Unmet Need For Assistance Research Articles

Unmet needs for help among persons with AIDS.

Current trends in AIDS care in the United States, including dehospitalization and improved outpatient treatment, may place many persons with AIDS (PWAs) at increased risk for having unmet need for help with daily living demands. Using interviews with 224 PWAs, we examined the prevalence and correlates of unmet need for assistance across six functional domains: personal care, instrumental activities of daily living (e.g. home chores, using transportation), social functioning, role performance, taking care of one's health and negotiating systems. Overall, 74.1% of respondents reported having either a partially or completely unmet need for help in one or more areas of functioning. Unmet need for help was highest for instrumental activities of daily living (46.4%). Unmet need was associated with illness severity (i.e. more symptoms and hospitalizations), minority status and support network characteristics (proximity, size and type of supporters). Implications of unmet needs data for improving the clinical care of PWAs are discussed.

Gender differences in spousal caregiving and unmet need for care.

This study investigated gender differences in spousal caregiving in a sample of 353 currently married people with cancer who were undergoing outpatient treatment. Results indicate that husbands were less likely than wives to help their sick spouses with household tasks, and husbands who helped were more likely to have other helpers, whereas wives tended to be sole caregivers. Wives provided approximately twice the hours of care that husbands provided. Women undergoing treatment who experienced high levels of morbidity received more hours of help with household tasks from nonspousal sources than men with comparable levels of morbidity, thus compensating for the deficit in hours of care provided by their husbands. At lower levels of morbidity, however, compensatory help to women was not sufficient to fill the gap in care. Women were more likely than men to report unmet need for assistance with household tasks, although not with personal care.

The changing needs of patients with cancer at home. A longitudinal view

Changes in the daily living needs of 629 patients with advanced cancer were investigated (1) during and (2) 3 to 6 months after a course of outpatient chemotherapy and/or radiation treatment. The analytic sample consisted of patients completing both baseline and follow-up interviews (n = 434). At both times, the point prevalence of need and unmet need for assistance with personal care, instrumental activities, transportation, and home health tasks was calculated. In addition, the prevalence of new need and unmet need at follow-up was determined as were the rates of resolution of baseline need. The prevalence of need for assistance with personal care increased from 7% at baseline to 16% at follow-up; the dynamic of need acquisition and resolution resulted in relatively constant prevalence rates in other task areas. Acquisition of need at follow-up was associated primarily with disease and treatment-related characteristics. Approximately one third of patients reporting need for assistance during at least one interview did not have enough help. New unmet need at follow-up was associated most strongly with patients' mobility and the ability of their informal support system to provide care. The apparently rapid fluctuation in patients' experience of need and unmet need suggests the necessity for ongoing appraisal of patients' physical condition and social situation.