Determining Unmet Needs Among Breast Cancer Survivors - An Exploratory Sequential Mixed Methods Study
Emmanuel Joseph FONG1,Whye Lian CHEAH1,Hazmi HELMY1
1Department of Community Medicine and Public Health, Malaysia Sarawak University (UNIMAS), Faculty of Medicine and Health Sciences, Kota Samarahan, Sarawak-Malaysia DOI : 10.5505/tjo.2018.1918 OBJECTIVE
This study characterized the unmet supportive care needs and factors contributing to unmet needs among breast cancer survivors in Kuching, Sarawak.

It was an exploratory sequential mixed methods study.

For qualitative exploration phase, 9 respondents were interviewed including survivors, healthcare providers, and informal caregivers which revealed the need for additional category of "Practical, social, and spiritual support", and was incorporated into the 34-item Supportive Care Needs Survey (SCNSSF34). For quantitative phase, a total of 259 survivors participated. Regression analysis revealed shorter duration of survivorship and younger age were significant factors contributing to greater overall unmet needs. Other significant factors causing higher unmet needs include late stage (Stage III & IV) cancer, undergoing active treatment, being employed, Malays and Sarawak indigenous groups, higher education attainment, and age at diagnosis of less than 50. Being married was associated with higher needs in the Sexuality domain but lower needs in the Physical and daily living domain.

Socio-demographic and medical characteristics of survivors were significant factors for unmet needs. Targeted and systematic delivery of supportive care according to these factors is crucial to improve quality of life and well-being of survivors. Keywords : Breast cancer survivors; mixed methods study; unmet needs