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postgraduate thesis: Unmet supportive care needs in Hong Kong Chinese patients newly diagnosed with colorectal cancer : a longitudinal study

TitleUnmet supportive care needs in Hong Kong Chinese patients newly diagnosed with colorectal cancer : a longitudinal study
Authors
Issue Date2015
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
Sam, K. [岑檠峰]. (2015). Unmet supportive care needs in Hong Kong Chinese patients newly diagnosed with colorectal cancer : a longitudinal study. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5662750
AbstractIntroduction Patient-centered care is a recognized approach to enhance quality of oncological care. While most studies on supportive care needs among cancer patients focused on the time patients receiving or completing adjuvant treatment, little is known about the extent of unmet supportive care needs among cancer patients at the time awaiting surgery which is often a primary treatment for some cancer types such as breast, lung and colorectal cancer. There is growing attention in supportive care need of colorectal cancer patient in recent decades with the advocacy of holistic care. The influence of supportive care unmet need on physical symptom and psychological distress is being concerned as a risk factor of the distress. Meanwhile, colorectal cancer in Hong Kong are being concerned by its growing incidence. Studies often targeted on prevalence of the needs but seldom on the association between supportive care needs and physical symptom and psychological distress. Moreover, surgery is often the primary treatment for curative colorectal cancer. There is little known about the influence of supportive care need during the surgical phase. The aim of this study was to investigate the extent of pre-surgical unmet supportive care needs among Hong Kong Chinese patients with colorectal cancer. It is hypothesized in this study that pre-surgical unmet needs influence on physical symptom and psychological distress at 4-week post-surgery. Methods Quantitative study was applied to analyze data of longitudinal study in supportive care needs, physical symptom distress, and psychological distress of Chinese patient with colorectal cancer. The data was collected at Queen Mary Hospital by School of Public Health, The University of Hong Kong. 503 patients were approached and 303 patients were eligible in this study. A total of 246 colorectal cancer patients provided written consent and enrolled to the longitudinal study. Primary outcomes were supportive care needs at pre-surgery, physical symptom distress and psychological distress in terms of anxiety and depression at 4-week post-surgery. A multiple linear regression was used to analyze the influence of supportive care needs on physical symptom and psychological distress at 4-week post-surgery, adjusted with participant’s baseline distress level, demographic and clinical characteristics. Results The present study showed a moderate pre-surgical unmet supportive care needs in health service and information (HSI) need with SCNS-SF34-C mean score of 36.29 (95% CI: 33.31, 39.27), ranging from 0 to 100. The extent of supportive care needs was small on Patient care and support (PCS) (mean score 18.35, 95% CI: 16.22, 20.48), Psychological (PSY) (mean score 11.15, 95% CI: 9.34, 12.96) and Physical and daily living (PDL) (mean score 10.10, 95% CI: 8.56, 11.69) domains. Low sexuality needs (Sex) (mean score 2.10, 95% CI: 0.98, 3.22) was observed in the present study. Furthermore, there was low level of post-surgical distress observed in this study. Physical symptom distress was reported with MSAS-SF mean score 0.42 (possible range of score 0 to 4) (95% CI: 0.36, 0.48). HADS Anxiety was reported with mean score of 1.64 (possible range of score 0 to 14) (95% CI: 1.26, 2.02) and HADS depression with mean score of 2.93 (possible range of score 0 to 14) (95% CI: 2.42, 3.43). In this study, the associations between specific domains of pre-surgical supportive care unmet needs and respective 4-week post-surgical distress were found to be significant. Greater pre-surgical unmet HSI need predicted higher post-surgical physical symptom distress (β =0.004, 95% CI: 0.002, 0.007). The unmet need in PSY domain predicted increasing post-surgical anxiety (β =0.043, 95% CI: 0.015, 0.071). The unmet needs in PSY (β =0.046, 95% CI: 0.008, 0.084) and PDL domains (β =0.052, 95% CI: 0.008, 0.097) predicted increasing post-surgical depression as well. In addition, patient characteristic of having colostomy was found to be a significant factor that increased both post-surgical physical symptom and psychological distress, while chemotherapy and low household monthly income were found to significantly increase post surgical depression among Hong Kong Chinese colorectal cancer patients. Conclusion Health service and information need was the most prevalent unmet need among Hong Kong Chinese patients waiting for colorectal cancer surgery. Moreover, pre-surgical supportive care unmet needs lead to greater post-surgical physical symptom distress, anxiety and depression. Therefore, provision of supportive care, in order to satisfy patient's unmet needs, should be able to relieve post-surgical distress of cancer patients. Resource, in terms of manpower, staff training, facility enhancement, service planning, electronic platform and patient information access, should be increased or reallocated in order to relieve supportive care unmet needs of colorectal cancer patients, especially in HSI, PSY and PDL domain needs. In addition, patient characteristics of having colostomy, chemotherapy and low household monthly income significantly increased post-surgical distress. Healthcare professionals should be aware of patient with those characteristics.
DegreeMaster of Public Health
SubjectRectum - Cancer - Patients - Care
Colon (Anatomy) - Cancer - Patients - Care
Dept/ProgramPublic Health
Persistent Identifierhttp://hdl.handle.net/10722/221788

 

DC FieldValueLanguage
dc.contributor.authorSam, King-fung-
dc.contributor.author岑檠峰-
dc.date.accessioned2015-12-09T00:21:12Z-
dc.date.available2015-12-09T00:21:12Z-
dc.date.issued2015-
dc.identifier.citationSam, K. [岑檠峰]. (2015). Unmet supportive care needs in Hong Kong Chinese patients newly diagnosed with colorectal cancer : a longitudinal study. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. Retrieved from http://dx.doi.org/10.5353/th_b5662750-
dc.identifier.urihttp://hdl.handle.net/10722/221788-
dc.description.abstractIntroduction Patient-centered care is a recognized approach to enhance quality of oncological care. While most studies on supportive care needs among cancer patients focused on the time patients receiving or completing adjuvant treatment, little is known about the extent of unmet supportive care needs among cancer patients at the time awaiting surgery which is often a primary treatment for some cancer types such as breast, lung and colorectal cancer. There is growing attention in supportive care need of colorectal cancer patient in recent decades with the advocacy of holistic care. The influence of supportive care unmet need on physical symptom and psychological distress is being concerned as a risk factor of the distress. Meanwhile, colorectal cancer in Hong Kong are being concerned by its growing incidence. Studies often targeted on prevalence of the needs but seldom on the association between supportive care needs and physical symptom and psychological distress. Moreover, surgery is often the primary treatment for curative colorectal cancer. There is little known about the influence of supportive care need during the surgical phase. The aim of this study was to investigate the extent of pre-surgical unmet supportive care needs among Hong Kong Chinese patients with colorectal cancer. It is hypothesized in this study that pre-surgical unmet needs influence on physical symptom and psychological distress at 4-week post-surgery. Methods Quantitative study was applied to analyze data of longitudinal study in supportive care needs, physical symptom distress, and psychological distress of Chinese patient with colorectal cancer. The data was collected at Queen Mary Hospital by School of Public Health, The University of Hong Kong. 503 patients were approached and 303 patients were eligible in this study. A total of 246 colorectal cancer patients provided written consent and enrolled to the longitudinal study. Primary outcomes were supportive care needs at pre-surgery, physical symptom distress and psychological distress in terms of anxiety and depression at 4-week post-surgery. A multiple linear regression was used to analyze the influence of supportive care needs on physical symptom and psychological distress at 4-week post-surgery, adjusted with participant’s baseline distress level, demographic and clinical characteristics. Results The present study showed a moderate pre-surgical unmet supportive care needs in health service and information (HSI) need with SCNS-SF34-C mean score of 36.29 (95% CI: 33.31, 39.27), ranging from 0 to 100. The extent of supportive care needs was small on Patient care and support (PCS) (mean score 18.35, 95% CI: 16.22, 20.48), Psychological (PSY) (mean score 11.15, 95% CI: 9.34, 12.96) and Physical and daily living (PDL) (mean score 10.10, 95% CI: 8.56, 11.69) domains. Low sexuality needs (Sex) (mean score 2.10, 95% CI: 0.98, 3.22) was observed in the present study. Furthermore, there was low level of post-surgical distress observed in this study. Physical symptom distress was reported with MSAS-SF mean score 0.42 (possible range of score 0 to 4) (95% CI: 0.36, 0.48). HADS Anxiety was reported with mean score of 1.64 (possible range of score 0 to 14) (95% CI: 1.26, 2.02) and HADS depression with mean score of 2.93 (possible range of score 0 to 14) (95% CI: 2.42, 3.43). In this study, the associations between specific domains of pre-surgical supportive care unmet needs and respective 4-week post-surgical distress were found to be significant. Greater pre-surgical unmet HSI need predicted higher post-surgical physical symptom distress (β =0.004, 95% CI: 0.002, 0.007). The unmet need in PSY domain predicted increasing post-surgical anxiety (β =0.043, 95% CI: 0.015, 0.071). The unmet needs in PSY (β =0.046, 95% CI: 0.008, 0.084) and PDL domains (β =0.052, 95% CI: 0.008, 0.097) predicted increasing post-surgical depression as well. In addition, patient characteristic of having colostomy was found to be a significant factor that increased both post-surgical physical symptom and psychological distress, while chemotherapy and low household monthly income were found to significantly increase post surgical depression among Hong Kong Chinese colorectal cancer patients. Conclusion Health service and information need was the most prevalent unmet need among Hong Kong Chinese patients waiting for colorectal cancer surgery. Moreover, pre-surgical supportive care unmet needs lead to greater post-surgical physical symptom distress, anxiety and depression. Therefore, provision of supportive care, in order to satisfy patient's unmet needs, should be able to relieve post-surgical distress of cancer patients. Resource, in terms of manpower, staff training, facility enhancement, service planning, electronic platform and patient information access, should be increased or reallocated in order to relieve supportive care unmet needs of colorectal cancer patients, especially in HSI, PSY and PDL domain needs. In addition, patient characteristics of having colostomy, chemotherapy and low household monthly income significantly increased post-surgical distress. Healthcare professionals should be aware of patient with those characteristics.-
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.lcshRectum - Cancer - Patients - Care-
dc.subject.lcshColon (Anatomy) - Cancer - Patients - Care-
dc.titleUnmet supportive care needs in Hong Kong Chinese patients newly diagnosed with colorectal cancer : a longitudinal study-
dc.typePG_Thesis-
dc.identifier.hkulb5662750-
dc.description.thesisnameMaster of Public Health-
dc.description.thesislevelMaster-
dc.description.thesisdisciplinePublic Health-
dc.description.naturepublished_or_final_version-

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