Unmet supportive care needs of patients with breast cancer: A systematic review

Abstract

Abstract Background Growing breast cancer patients increases the demand for unmet needs. Few research has focused on any systematic research into unmet need among these groups. This aim is to clarify major elements of unmet needs and factors influencing in order to provide a basis for provision of appropriate medical services. Method A throughout search was conducted in Cochrane Library, PubMed, Embase, Web of Science, Medline from inception through December 2022. Studies investigated unmet supportive care needs of patients with breast cancer were included. Two independent researchers extracted the data, evaluated the quality of eligible studies, and performed double-checks. Methodological quality was independently appraised by two authors in accordance with JBI critical appraisal tools. Content analytic approach was applied to narrative synthesis. For quantitative studies, the meta-analysis was also performed to pool the proportions through Review Manager Software. Results Our present review identified 63 studies evidencing the unmet needs of patients with breast cancer. A total of 10534 records were retrieved and 63 studies were included finally. The overall risk of bias was low to moderate. Self-made questionnaire was the most used instrument, followed by The Short-form Supportive Care Needs Survey questionnaire (SCNS-SF34). Social support (74%), fear of cancer recurrence/ spreading (55%), daily activity (54%), sexual/intimacy (52%) and information support (50%) were the unmet needs with most proportion. Information need and psychological/emotional need were been found to appear most frequently. The most reported unmet needs among breast cancer patients were dignity (55.8%), physical/symptom (55%), and daily activity (52.7%). Meanwhile, in breast cancer survivors, peer communication (65.5%), daily activity (56.5%), medical counselling (52.2%), and fear of cancer recurrence/ spreading (52%) were frequently reported. It was found that unmet needs were significantly associated with many factors such as demographic data, treatment, disease status, quality of life, performance status and some psychological indicators. Conclusion Breast cancer patients are experiencing a large number of unmet needs in fear of cancer recurrence, daily activity, sexual/intimacy, psychology and information. Standard assessment tools that specifically to unmet needs among breast cancer patients were absent. Patients with different characteristics had various unmet support need, which emphasized the necessity to verified elaborate care plan for different patients. We identified some potential risk factors of unmet need. Data synthesis through meta-analysis to confirm the influencing factors are demanded.