Dynamic Changes Of Supportive Care Needs,Quality Of Life And Their Correlation In Patients With Gynecologic Cancer

Objective:1. To investigate the level and influencing factors of supportive care needs among women with preliminary diagnosed gynecologic cancer.2 To investigate the dynamic changes of supportive care needs and quality of life in gynecological cancer patients at different diagnostic times.3. To examine the correlation between supportive care needs and quality of life at diferent aiagnostic times, to provide practiacl guidance for staff medical improving patients QOL and maximun meet their needs.Methods:1.By convenient sampling, the 100 patients with preliminary diagnosed gynecologic cancer in three hospitals in Chong’qing were investigated through a self-designed general status questionnaire, the chinese version of the Supportve Care Needs Survey(SCNS).2.Based on the current investigation,a prospective longitudinal study was conducted on 156 newly gynecologic cancer, a self-designed general status questionnaire, the chinese version of the Supportive Care Needs Survey(SCNS)and Functional Assessment of Cancer Therapy(FACT-G)were completed by these patients at three time points(newly diagnosed,3months after diagnosis and 6months after aiagnosis).3 The data was analyzed by SPSS 21.0. Statistical significance between multiple groups was performed using descriptive analysis, one-way analysis of variance(ANOVA), multiple stepwise regression analysis,Spearman correlation analysis was perfoemed for the relationship between supportive care needs and QOL.Results: 1. The level and influencing factors of supportive care needs among women with preliminary diagnosed gynecologic cancer:(1)Health System And Information, 2.34±0.38;Physical And Daily Living,2.10±0.70;Psychological,1.90±0.40;Sexuality, 1.77±0.93;Patient Supportand Care,1.68±0.41;The prevalence of unmet needs for each domain were documented,namely, Health System And Information, 53%;Physical And Daily Living,42%;Psychological,44%;Sexuality, 40%;Patient Supportand Care,37%;(2)In the gynecologic cancer Subscale, “Fears about the cancer returning”、 “To be informed about things you can do to help yourself get well”、 “Fears about the cancer spreading”、 “To be informed about cancer that is under control or diminishing(that is, remission)”.(3)The multiple stepwise regression analysis indicated five factors, age, the income, treatment stage and education which entered into the regression equation of SCNS. 2. The dynamic changes of supportive care needs,QOL and their correlation of gynecological cancer patients:(1)The score of health system and information domain、patient support and care domain、sexuality were higher at the time of diagnosis, at the time of 3months after diagnosis The score of psychological domain and the physical and daily living domain was increased significantly, health system and information domain of unmet needs got the highestscore at the time of 6months after diagnosis, the score of sexuality appearsed to rise again trend.(2) The score of QOL fluctuated in the range of 74.10±13.05 ~76.43±11.07,the higest level at T3,the lowest level at T2,through the LSD-T test, the all domains were significant different between the three time points.(3) The supportive care needs and the QOL(except the Social/Family Well-being) showed negative correlation(correlation coefficient:-0.28~-0.71), the Physical and Daily Living domain and the Psychological domain showed a big and significantly negative correlation with QOL(r=-0.38 ~-0.61, P <0.01; r=-0.39 ~-0.71, P <0.01).Conclusions:1. The highest level of need in women with preliminary diagnosed gynecologic cancer were the Health Systemand Information domain,the second highest level were the Physical And Daily Living domain.Among the 5 domainsof supportive care needs, the higest unmet needs rate were Health system and Information domain, the lowest unmet needs rate were Physical and Daily Living domain;Treatment stage, age,education and income is the influencing factors of supportive care needs.2.Supportive care needs in newly diagnosed patients varied differently at each time point.the longitudinal survey showed the Psychological domain and the Physical and Daily Living domain had a rising trend in the 3months after diagnosis,the Sexuality needs、the Health Systemand Information domain 、 the Supportive Care Needs domain decreased significantly in the 3months after diagnosis.3. Total QOL of preliminary diagnosed gynecologic cancer were worse than other cancer patients in China, the social function domain wrere maximize damaged at three time points, the patients in the first 3 months were found with poor QOL under prospective longitudinal survey,6months after aiagnosis the QOL would be significantly change better.4. the supportive care needs of preliminary diagnosed gynecologic cancer was negatively correlated with total QOL, Especially when patients with high demand dimensions in the Physical and Daily Living domain and the Psychological domain,quality of life in patients were more significant damaged.