Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Setting, and Population
2.2. Data Collection
2.3. Measurement of Unmet Need
2.4. Other Measures
2.5. Statistical Analysis
3. Results
3.1. General Characteristics of Study Participants
3.2. Prevalence of Unmet Needs
4. Discussion
4.1. Correlates of Unmet Needs
4.2. Clinical Implications
4.3. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Total Study Population (n = 949) |
---|---|
Number (%) | |
Sociodemographic characteristics | |
Mean age, years * | 63.4 ± 8.8 |
<65 | 510 (53.7) |
≥65 | 439 (46.3) |
Sex | |
Male | 529 (55.7) |
Female | 420 (44.3) |
Smoking status | |
Never smoker | 464 (48.9) |
Ex- or current smoker | 485 (51.1) |
Education level | |
≥University | 353 (37.2) |
High school | 328 (34.6) |
≤Middle school | 267 (28.1) |
Unknown | 1 (0.1) |
Marital status | |
Married | 820 (86.4) |
Working status | |
Unemployed | 551 (58.1) |
Employed | 398 (41.9) |
Household monthly income | |
<USD$3000 | 335 (35.3) |
≥USD$3000 | 536 (56.5) |
Unknown | 78 (8.2) |
Disease-related characteristics | |
Comorbidity | |
No | 239 (25.2) |
Yes | 710 (74.8) |
Pathologic stage | |
0 | 12 (1.3) |
I | 697 (73.4) |
II | 140 (14.8) |
III ** | 100 (10.5) |
Time since the end of active treatment | |
<18 months | 461 (48.6) |
≥18 months | 488 (51.4) |
Psychological characteristics | |
Fear of cancer recurrence (FCR) | |
Low FCR (<13) | 419 (44.2) |
High FCR (≥13) | 530 (55.8) |
Function domain of EORTC-QoL-C30 | |
Poor Physical Function | 168 (17.7) |
Poor Role Function | 384 (40.5) |
Poor Emotional Function | 293 (30.9) |
Poor Cognitive Function | 244 (25.7) |
Poor Social Function | 332 (35.0) |
CaSUN-K’s Survey Items | Question Number | No Need | Met Need | Unmet Need, Weak | Unmet Need, Moderate | Unmet Need, Strong | Unmet Need Moderate-to-Strong |
---|---|---|---|---|---|---|---|
Number (%) | Number (%) | Number (%) | Number (%) | Number (%) | Number (%) | ||
Information | |||||||
Up-to-date information | 1 | 178 (18.8) | 135 (14.2) | 239 (25.2) | 178 (18.8) | 219 (23.1) | 397 (41.8) |
Information for others | 2 | 221 (23.3) | 108 (11.4) | 256 (27.0) | 177 (18.7) | 187(19.7) | 364 (38.4) |
Understandable information | 3 | 176 (18.5) | 98 (10.3) | 255 (26.9) | 188 (19.8) | 232 (24.4) | 420 (44.3) |
Comprehensive cancer care | |||||||
Best medical care | 4 | 238 (25.1) | 154 (16.2) | 175 (18.4) | 172 (18.1) | 210 (22.1) | 382 (40.3) |
Local healthcare services | 5 | 228 (24.0) | 124 (13.1) | 175 (18.4) | 192 (20.2) | 230 (24.2) | 422 (44.5) |
Manage health with team | 6 | 144 (15.2) | 143 (15.1) | 203 (21.4) | 193 (20.3) | 266 (28.0) | 459 (48.4) |
Communication among doctors | 7 | 145 (15.3) | 131 (13.8) | 200 (21.1) | 200 (21.1) | 273 (28.8) | 473 (49.8) |
Complaints are addressed | 8 | 236 (24.9) | 127 (13.4) | 176 (18.5) | 185 (19.5) | 225 (23.7) | 410 (43.2) |
Complimentary therapy * | 9 | 405 (42.7) | 80 (8.4) | 199 (21.0) | 134 (14.1) | 131 (13.8) | 265 (27.9) |
Accessible hospital parking | 18 | 557 (58.7) | 95 (10.0) | 95 (10.0) | 66 (7.0) | 136 (14.3) | 202 (21.3) |
Existential survivorship | |||||||
Reduce stress in my life | 10 | 274 (28.9) | 142 (15.0) | 262 (27.6) | 150 (15.8) | 121 (12.8) | 271 (28.6) |
Concerns about cancer coming back | 19 | 155 (16.3) | 71 (7.5) | 234 (24.7) | 159 (16.8) | 330 (34.8) | 489 (51.5) |
Emotional support for me | 20 | 352 (37.1) | 102 (10.7) | 218 (23.0) | 166 (17.5) | 111 (11.7) | 277 (29.2) |
New relationships | 23 | 470 (49.5) | 107 (11.3) | 184 (19.4) | 102 (10.7) | 86 (9.1) | 188 (19.8) |
Talk to others | 24 | 355 (37.4) | 110 (11.6) | 230 (24.2) | 138 (14.5) | 116 (12.2) | 254 (26.8) |
Handle social/work situations | 25 | 462 (48.7) | 100 (10.5) | 196 (20.7) | 109 (11.5) | 82 (8.6) | 191 (20.1) |
Changes to my body | 26 | 371 (39.1) | 113 (11.9) | 234 (24.7) | 142 (15.0) | 89 (9.4) | 231 (24.3) |
Ongoing case manager * | 28 | 490 (51.6) | 68 (7.2) | 167 (17.6) | 110 (11.6) | 114 (12.0) | 224 (23.6) |
Move on with my life | 29 | 424 (44.7) | 124 (13.1) | 216 (22.8) | 105 (11.1) | 80 (8.4) | 185 (19.5) |
Changes to beliefs | 30 | 422 (44.5) | 111 (11.7) | 228 (24.0) | 114 (12.0) | 74 (7.8) | 188 (19.8) |
Acknowledging the impact | 31 | 518 (54.6) | 121 (12.8) | 165 (17.4) | 85 (9.0) | 60 (6.3) | 145 (15.3) |
Survivor expectations | 32 | 415 (43.7) | 140 (14.8) | 209 (22.0) | 101 (10.6) | 84 (8.9) | 185 (19.5) |
Decisions about my life | 33 | 467 (49.2) | 110 (11.6) | 192 (20.2) | 103 (10.9) | 77 (8.1) | 180 (19.0) |
Spiritual beliefs | 34 | 546 (57.5) | 136 (14.3) | 134 (14.1) | 82 (8.6) | 51 (5.4) | 133 (14.0) |
Make my life count | 35 | 476 (50.2) | 117 (12.3) | 189 (19.9) | 96 (10.1) | 71 (7.5) | 167 (17.6) |
Quality of life | |||||||
Manage side effects | 11 | 352 (37.1) | 83 (8.7) | 201 (21.2) | 136 (14.3) | 177 (18.7) | 313 (33.0) |
Changes to quality of life | 12 | 300 (31.6) | 112 (11.8) | 235 (24.8) | 143 (15.1) | 159 (16.8) | 302 (31.8) |
Relationships | |||||||
Support partner/family | 21 | 410 (43.2) | 100 (10.5) | 203 (21.4) | 133 (14.0) | 103 (10.9) | 236 (24.9) |
Impact on my relationship | 22 | 450 (47.4) | 92 (9.7) | 188 (19.8) | 122 (12.9) | 97 (10.2) | 219 (23.1) |
Changes to partner’s life * | 13 | 900 (94.8) | 23 (2.4) | 11 (1.2) | 6 (0.6) | 9 (0.9) | 15 (1.6) |
Problems with sex life | 27 | 707 (74.5) | 66 (7.0) | 109 (11.5) | 44 (4.6) | 23 (2.4) | 67 (7.1) |
Financial issues (new dimension) | |||||||
Impact on my working life * | 14 | 729 (76.8) | 59 (6.2) | 78 (8.2) | 37 (3.9) | 46 (4.8) | 83 (8.7) |
Financial support * | 15 | 502 (52.9) | 77 (8.1) | 141 (14.9) | 104 (11.0) | 125 (13.2) | 229 (24.1) |
Life/travel insurance * | 16 | 584 (61.5) | 73 (7.7) | 139 (14.6) | 71 (7.5) | 82 (8.6) | 153 (16.1) |
Legal services * | 17 | 600 (63.2) | 53 (5.6) | 118 (12.4) | 92 (9.7) | 86 (9.1) | 178 (18.8) |
Information | Comprehensive Cancer Care | Existential Survivorship | Quality of Life | Relationship | Financial Issues | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR (95% CI) | aOR * (95% CI) | OR (95% CI) | aOR * (95% CI) | OR (95% CI) | aOR * (95% CI) | OR (95% CI) | aOR * (95% CI) | OR (95% CI) | aOR * (95% CI) | OR (95% CI) | aOR * (95% CI) | |
Sociodemographic characteristics | ||||||||||||
Age | ||||||||||||
≥65 years | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
<65 years | 1.09 (0.85, 1.41) | 1.09 (0.84, 1.40) | 1.20 (0.93, 1.56) | 1.19 (0.91, 1.55) | 1.17 (0.89, 1.55) | 1.48 (1.09, 2.02) | 1.54 (1.09, 2.18) | |||||
Sex | ||||||||||||
Female | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
Male | 0.88 (0.67, 1.13) | 1.11 (0.86, 1.43) | 1.37 (1.01, 1.85) | 0.77 (0.59, 1.00) | 0.83 (0.63, 1.07) | 1.00 (0.76, 1.32) | 0.92 (0.68, 1.25) | |||||
Marital status | ||||||||||||
Non-married | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
Married | 0.81 (0.56, 1.18) | 1.24 (0.86, 1.80) | 0.61 (0.41, 0.91) | 0.75 (0.51, 1.09) | 1.04 (0.70, 1.56) | 0.40 (0.27, 0.59) | ||||||
Education level | ||||||||||||
≥University | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
High school | 1.00 (0.74, 1.35) | 1.10 (0.82, 1.49) | 1.08 (0.80, 1.47) | 1.01 (0.74, 1.38) | 0.92 (0.67, 1.28) | 1.02 (0.71, 1.45) | ||||||
≤Middle school | 1.09 (0.79, 1.50) | 1.05 (0.77, 1.45) | 1.04 (0.75, 1.44) | 1.06 (0.76, 1.46) | 0.86 (0.61, 1.21) | 0.86 (0.59, 1.27) | ||||||
Employment status | ||||||||||||
Employed | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
Unemployed | 1.07 (0.83, 1.39) | 0.90 (0.69, 1.16) | 1.29 (0.99, 1.68) | 1.09 (0.84, 1.42) | 1.16 (0.88, 1.54) | 0.97 (0.71, 1.32) | ||||||
Household monthly income | ||||||||||||
<USD$3000 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
≥USD$3000 | 0.91 (0.69, 1.19) | 1.03 (0.78, 1.35) | 0.79 (0.60, 1.05) | 0.92 (0.70, 1.22) | 0.90 (0.67, 1.20) | 0.76 (0.55, 1.05) | ||||||
Disease-related characteristics | ||||||||||||
Comorbidity | ||||||||||||
No | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
Yes | 1.12 (0.83, 1.50) | 1.21 (0.90, 1.62) | 1.13 (0.84, 1.52) | 1.27 (0.93, 1.72) | 1.06 (0.77, 1.45) | 0.80 (0.57, 1.13) | ||||||
Pathologic stage | ||||||||||||
0–I | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
II | 1.25 (0.87, 1.79) | 1.09 (0.76, 1.56) | 1.23 (0.85, 1.79) | 1.37 (0.95, 1.97) | 1.47 (1.01, 2.14) | 1.32 (0.87, 2.01) | ||||||
III | 1.37 (0.80, 1.07) | 1.38 (0.90, 2.10) | 1.67 (1.07, 2.62) | 1.92 (1.26, 2.92) | 1.19 (0.76, 1.86) | 1.72 (1.08, 2.72) | ||||||
Lapse after active treatment | ||||||||||||
≥18 months | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
<18 months | 1.49 (1.16, 1.93) | 1.58 (1.22, 2.04) | 1.50 (1.11, 2.02) | 1.65 (1.27, 2.14) | 1.55 (1.12, 2.14) | 1.70 (1.31, 2.21) | 1.59 (1.17, 2.15) | 1.43 (1.09, 1.89) | 1.55 (1.14, 2.11) | |||
Psychological characteristics | ||||||||||||
Fear of Cancer Recurrence | ||||||||||||
Low FCR (<13) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
High FCR (≥13) | 4.64 (3.52, 6.12) | 4.13 (3.02, 5.64) | 4.29 (3.26, 5.64) | 3.87 (2.83, 5.30) | 7.05 (5.28, 9.41) | 5.99 (4.32, 8.30) | 4.97 (3.69, 6.68) | 3.90 (2.79, 5.46) | 5.44 (3.90, 7.57) | 4.39 (3.02, 6.39) | 3.89 (2.72, 5.57) | 2.77 (1.85, 4.15) |
EORTC-QoL-C30 | ||||||||||||
Poor Physical Function | 2.27 (1.60, 3.21) | 1.92 (1.36, 2.71) | 3.13 (2.10, 4.67) | 1.64 (1.01, 2.65) | 2.14 (1.53, 3.00) | 1.78 (1.26, 2.50) | 1.71 (1.18, 2.48) | |||||
Poor Role Function | 2.22 (1.71, 2.90) | 2.05 (1.57, 2.67) | 2.19 (1.66, 2.88) | 2.19 (1.68, 2.86) | 2.30 (1.74, 3.04) | 2.45 (1.80, 3.35) | 1.56 (1.09, 2.24) | |||||
Poor Emotional Function | 3.47 (2.58, 4.66) | 1.93 (1.35, 2.77) | 3.11 (2.32, 4.17) | 1.70 (1.18, 2.44) | 3.99 (2.89, 5.52) | 1.65 (1.09, 2.49) | 3.53 (2.65, 4.71) | 1.86 (1.30, 2.65) | 3.65 (2.72, 4.89) | 1.87 (1.31, 2.68) | 3.73 (2.72, 5.13) | 2.31 (1.60, 3.35) |
Poor Cognitive Function | 2.64 (1.95, 3.59) | 1.65 (1.18, 2.31) | 2.38 (1.75, 3.23) | 2.67 (1.92, 3.70) | 2.17 (1.62, 2.92) | 2.32 (1.72, 3.15) | 2.39 (1.72, 3.30) | |||||
Poor Social Function | 2.73 (2.07, 3.61) | 2.87 (2.17, 3.80) | 1.89 (1.34, 2.66) | 4.18 (3.07, 5.70) | 2.34 (1.59, 3.44) | 3.27 (2.48, 4.33) | 2.00 (1.42, 2.80) | 3.01 (2.26, 4.01) | 1.79 (1.26, 2.53) | 2.57 (1.88, 3.51) |
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Park, J.; Jung, W.; Lee, G.; Kang, D.; Shim, Y.M.; Kim, H.K.; Jeong, A.; Cho, J.; Shin, D.W. Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea. Healthcare 2023, 11, 2012. https://doi.org/10.3390/healthcare11142012
Park J, Jung W, Lee G, Kang D, Shim YM, Kim HK, Jeong A, Cho J, Shin DW. Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea. Healthcare. 2023; 11(14):2012. https://doi.org/10.3390/healthcare11142012
Chicago/Turabian StylePark, Junhee, Wonyoung Jung, Genehee Lee, Danbee Kang, Young Mog Shim, Hong Kwan Kim, Ansuk Jeong, Juhee Cho, and Dong Wook Shin. 2023. "Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea" Healthcare 11, no. 14: 2012. https://doi.org/10.3390/healthcare11142012
APA StylePark, J., Jung, W., Lee, G., Kang, D., Shim, Y. M., Kim, H. K., Jeong, A., Cho, J., & Shin, D. W. (2023). Unmet Supportive Care Needs after Non-Small Cell Lung Cancer Resection at a Tertiary Hospital in Seoul, South Korea. Healthcare, 11(14), 2012. https://doi.org/10.3390/healthcare11142012