Variations in supportive care needs of patients after diagnosis of localised cutaneous melanoma: a 2-year follow-up study

Beesley, Vanessa L., Smithers, B. Mark, O'Rourke, Peter, Janda, Monika, Khosrotehrani, Kiarash and Green, Adèle C. (2016) Variations in supportive care needs of patients after diagnosis of localised cutaneous melanoma: a 2-year follow-up study. Supportive Care in Cancer, 1-10. doi:10.1007/s00520-016-3378-9


Author Beesley, Vanessa L.
Smithers, B. Mark
O'Rourke, Peter
Janda, Monika
Khosrotehrani, Kiarash
Green, Adèle C.
Title Variations in supportive care needs of patients after diagnosis of localised cutaneous melanoma: a 2-year follow-up study
Journal name Supportive Care in Cancer   Check publisher's open access policy
ISSN 1433-7339
0941-4355
Publication date 2016-08-25
Sub-type Article (original research)
DOI 10.1007/s00520-016-3378-9
Open Access Status Not yet assessed
Start page 1
End page 10
Total pages 10
Place of publication Heidelberg, Germany
Publisher Springer
Collection year 2017
Language eng
Formatted abstract
Purpose: We aimed to describe variations in unmet supportive care needs of patients diagnosed with localised melanoma at high risk of recurrence and factors associated with initial and persisting moderate-to-high needs.

Methods: We ascertained 386 patients diagnosed with clinical stage IB-II melanoma and administered surveys every 6 months for 2 years. The proportion experiencing at least one moderate-to-high need was assessed among salient subgroups: 306 patients with no previous melanoma and 80 with previous melanoma at enrolment, 30 who experienced disease recurrence during follow-up and 31 who developed another primary. Baseline factors associated with (a) needs at enrolment and (b) persistent needs over 2 years (or as long as disease-free) were identified by logistic regression analyses.

Results: The proportion of patients with needs substantially declined over the first 6 months (if no previous melanoma, from 48 to 22 %, p < 0.001; previous melanoma, 35 to 17 %, p = 0.007), and in those remaining disease-free, needs declined further by 24 months (to 14 and 6 % respectively). By contrast, 50 % of those experiencing recurrence, and 39 % of those who developed another primary, reported needs. Stressful life events and anxiety were associated with needs at enrolment. At least one need, mainly fear of recurrence, persisted in 22 % of disease-free participants. Persistent needs were predicted by age, depression, anxiety and other stressful life events.

Conclusions: Melanoma patients’ needs peak when first diagnosed and if disease recurs. Younger people or those experiencing additional stressful events, anxiety or depression are more likely to experience persistent needs and may benefit from tailored support.
Keyword Anxiety
Depression
Localised melanoma
Longitudinal study
Supportive care needs
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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