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Prevalence and Correlates of Supportive Care Needs in Oral Cancer Patients With and Without Anxiety During the Diagnostic Period

Chen, Shu-Ching PhD, RN; Yu, Wen-Pin MS, RN; Chu, Tsung-Lan MS, RN; Hung, Hsiu-Chin MS, RN; Tsai, Mei-Chu MS, RN; Liao, Chun-Ta MD

doi: 10.1097/NCC.0b013e3181d0b5ef
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Background: Many oral cancer patients experience profound anxiety and supportive care needs during the diagnostic phase.

Objective: The purposes of this study were to (1) examine and compare levels of disease impact, symptom distress, supportive care needs, and prevalence of unmet care needs in oral cancer patients with and without anxiety during the diagnostic period and (2) examine and compare the correlates of supportive care needs of patients in these 2 groups.

Methods: A total of 165 oral cancer patients from the otolaryngology inpatient wards of a medical center in northern Taiwan participated in this study: 65 with anxiety and 100 without anxiety. A cross-sectional survey was conducted using a variety of questionnaires.

Results: Patients with anxiety experienced higher levels of disease impact, intrusion, and avoidance than patients without anxiety. Both groups had moderate-to-severe levels of symptom distress and high supportive care needs, with the highest prevalence of unmet needs being in the area of health system and information, followed by psychological care. In patients with anxiety, overall supportive care needs were correlated to religious beliefs and symptom distress. In patients without anxiety, overall care needs were associated with time since diagnosis and symptom distress. Religion was most highly correlated with each need domain.

Conclusion: Assessment and screening for anxiety should be increased in head and neck cancer care outpatient settings to determine patients' mood during the diagnostic stage.

Implications for Practice: Provision of extensive information, satisfactory consultation, and spiritual encouragement are necessary to improve the quality of health care.

Author Affiliations: Department of Nursing, Chang Gung Institute of Technology (Dr Chen, Mss Yu and Chu); and Department of Nursing (Mss Yu, Chu, and Tsai) and Otolaryngology Head and Neck Surgery Wards, Department of Nursing, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Kweishan, Taoyuan, Taiwan (Ms Hung); Division of Head and Neck Surgery, Department of Otorhinolaryngology, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, College of Medicine, Chang Gung University, Taoyuan, Taiwan (Dr Liao); and Department of Head and Neck Oncology Group, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, Kweishan, Taoyuan, Taiwan (Drs Liao and Chen).

This study was supported by the National Science Council Research Program in Taiwan (grant NSC96-2314-B-255-005).

Correspondence: Tsung-Lan Chu, MS, RN, Department of Nursing, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at LinKou, 5, Fu-Shin St, Kweishan, Taoyuan, 333, Taiwan (jec75@adm.cgmh.org.tw).

Accepted for publication December 19, 2009.

© 2010 Lippincott Williams & Wilkins, Inc.