective model for setting up a targeted and sustained service system that links social workers with psychological and medical resources, which capitalize on social resources to buffer the negative impacts of the disease. Social workers play an essential role during such a public health emergency, providing critical services for patients and families, medical workers, self-quarantined residents, and the general population. Applications The service mode of interdisciplinary remote networking, based on the frontline experiences of social work interventions in China, may serve as a framework for combating COVID-19 in other countries. The framework is among the initiatives that provide transferrable skills to social work practitioners working in network-based social work services during public health emergencies. Thus, the framework presents implications for future practice development in both disaster social work and also public health social work.

Prevalence and Correlates of Unmet Supportive Needs of Nigerian Patients With Cancer.

PURPOSEDiagnosis and treatment of cancer are associated with significant psychological distress, and patients face a broad range of challenges that create a vacuum of unmet needs felt by patients, such as a loss of personal control and frustration. The aim of the current study was to determine the magnitude, distribution, and correlates of unmet needs in Nigerian patients with cancer.PATIENTS AND METHODSUsing a descriptive cross-sectional approach, we assessed 205 patients with cancer who attended oncology outpatient clinics at the Lagos University Teaching Hospital. Eligible patients were administered the Supportive Care Needs Survey (SCNS) –Short Form 34 with a focus on five domains of need: psychological, health system and information, physical and daily living, patient care and support, and sexuality.RESULTSMean age was 47.4 ± 12.3 years and patients were predominantly female (96.6%). The most common diagnosis was breast cancer (92.2%), and mean duration since diagnosis was 20.9 ± 21.9 months for all patients. Mean SCNS score was 83.9 ± 24.8 and at least 46% of participants indicated unmet needs in 15 items of the SCNS. The most frequent unattended needs were related to the health information (53.4%), physical and daily living (49.4%), psychological (48.5%), sexuality, and patient care and support domains. None of the factors considered—age, sex marital status, family type, educational attainment, employment status, economic status, the presence of financial support, social support, and cancer type—was significantly predictive of unmet needs in these patients (P > .05).CONCLUSIONNigerian patients with cancer experience considerable levels of unmet needs. These needs require urgent and long-term interventions to help patients achieve increased care satisfaction and a better quality of life.

Towards person-centred care for people living with HIV: what core outcomes matter, and how might we assess them? A cross-national multi-centre qualitative study with key stakeholders.

People living with HIV (PLWH)have multidimensional concerns requiring person-centred care. Routine use of patient-reported outcome measures (PROMs) improves outcomes. No brief PROM currently reflects the breadth of concernsfor PLWH. This study sought to identify priority outcomes for PLWH, model current practice, explore views on introducing PROMs into routine care, and devise a model for person-centred care incorporating the PROM. A cross-national multi-centre study (London, Brighton and Dublin) was carried out. Semi-structured qualitative interviews with adult PLWH, HIV health care professionals and HIV commissioners (responsible for planning and commissioning services) were performed. Interviews were analysed using thematic and framework analysis. PLWH (n=28), professionals (n=21) and commissioners (n=8) described concerns related to living with HIV across six domains: physical (e.g. pain and gastrointestinal symptoms), cognitive (e.g. memory and sleep), psychological (e.g. anxiety and depression), social (e.g. isolation and intimacy), welfare (e.g. finances and fears regarding change of immigration status), and information (e.g. long-term outcomes) needs. Themes were highly inter-related, impacting across domains of need (e.g. physical and cognitive problems impacting on psychological and social wellbeing). Perceived benefits of using PROMs in routine HIV care included improved person-centredness, patient empowerment, fewer missed concerns, increased engagement with services, and informed planning of services. Potential challenges included heterogeneity of PLWH, literacy, and utility for those who struggle to engage with care. This study presents a novel model of person-centred care incorporating an HIV-specific PROM. The model reflects priorities of key stakeholders. Explicit use of PROMs in routine HIV care could afford benefits forPLWH, clinical teams and commissioners.

Enabling patients with advanced chronic obstructive pulmonary disease to identify and express their support needs to health care professionals: A qualitative study to develop a tool.

Background:Patients with advanced chronic obstructive pulmonary disease have difficulty reporting their holistic support needs to health care professionals, undermining delivery of person-centred care. We lack tools that directly support patients with this.Aim:To develop an evidence-based, designed-for-purpose, tool to enable patients to directly identify and express support needs to health care professionals.Design:Two-stage qualitative study. Stage 1: domains of support need were identified through a systematic review, analysis of an established qualitative dataset and patient/carer focus groups. Stage 2: draft tool developed using the identified domains of need and then refined through feedback from patients, carers and health care professionals, ensuring acceptability and suitability.Setting/participants:Stage 1 patients/carers recruited via four primary care practices and two patient support groups (East of England). Stage 2 health care professionals recruited via the Clinical Research Network and local community trust and patients/carers through two further practices and two additional support groups (East of England). In total, 57 patients, carers and health care professionals participated.Results:A comprehensive set of evidence-based support domains (for example: overcoming boredom or loneliness, knowing what to expect in the future) was identified and formulated into questions. The resulting tool asks patients to consider whether they need more support in 15 broad areas. Patients, carers and clinical stakeholders broadly endorsed the tool’s content and wording.Conclusion:The Support Needs Approach for Patients (SNAP) tool is a concise evidence-based tool designed to help patients with advanced chronic obstructive pulmonary disease identify and express their support needs to enable delivery of person-centred care.

Holistic needs assessment in brain cancer patients: A systematic review of available tools.

This systematic review describes tools which could be considered for use for holistic needs assessment (HNA) in brain cancer. MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO were searched. Studies were included which met the following criteria; primary research published in English which reported the development, psychometric testing or clinical utility testing of patient-reported outcome measures (PROMs) for the assessment of adult brain cancer patients' needs, problems or concerns or generic cancer needs assessment tools developed specifically on a brain cancer or brain tumour population. Nine articles describing four tools were identified. The tools were first assessed using the COSMIN protocol for systematic reviews of measurement properties and then assessed for their quality and usefulness as a holistic needs assessment tool. None of the four tools had strong psychometric properties; however, the two symptom questionnaires had better psychometric properties but would need adapted to holistically assess the multiple domains of need. The two HNA tools had only minimal psychometric testing. The lack of a tool, which adequately meets all requirements for HNA, supports the need to further development of tools to optimise this intervention.

The Unmet Supportive Care Needs of Nigerian Patients With Cancer

Background: Cancer is an important cause of morbidity and mortality globally, and its incidence has been on the increase in Nigeria, and the rest of the world. The diagnosis and treatment of cancer is associated with significant psychological distress and patients face a broad range of challenges which create a huge vacuum of “unmet needs” that patients feel as a loss of personal control and frustration. This impacts negatively on their quality of life and other care outcomes. Aim: This study was aimed at determining the magnitude, distribution, and predictors of unmet needs in Nigerian cancer patients. Methods: Using a descriptive cross-sectional approach, 205 cancer patients attending oncology outpatient clinics at Lagos University Teaching Hospital (LUTH), Idi-Araba, were assessed for unmet needs. Eligible patients were given the self-administered Supportive Care Needs Survey - Short Form (SCNS-SF34) questionnaire with focus on five domains of need - psychological, health system and information, physical and daily living, patient care and support, and sexuality. Data analysis was carried out with SPSS version 20, and the level of significance was set at &lt; 0.05. Results: The mean age of the 205 cancer patients was 47.4 ± 12.3 years, who are predominantly females (96.6%). The most common diagnosis was breast cancer (92.2%), and the mean duration since diagnosis was 20.9 ± 21.9 months for all the patients. The mean SCNS score was 83.9 ± 24.8, and at least 46% of the participants indicated unmet needs in 15 items of the SCNS. The most frequent unmet needs were related to the health information (53.4%), physical and daily living (49.4%), and psychological (48.5%) need domains. The most frequently met needs were in the sexuality, and patient care and support need domains. None of the factors considered (age, gender, marital status, family type, educational attainment, employment status, economic status, presence of financial support, social support, and cancer type) were significantly predictive of unmet needs in these patients ( P &gt; 0.05). Conclusion: Nigerian cancer patients experience high levels of unmet needs, particularly in the areas of health information, physical and daily living, and psychological health. Hence, there is an urgent need to provide sustainable and long-term interventions and support for these patients to help them achieve increased care satisfaction, improved treatment outcomes, and a better quality of life.

The supportive care needs of individuals recovering from first episode psychosis: A scoping review.

First episode psychosis (FEP) can be a traumatic experience that may alter an individual's ability to meet their own needs. The Supportive Care Needs Framework (SCNF) could complement the recovery-oriented, person-centred approach that is the current foundation of mental health care. To identify the supportive care needs (SCNs) of individuals recovering from a FEP. A scoping review of the literature was undertaken. Review questions were developed, and relevant studies were identified through database and hand searches of peer-reviewed journal articles. Data from selected articles were tabulated, and contextual meaning was given to the data through a process of collating, summarizing, and reporting. A total of 14 peer-reviewed journal articles met inclusion criteria. SCNs were identified at different stages of recovery, ranging from initial treatment to 7 years postdiagnosis. Emotional, informational, practical, psychological, and social needs were identified in over half of the included articles, while needs in the physical and spiritual domains were identified in less than five. Unmet needs in each of the seven domains of need of the SCNF were identified in this population. There are a number of gaps in the literature relating to the specific needs of this population and the timing for which individuals may require more supportive care in their recovery journey.

Holistic Needs Assessment in Brain Cancer Patients: A Systematic Review of Available Tools

This systematic review describes tools which could be considered for use for holistic needs assessment (HNA) in brain cancer. MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO were searched. Studies were included which met the following criteria; primary research published in English which reported the development, psychometric testing or clinical utility testing of patient-reported outcome measures (PROMs) for the assessment of adult brain cancer patients' needs, problems or concerns or generic cancer needs assessment tools developed specifically on a brain cancer or brain tumour population. Nine articles describing four tools were identified. The tools were first assessed using the COSMIN protocol for systematic reviews of measurement properties and then assessed for their quality and usefulness as a holistic needs assessment tool. None of the four tools had strong psychometric properties; however, the two symptom questionnaires had better psychometric properties but would need adapted to holistically assess the multiple domains of need. The two HNA tools had only minimal psychometric testing. The lack of a tool, which adequately meets all requirements for HNA, supports the need to further development of tools to optimise this intervention.

Supportive care needs and psychological distress and/or quality of life in ambulatory advanced colorectal cancer patients receiving chemotherapy: a cross-sectional study.

Although currently many advanced colorectal cancer patients continuously receive chemotherapy, there are very few findings with regard to the supportive care needs of such patients. The purposes of this study were to investigate the patients' perceived needs and the association with psychological distress and/or quality of life, and to clarify the characteristics of patients with a high degree of unmet needs. Ambulatory colorectal cancer patients who were receiving chemotherapy were asked to complete the Short-Form Supportive Care Needs Survey questionnaire, which covers five domains of need (health system and information, psychological, physical, care and support, and sexuality needs), the Hospital Anxiety and Depression Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Complete data were available for 100 patients. Almost all of the top 10 most common unmet needs belonged to the psychological domain. The patients' total needs were significantly associated with both psychological distress (r = 0.65, P < 0.001) and quality of life (r = -0.38, P < 0.001). A multiple regression analysis revealed that the female gender was significantly associated with higher total needs. The moderate to strong associations that exist between patients' needs and psychological distress and/or quality of life suggest that interventions that respond to patients' needs may be one possible strategy for ameliorating psychological distress and enhancing quality of life. Female patients' needs should be evaluated more carefully.

Infertility Stress in Couples Undergoing Intrauterine Insemination and In Vitro Fertilization Treatments.

Aim:The main aim of the study was to assess the stress levels of husbands and wives undergoing intrauterine insemination (IUI) and in vitro fertilization (IVF) treatments, and also to observe whether the stress levels differed between the methods of treatments.Materials and Methods:This research focused on 120 infertile couples who underwent IUI and In Vitro Fertilization-Intra Sperm Cytoplasmic sperm Injection (IVF-ICSI) at an infertility clinic from April 2014 to November 2014. Sixty couples who underwent each method of treatment were selected using purposive sampling technique. Fertility Problem Inventory (Newton et al., 1999) was used to collect the data after obtaining their consent.Statistical Analysis:Statistical analysis was performed at descriptive (mean, standard deviation, and Kolmogorov test) and inferential (analysis of variance, ANOVA) levels.Results and Conclusion:The prevalence of global stress was very high in couples undergoing IUI and IVF treatments, as found by descriptive analysis [mean = 149.95, standard deviation (SD) = 29.76]. Considering the various subscales, stress related to the need for parenthood was found to be high (mean = 45.95, SD = 9.53). Infertility stress (global) was higher among wives when compared to their husbands (f = 9.408; P = 0.002), and the same was noted on the domains of need for parenthood (f = 10.145; P = 0.002), social concern (f = 11.107; P = 0.001), and sexual concern (f = 4.013; P = 0.046). No difference in the levels of global stress was observed when both the modes of treatments were compared (f = 0.180, P = 0.672). For couples, infertility stress showed no significant difference irrespective of whether they underwent IUI or IVF.

Anxiety in disease-free breast cancer patients might be alleviated by provision of psychological support, not of information.

This study investigates the prevalence of clinical anxiety, the possible impact of patients' anxiety on quality of life and the association between their anxiety levels and patients' perceived needs. Randomly selected disease-free patients with breast cancer who survived >2 years were invited to participate in the study. The participants were asked to complete the Hospital Anxiety and Depression Scale, the European Organization for Research and Treatment of Cancer QLQ-C 30 and the Short-form Supportive Care Needs Survey questionnaire, which covers five domains of need (health system and information, psychological, physical, care and support and sexuality needs). Complete data were available for 146 of the patients, and 14% of them suffered from clinical anxiety. Anxiety score had a statistically significant correlation with all domains of quality-of-life measures. The only perceived need that was significantly associated with anxiety was the psychological domain. Not negligible patients may suffer from clinical anxiety >2 years after their initial cancer diagnoses. Anxiety can impact on patients' quality of life, and unmet psychological needs are expected to increase anxiety levels. Management of anxiety could be one of the key components to improving the quality of life for breast cancer survivors and that reducing their unmet psychological needs may contribute to alleviating anxiety.

Difference of patient's perceived need in breast cancer patients after diagnosis.

The purpose of this study was to investigate the difference of patients' perceived needs after cancer diagnosis. Differences in quality of life and psychological distress were also examined. Ambulatory breast cancer patients who were randomly selected participated in this study. The patients were asked to complete the Short-form Supportive Care Needs Survey, which covers five domains of need (health system and information, psychological, physical, care and support and sexuality needs), the European Organization for Research and Treatment of Cancer QLQ-C 30 and the Hospital Anxiety and Depression Scale. A total of 408 patients were enrolled and distributed into four groups [Group 1 (N = 115)], within 1 year of diagnosis; Group 2 [N = 105], 1-3 years since diagnosis; Group 3 [N = 94], >3 years since diagnosis; and Group 4 [N = 94], recurrence). Significant differences were observed in total, psychological, physical and daily living, and patient care and support needs, as well as in quality of life, whereas there were no significant differences in health system and information, sexuality needs and psychological distress. In general, Groups 1 and 4 had a higher need level and lower quality of life. Patients' perceived needs and quality of life may vary according to time since cancer diagnosis and the presence of cancer recurrence. The findings suggest that different care for supporting breast cancer survivors after diagnosis should be recommended, and that the time since diagnosis and/or the presence of recurrence may be relevant indicators for providing optimal and individualized care.