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      Supportive care needs of men living with prostate cancer in England: a survey

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          Abstract

          Men with prostate cancer have various treatment options depending upon their stage of disease, age and presence of comorbidity. However, these treatments typically induce side effects, which generate currently ill-defined supportive care needs. This study examined the supportive care needs of men with prostate cancer within England. A postal questionnaire survey was conducted in six acute NHS Trusts. Seven hundred and forty-one men with prostate cancer participated. They had been diagnosed 3–24 months prior to the survey and had received various treatments. Men surveyed had specific and significant unmet supportive care needs. Areas of greatest need are related to psychological distress, sexuality-related issues and management of enduring lower urinary tract symptoms. High levels of psychological distress were reported, and those reporting psychological distress reported greater unmet supportive care needs. Unmet sexuality-related need was highest in younger men following radical prostatectomy. Lower urinary tract symptoms were almost universal in the sample. Perceived quality of life varied; men unsure of their remission status reported lowest quality of life. Psychological distress impacts significantly on perceived unmet need and is currently not being assessed or managed well in men living with prostate cancer in England.

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          Most cited references 26

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          The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.

          A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.
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            The unmet supportive care needs of patients with cancer. Supportive Care Review Group.

            The aim of this study was to determine the prevalence and predictors of the perceived unmet needs of cancer patients undergoing treatment for their disease at public treatment centers. A total of 1,492 consecutive patients attending the surgical, radiation, or medical oncology departments of 9 major public cancer treatment centers in New South Wales, Australia, were asked to participate. Of the 1,370 eligible patients, 1,354 (99%) consented to participate and 888 (65%) returned completed surveys. Eligible consenting patients were given a Supportive Care Needs Survey to complete at home and return by mail within 7 days. Patients' perceived needs were assessed across the following five areas: psychologic, health system and information, physical and daily living, patient care and support, and sexuality. Patients' perceived needs were highest in the psychologic, health system and information, and physical and daily living domains. Logistic regression modeling revealed subgroups of patients with different types of needs. The significant predictors of reporting some unmet need for help varied according to the domain examined. This statewide study shows that cancer patients experience high levels of unmet needs across the range of domains examined. The study provides information that may be valuable in identifying areas where interventions could be tested and evaluated in an attempt to address the unmet needs of people living with cancer. Copyright 2000 American Cancer Society.
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              Evaluation of an instrument to assess the needs of patients with cancer. Supportive Care Review Group.

              This study aimed to assess the face, content, and construct validity and the internal reliability of a tool for assessing the generic needs of patients with cancer (the Supportive Care Needs Survey). A total of 1,492 consecutive patients attending the surgical, radiation, or medical oncology departments of 9 cancer treatment centers in New South Wales, Australia, were asked to participate. Of the 1,370 eligible patients, 1,354 (99%) consented to participate and 888 (65%) completed the survey. Eligible consenting patients were given a Supportive Care Needs Survey to complete at home and return by mail within 7 days. In the assessment of construct validity, the principal components method of factor analysis identified 5 factors with eigenvalues greater than 1, which together accounted for 64% of the total variance (patients' needs in the domains of psychologic, health system and information, physical and daily living, patient care and support, and sexuality). Face and content validity were found to be high following pilot tests and tests of reading ease. Internal reliability coefficients (Cronbach alpha) of all 5 factor-based scales were found to be substantial, ranging from 0.87 to 0.97. These findings suggest that the Supportive Care Needs Survey provides a reliable and valid index of the global needs of oncology patients. The standardized and widespread application of this instrument is recommended following further refinement and evaluation. Copyright 2000 American Cancer Society.
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                Author and article information

                Journal
                Br J Cancer
                British Journal of Cancer
                Nature Publishing Group
                0007-0920
                1532-1827
                27 May 2008
                10 June 2008
                17 June 2008
                : 98
                : 12
                : 1903-1909
                Affiliations
                [1 ]King's College London, Division of Health and Social Care Research, Florence Nightingale School of Nursing Midwifery 5th Floor, Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NN, UK
                [2 ]London Oncology Clinic 95 Harley Street, London W1G 6AF, UK
                [3 ]Division of Health and Social Care Research, Florence Nightingale School of Nursing Midwifery 5th Floor, Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NN, UK
                [4 ]European Institute of Health and Medical Sciences, University of Surrey Stagg Hill, Guildford, Surrey GU2 7TE, UK
                [5 ]The Royal Marsden Hospital NHS Foundation Trust Fulham Road, London SW3 6JJ, UK
                [6 ]Division of Health and Social Care Research, Florence Nightingale School of Nursing Midwifery 5th Floor, Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NN, UK
                [7 ]Division of Health and Social Care Research, Florence Nightingale School of Nursing Midwifery 5th Floor, Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NN, UK
                Author notes
                [* ]Author for correspondence: emma.ream@ 123456kcl.ac.uk
                Article
                6604406
                10.1038/sj.bjc.6604406
                2441950
                18506142
                Copyright 2008, Cancer Research UK
                Categories
                Clinical Studies

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